Herniated Disc? Bulging Disc? Slipped Disc? What's the Difference?

If you’ve been to a doctor or done some Internet research, you have undoubtedly come across the terms “pinched nerve,” “bulging disc,” and “herniated disc” while looking for causes of spine pain. These terms are frequently used interchangeably in many articles and discussions, but what do they mean? What’s the difference? And how do you know which one is causing you pain?

All of these terms are ultimately used to describe spinal disc pathology and associated pain. Even healthcare professionals tend to not agree on a precise definition of these terms, which can be frustrating when hearing your diagnosis described differently (such as ruptured disc, torn disc, slipped disc, or disc protrusion) by various physicians.

THE DIFFERENCE EXPLAINED

The difference between a herniated and bulging disc are simple. To use a common metaphor among physicians, think of a disc like a jelly donut. The donut has a liquid center surrounded by a thicker shell. If you press down on the donut, the sides bulge out as the jelly inside presses against them – this is a bulging disc or disc protrusion. If you press down on the donut hard enough that the jelly comes out, it becomes a herniated disc, ruptured disc, or torn disc.

BUT WHAT DOES IT MEAN FOR ME?

If you’re in pain, the nuances in the definitions are likely of little interest to you. The question you’re asking is why am I in pain and how do I get better? Here’s a brief primer on how each condition causes pain:

Pinched Nerve Pain

When a disc herniates, the material leaking out from the disc rather than the disc itself causes the pain. The material inside the disc can pinch or irritate a nearby nerve causing what is called radicular pain (or nerve root pain) that may radiate to other parts of the body. Leg pain from a pinched nerve is referred to as sciatica.

Disc Pain

A degenerated disc can cause pain within the disc space itself. This type of pain is referred to as axial pain, or degenerative disc disease.

DIAGNOSING AND TREATING PAIN

All of these terms refer to radiographic findings (such as a CT or MRI scan), and while these findings are important they’re only one piece of the puzzle in diagnosing disc problems. The truth is just because a scan shows a herniated or ruptured disc doesn’t necessarily mean the disc is the cause of your back pain. The pain may be caused by a muscle strain or other soft tissue injury, in which case treating your bulging disc won’t provide any relief.

Your doctor will use the results of a CR or MRI scan combined with your medical history and symptoms to determine the cause of your pain and the best treatment course. The correct treatment plan will depend on this diagnosis.

"I was extremely pleased with the consultation & exam. The doctor was thorough and just fantastic in discussing my condition and giving me all of my options. Thank you so much!"
-Christine T.

Spring Spine Training, Part 1 – Exercising to Manage Back Pain

Spring is finally here! It’s time to get outside and enjoy the sunshine. That means playing golf, riding your bike, hiking, or getting some work done out in the yard. For some of us, however, there’s an issue that will keep you inside - back or neck pain. Being a little informed can have a big effect on your level of pain and help you manage it in the long term.

But My Back Only Hurts a Little 

Low back pain is a reality for most of us at one point or another. The pain can range from being a minor nuisance to completely debilitating. No two people are identical, however, and that certainly applies to how we experience pain. A muscle injury may send one patient to the emergency room with excruciating pain, while a patient with a herniated disc may experience only mild, intermittent discomfort.

 The goal of any treatment - conservative treatment, interventional pain management, chiropractic adjustment, or physical therapy - is to relieve back pain long enough to let you resume normal activity. The last thing you may want to do after an injury is get up and move around, but with rest and treatment, this is often the very best thing you can do for long-term spine health. The right program of exercise and stretching can make a world of difference for your back pain.

What Kinds of Exercises Can I Do? 

Most importantly, check with a doctor before beginning any home exercise or therapy program. It’s important that the exercises are performed correctly and that there’s no risk of further injury. Here are some important rules:

1. If you experience sharp pain, stop! 
2. For dull aches or stiffness, stay within reasonable boundaries for your pain tolerance. 
3. Don’t push yourself too hard. 
4. Do these exercises at least once a day and do them whenever your back feels stiff or sore

Here are some exercises that you can do throughout your day: 

Sitting Bend Overs

• Slowly bend forward from a seated position and attempt to reach the floor. Spread the knees as needed to allow for a full range of motion. Hold for 3-10 seconds or until it feels “loose.” Do the opposite—sit and arch your low back as far back as is comfortable. Repeat frequently for short hold-times—make it “fit” your time limitations/schedule! 

Sitting Hip / Back Stretch 

1. Cross your legs. 
2. Raise the knee to the opposite shoulder. 
3. Arch the lower back until you feel an increase stretch in your buttocks. 
4. Twist your trunk to the side of the raised knee. 
5. Move your knee up/down and around to “feel” for the tightest “knots” and “work” them loose. 
6. Modify by bending forward. 
7. Repeat on the opposite side. 

Sitting Trunk Rotations 

1. Slowly twist your shoulders and trunk to one side while keeping your knees straight. 
2. Reach back and pull for additional stretch, if comfortable. 
3. Hold for 3-10 seconds or until it feels “loose.” 
4. Repeat on the opposite side. 

 These are some activities that you can do every day to increase strength and mobility in your spine. Again, be sure you consult with a physician before beginning any home therapy routine. In the next article, we’ll discuss the McKenzie method and some additional home exercises to promote long-term spine health.

Mark Schlereth's Pain Free Journey

Mark Schlereth suffered from severe back pain following his NFL career. He came to SpineOne to live pain free. 

Pokémon Go can be a real pain in the neck!

You may have noticed strange new creatures roaming the streets of Denver this month. They can be spotted wandering our streets, our parks, and our malls, sometimes muttering at their phones, sometimes coordinating in groups. They are the Pokémon hunters, and they’re out in the world searching for virtual critters to snare for their collections.

Pokémon Go hit the world in July and quickly became a popular new pastime. Within the smartphone-based, augmented reality game, players capture, battle, and train these virtual creatures as if they were in the same real-world location as the players.

While the game is being praised for its health benefits – bringing folks outside who would otherwise sit at home playing – the game isn’t without some risk. The stress on your neck from staring down at your phone can be a long-term hazard. Honestly, this isn’t new, and certainly isn’t unique to Pokémon Go. The condition, known as “Text Neck,” is not only real, it also poses a real risk.

Pokémon Neck? Or Text Neck?

Text Neck is what happens when you stare down or stay hunched over an activity for too long.  This posture isn’t exactly new; people have done this for centuries with books, drawings, sewing, and many other activities. The condition is referred to as “Text Neck” because the saturation of mobile devices and our cultural addiction to them have multiplied the amount of time we spend hunched over.

Your head weighs, on average, around 10 pounds. With a healthy spine, you never have to think about that weight; your neck manages it with ease. As you bend your neck forward, the stress on your cervical spine increases exponentially. Some experts say that the stress on your cervical spine doubles with every inch your head tilts down.

That’s some alarming math, when you think about the posture you use while playing games on your phone. While you’re staring down at your smartphone trying to ‘catch ’em all,’ the stress on your cervical spine can increase to 50 pounds! Now take into account that we spend around three hours a day staring at our smartphones; it adds up to extreme stress on your neck. 

Does it Hurt?

You’ve probably been staring at your device for years and haven’t noticed any problems. That’s where this condition’s insidious nature is important to understand. Its effects are subtle but cumulative. Stretching your body’s tissue for extended periods of time causes it to become sore and inflamed. Repeated stress on the vertebrae can also lead to herniated disks, pinched nerves, and eventually improper curvature of the spine. It has also been linked to headaches, other neurological issues, depression, and heart disease. These symptoms can creep up on you slowly, but chances of a negative impact on your life increase each time you hunch over your phone.

Maybe most alarming is how often we see this behavior in kids and young adults whose spines are still developing. Time will tell what the long-term effects of the increased spine pressure will be but it can possibly result in degeneration of the spine, bone spurs, and muscle deformity.

What Can I Do?

Luckily there are some steps you can take every day to minimize the impact that your mobile devices have on your spine health. Here are some suggestions­­­­­­:

Hold your phone higher

Holding your device higher and bending your neck less can dramatically reduce the strain on your cervical spine. Holding your device in this way can also improve your situational awareness so you don’t run into anything while searching for your next catch.

Stretches

Did one get away? Did you catch one? When you get a couple of minutes during your game, stop to stretch your neck and reset your brain. Tilt your head from left to right a few times. Look over your left shoulder, and then slowly turn your head to look over your right shoulder. Roll your shoulders and neck. Anything you can do to get those stiff muscles moving will pay off.

Set it Down

We all have our obsessions. So while maybe easier said than done, it’s nonetheless important to put the phone down every once in a while. Maybe a Pokémon gets away. Maybe a text message gets missed. But the benefit to your health and wellness will be worth it in the long run.

Whether you’re a rock climber, artist, or Pokémon hunter, the lesson remains the same: have fun with your passion but take care of yourself. Even taking a few minutes out of every hour to stretch and rejuvenate yourself will be worth it. There will always be more critters to catch. Happy hunting!

Learn How to Lower Your Golf Score without Lower Back Pain

As much as we would like to think so, we here at SpineOne are not golf pros, but we do have some back pain tips that likely will also shave some strokes off your game.

It’s our belief that there are two types of golfers in this world; those whom have back pain and those whom will have back pain. However, you can still enjoy the game with less pain by following these simple tips before, during and after stepping onto the tee box.

NOTE: If you already have back pain or if any of the following exercises increase your back pain, you should stop and check with a back pain specialist before continuing.

Make sure you stretch and warm up before you play. Every type of athlete warms up before competition. Golf is no different. Here are a few simple stretches you can do before you grip it and rip it (the golf club, not your back).

Figure 1: Leg Swings

1. Leg Swings (Figure 1). Standing on one leg, swing the opposite leg forward and backward while keeping your knee straight. You can use a driver for balance. Swing the leg from side to side 15 times in each direction and then switch your legs and repeat.

Figure 2: Dynamic Lunge with Reach

 2. Dynamic Lunge with Reach (Figure 2). Lunges are a great way to activate key hip muscles, and since we are golfing, we also need to kick in the upper body musculature and abdominals. To begin, take and hold a golf club at both ends and while performing a lunge and reach overhead. Complete five repetitions for each leg.

Figure 3: Dynamic Lunge and Twist

Next, lunge forward and place the golf club behind your shoulders (Figure 3). Twist your body to the right five times and to the left five times.

3. Pivot Rotations (Figures 4a and 4b). To get the hips and thoracic spine involved in the rotation, take a golf club and hold at both ends with your feet shoulder width apart. Rotate the club to each side. Allow your hips to rotate with this motion and shift your weight to the opposite toe. Complete 20 repetitions.

Figure 4b: Pivot Rotations

Figure 4a: Pivot Rotations

Club up. There is no shame in moving up a club or two to get more distance with less effort, especially if you have back pain.  It is more embarrassing to swing too hard, pull your head up and miss the ball completely only to take an early ride back to the clubhouse with a sprained back and a new appointment with your back pain and spine specialist.

Practice good body mechanics.  Good body mechanics throughout your swing not only improve your game, but they also reduce stress on your low (lumbar) back, which decreases the risk for back injury and pain.  Many golfers try to rotate through their swing at the low back.  The low back is not designed for rotation and will become very unhappy if one repeatedly rotates at their lumbar spine.

Many golfers drop their hips down, tuck in their butt and hunch their shoulders when addressing the ball, causing shear stress across the lower back.  The opposite of this position is a hyper-arched back, which over extends the back muscles, creating un-needed stress on the low back.

The best solution for swinging the club with little or no lower back rotation is to make sure your back is in a “neutral” position (Figure 5) instead of an over-extended or flexed position while addressing the ball.  This is accomplished by moving your back between these two extremes until you find a comfortable and natural posture between the two positions. This allows for rotation at the middle (thoracic) back—alleviating stress, pain and possible injury to the lower back. 

Strengthen your core. As mentioned in a previous blog, 11 Simple Exercises That Prevent Low-Back Pain, prevention is the best prescription when it comes to confronting back pain.  When you are not golfing, you can implement a few simple exercises to strengthen your abdominal and gluteal muscles.  These will help strengthen your core, increase flexibility and assist with rotation in your swing.

If chronic back pain keeps you from doing what you love to do and you are unable to find a solution, it may be time to speak to spine care specialist.  SpineOne offers a comprehensive evaluation, diagnosis and treatment plan tailored to meet the pain management needs of each individual patient. The physicians at SpineOne practice minimally invasive procedures to get you back on your feet and enjoying your life again. SpineOne provides doctor consultations, MRIs and treatments all from the same facility for your convenience. Same-day appointments are also available upon request.

If you suffer from chronic back pain, get your life back by contacting us today!

8 Stretches That Can Help Ease the Pain of Sciatica

8 Stretches That Can Help Ease the Pain of Sciatica