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Can Exercise Be Doing My Herniated Discs More Harm Than Good?

Posted Jun 02 2009 4:34pm

San Francisco Chiroractor and Disc Herniation Doctor Comments:

If we were to pull ten random people off the streets of San Francisco and perform lumbar MRI exams on all of them, five of them would probably show some sort of disc herniation or disc bulging. Six or seven of them would most likely have some advanced degeneration, and five or six would actually have back pain. Would the people with the disc herniations have the back pain ? Not necessarily. What about the people with the disc degeneration, would they have back pain. Maybe, maybe not. Back pain is tricky because at any given time, half the population has it. Something like 80% of the population will have bad back pain at some point in their lives. And, just because someone has disc herniations or disc bulges, it does not mean they will have back pain. You see, most of the time back pain either resolves on it's own, or responds to chiropractic, physical therapy, or exercise. But, about 10-15% of the time, nothing seems to help and the symptoms will not go away. This is what we call chronic back pain. Sometimes the symptoms of chronic back pain can  be crippling. Nothing seems to work. Pain pills, exercise, physical therapy, chiropractic, massage, acupuncture, etc. Some patients end up having surgery. Now, when we examine the spines of patients with chronic back pain, usually what we see is not good. My experience has been that about 70-80% of the patients I consult with that have chronic severe back pain, have combinations of disc herniations, disc bulges, stenosis, disc degeneration, subluxations, muscle spasms, chronic inflammation, facet syndromes, and other findings. It is rare that we examine someone with chronic back pain and the spine looks normal, although it does happen sometimes. Patients with chronic back pain need to be very careful what exercises they perform. Some patients tell me they know the exercise they are doing is making them worse (usually self prescribed), but they just need to do it to maintain sanity. I understand completely and there are usually exercises we can come up with that will be safe and effective with less risk. Depending on the level of severity of your condition, we may not want you to exercise for a week or two while we try to get the inflammation and pain under control. Then, we will take you through step by step program of stretches, strengthening exercises, and core (spinal and abdominal) strengthening exercises. Some exercise you do at home. Some you do at the clinic. We monitor your progress closely and move you through the levels of intensity in a controlled manner. The exercises are done in conjunction with manual therapies and spinal decompression, depending on the individual case. One thing for sure, exercise can do you more harm than good if you you have serious chronic back pain and you do the wrong kinds of exercises. Make sure you only do what your doctor prescribes. 

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