Orthopaedic & Sports Massage Therapy

Recovery from Herniated Disc and Back Pain

So you want to recover from back pain caused by a hearted disc?

Think of your intervertebral discs as a jelly filled donut. The jelly on the inside would be your nucleus pulposus, which is a gelatinous substance made up primarily of water. The donut surrounding the jelly would be your annulus fibrosis, which is made up of numerous concentric rings of fibrocartilage that keep the jelly intact.

Herniated discs (Herniated Nucleus Pulposus HNPs ) occur typically in middle age individuals and may be accompanied with one side lower body symptoms and back pain. These neurological symptoms originated from irritation to the NERVE ROOTS by the nucleus pulposus (the jelly) of an intervertebral disc. Often, FLEXION or forward bending positions like sitting make the symptoms WORSE, whereas EXTENSION positions such as standing or lying down tend to alleviate or LESSEN the symptoms.

Model of a Disc Herniation

The proposed movement of the nucleus pulposus (jelly) is that flexion causes the jelly to move posteriorly (backwards), whereas extension causes the jelly to move anteriorly (forward). Callaghan+McGill (2001) found that repetitive flexion to extension motions produced a HNP. Scannell and McGill (2009) found that cyclic or continuous neutral to full flexion motions also produced an HNP. Furthermore, Fennell et al (1996) found that this posterior migration of the jelly appears to require CUMULATIVE motion. Other evidence by Scannell and McGill (2009) found that repeated extension motions have the ability to REVERSE the posterior displacement of the jelly, under the specific conditions that 70% of the disc height remains. I know very scientific….
Centralisation is when distal pain or spinal pain in response to repeated movements or sustained postures, stops. This typically occurs when there is a preference for a direction of movement (for example flexion or extension) that abolishes or decreases symptoms (McKenzie/May 2003). Often EXTENSION is seen as a directional preference for patients with a HNP. If you notice that you tend to feel better when WALKING, STANDING, or LAYING DOWN (in comparison to driving/sitting/bending forward), you would most likely benefit from repetitive EXTENSION movement. Get moving people. 

My job as an orthopaedic massage expert is to “relax” the muscles and soft tissue around the disc which is causing the pain. However, experience with this pathology often means working whole  biomechanical dynamic chains of movement so not concentrating in just the areas of back pain but often working to relax the muscles of the whole back (spinalis, iliocostalis and longissimus as the deeper structures and the trapezius, lattisimus dorsi, the rhomboids and the thoracolumbar fascia. 

If you have any queries about this and other issues of your body or pains you might be feeling then big yourself a 15 min assessment and consultation with EveryBody Health. It’s free and at least you will be better informed about your situation.
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