Exercises and bulging discs
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Regular exercise can prevent problems with the back.
Exercising helps strengthen the muscles in the back. It can reduce the risk of injuries and by strengthening the core, will also reduce back strain.
Stretching reduces risk of muscle spasm. Aerobic exercise leads to the production of endorphins which reduce pain. Improved posture is another benefit of exercise.
Exercises should only be done after consultation with an experienced and knowledgeable physical therapist.
Here are some commonly prescribed exercises. Do not do these until you have consulted with your physician or therapist.
Lie on your back on the floor. Bend one knee up towards the chest and hold with your hands for a count of five. Keep the other leg straight on the floor. Hold for five counts. Return to the starting position and repeat on the opposite side.
Lie on your back on the floor. Tighten the buttocks and stomach muscles so that the lower back flattens and the pelvis tilts upwards and towards the head. Relax. Tilt pelvis downward by arching the lower back off the floor. Relax. Repeat 5-10 times.
Lie on your back on the floor. Roll both knees to one side slowly, then to the other. Keep elbows on the floor. 10 repetitions each side. Modified crunch
Lie on your back on the floor. Hands behind the neck. Tuck your chin in while looking at the ceiling. Slowly lift your head and shoulders up about 4-6 inches from the floor and hold for 2-3 seconds. Lower shoulders (keep chin in) back to the floor. Do not pull on the neck or head! 5 reps.
Lie on your back on the floor. Place your feet flat on the floor. Slowly lift your buttocks and back off the floor. Hold for 2-3 seconds. Lower slowly. 5-10 reps.
Lie on your stomach on the floor. Prop your upper body up on the elbows, keeping hips on the floor. Start slowly since this may be uncomfortable at first. This position is typically held for five to 30 seconds per repetition, for 10 repetitions.
After you feel comfortable with this exercise, then it's time to move to a more advanced one.
From the prone position, press up on the hands while the pelvis remains in contact with the floor. This position is typically held for 1 second, repeated 10 times.
A similar exercise can be done standing by arching backward slowly with hands on hips. The prone position is preferred, though.
These “extension” exercises should be done frequently throughout the day. As the pain leaves the leg, exercises are advanced to strengthen the low back and abdominal muscles to prevent recurrences of sciatica pain caused by disc bulging. To strengthen the low back muscles:
Lie on your stomach on the floor with hands clasped behind the lower back. Raise the head and chest slightly about 2-3 inches while looking at the floor. Do not extend the neck.
In the prone position with the head and chest on the floor, slightly raise an arm and opposite leg slowly 2-3 inches from the floor, with the knee locked.
To strengthen the abdominal muscles (core):
1. Lay on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up, lifting the head and shoulders from the floor. Do not lift too high. Keep your eyes looking at the ceiling so you don't strain your neck.
2. Lay on your back. Tighten the lower stomach muscles and slowly raise a straight leg 8 to 12 inches from the floor, keeping the low back held flat against the floor. Repeat on the other side.
Aerobic conditioning is good for general body fitness. Walking is an excellent form of exercise for the low back.
The type of exercise often recommended for treating disc degeneration and bulging which is causing sciatica is a dynamic lumbar stabilization program. The purpose is to find the most comfortable position for the lumbar spine and pelvis and train the body to maintain this position during activities. One can improve the proprioception (sense of position in space) of the lumbar spine and reduce excess motion at the different spinal segments. This will reduce the amount of pain.
Always warm up before exercising!
Exercises that should be avoided if you have bulging discs include any activity that involves prolonged sitting (rowing, a standard stationary bike), excessive strain on the back (cross country skiing and cross country skiing machines), and impact loading (running). Exercises or activities that involve twisting of the trunk (golf) also should be avoided.
Obviously, any exercise that makes your back pain worse should be avoided.
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