Common pathologies due to physical trauma or poor posture, lumbar disc herniations can cause intense pain and degenerate if not treated in time. In this context, any movement that increases pressure on the affected intervertebral disc must be avoided, otherwise the pain will worsen. Lifting heavy objects, sudden flexions or extensions, twisting of the back, Dr Maurice Demol, general practitioner and sports doctor in Brussels, invites you to know the actions to avoid and those to favor to keep your back in good health.
What is a herniated disc?
Herniated disc is a fairly common condition and most often very painful. It occurs when part of an intervertebral disc protrudes into the canal where the root of a nerve coming from the spinal cord passes. This protrusion is due to a crack or rupture of the fibrous envelope of the intervertebral disc (soft part of the disc). “It can compress surrounding nerves and cause pain and numbness; sometimes even a loss of muscular strength along the path of the affected nerve, leading to possible paralysis.”, describes Dr Maurice Demol, general practitioner and sports doctor in Brussels. Generally speaking, it can be very difficult to move around or perform certain movements when you suffer from this condition.
What are the causes ?
Repetitive movements with poor back position, frequent carrying of heavy loads, poor posture, aging, the origin of herniated discs is diverse. It can thus be caused by:
- Degeneration of intervertebral discs : This wear is a natural process linked to aging. When the discs between the vertebrae wear out, it causes pressure on the nerves and tissues surrounding the disc. The discs thus lose their elasticity and their ability to absorb shock, making them more vulnerable to cracks and tears. This degeneration can be accelerated by smoking, repetitive professional movements, intense physical work, carrying excessive loads, poor diet, being overweight or a sedentary lifestyle;
- Inappropriate movements : Certain movements can damage the intervertebral discs and cause a herniated disc. Sudden movements, excessive twisting and flexion of the spine, incorrect repetitive movements (especially when lifting weights, bending or chain work) exert constant pressure on the intervertebral disc and cause its premature wear;
- Bad posture : Spending a lot of time sitting or standing in tense postures or performing activities in a reclined or hunched position weakens the back and trunk muscles and/or places additional pressure on the intervertebral discs. If the spine is not correctly aligned or stable, the risk of injury to the intervertebral disc, and therefore the appearance of a herniated disc, increases;
- Practicing certain sports : Certain sports such as football, tennis, gymnastics, golf increase the risk of herniated discs, especially those that involve repetitive spinal movements and/or high impacts and twisting. Top athletes and fitness enthusiasts therefore benefit from strengthening their back muscles to minimize the risk of injury.
What are the symptoms ?
“The symptoms of a herniated disc are usually pain in the affected area which may be accompanied by pain, numbness and/or loss of strength in one of the limbs through which the possibly compressed nerve passes”, explains the specialist. These signs vary depending on the stage of the herniated disc and its intensity. Shooting pain, extending down the leg, muscle weakness, swelling in the lower back, numbness or tingling in the lower extremities, difficulty moving, controlling movements or standing, sciatica, urinary problems ( incontinence, difficulty urinating) are thus part of the clinical picture. The pain may be constant or intermittent. Most often, it intensifies during sudden movements or when the person sits or stands for long periods of time.
What tests should be carried out to make the diagnosis?
The clinical examination by the referring doctor, as well as imaging tests (MRI or CT scan), make it possible to make the diagnosis fairly quickly.
What treatment for a herniated disc?
Treatment for herniated disc varies depending on the severity of symptoms and the type of herniation. Most often, these are non-surgical treatments. Medications to relieve pain (analgesics), treatments to relax muscles (heat, muscle relaxants), physical therapies (physiotherapy, chiropractic, acupuncture, etc.), appropriate physical exercises (gentle stretching; warm-ups for example, to strengthen the back muscles and reduce pressure on the discs), change in lifestyle, stress management, care is often global. Taking care of your body helps reduce pain and speed up healing.
A balanced diet rich in antioxidants is also recommended to strengthen the immune system and prevent relapses. In severe cases, surgery may be considered to relieve pressure on the pinched nerve and restore full mobility: this may include microdiscectomies or laminectomies.
What movements should you not do when you suffer from it?
The first thing to note is that not all movements are prohibited for people with a herniated lumbar disc. On the contrary, certain exercises can help relieve pain. However, it is essential to discuss with a health professional, to ensure that the exercises or physical activity planned will not have negative effects on the pathology.
However, here are the risky movements:
- Excessive flexion and extension of the spine;
- Twists and rotations of the trunk;
- Lifting heavy objects;
- Sudden or repetitive movements;
- Prolonged sitting or standing positions;
- High-impact sports training;
- But also: deadlifts and standing rows: squats, lunges and leg presses, classic abdominal exercises, exercises with weights, running on a treadmill, etc.
To avoid excessive pressure on your lumbar discs, there are a few tips to follow:
- Bend your knees when picking up an object, instead of just arching your back to lean forward. Go down with your back straight;
- Take care of your back when gardening or cleaning: use a stool or cushion to sit or kneel on; choose utensils with long handles or handles; break down and distribute your tasks over a longer period. Keep your back straight when sweeping or mopping;
- To put on shoes or socks, sit in a chair and bring your foot towards you by bending your knee, rather than bending your back;
- Use a stable stepladder to keep your back straight when you need to reach a tall object;
- Do not turn suddenly, especially when carrying a load, picking something up from the ground, or turning to talk to someone. Strive to rotate your entire body, not just your torso;
- Use your leg strength, bending your knees, when lifting a heavy object;
- Do not lift a heavy weight at arm’s length: hold the object against you instead, to limit tension on the spine and intervertebral discs;
- Avoid changing direction suddenly when running to catch something;
- Take regular breaks to move and stretch your back, after long periods (especially work) sitting or standing;
- Do not take long car journeys: your back will suffer. Choose the train or plane, in which you can get up and walk;
- If you have to drive, adjust your seat as upright as possible, activate the lumbar adjustment function to avoid rounding your lower back too much and take regular breaks;
- Don’t lie down for too long, even if it hurts. Alternate rest and walking. Healing comes through movement;
- Choose chairs over soft, deep sofas and armchairs. Sitting with a rounded back tends to bring out the hernia and increases the pain, especially when you get up;
- Adjust your computer screen to eye level to avoid excessive extension of the neck and spine;
- Avoid overloading your luggage: distribute the weight evenly and choose suitcases on wheels to facilitate transport;
- Do not repeat a movement if it causes repeated shocks or pain.
What sports are prohibited?
“There is no sport definitively prohibited in the event of a herniated disc, because remember that physical activity is essential, even when the pathology occursinsists Dr Maurice Demol. However, certain sports should be avoided during the painful episode and until the back has been specifically strengthened.
- Sports that involve twisting, sudden exercises or repeated impacts: running, CrossFit, heavy weight training, football, rugby, basketball, volleyball, handball, ski jumping, gymnastics, skydiving , mountain biking, trampoline, bungee jumping, aerobics…
- Combat sports: boxing, kickboxing, free fighting and others…