How NOT to get up when you have a disc bulge!
I was working with a new back pain patient today…
And I always watch how they move around before I start doing any “formal” assessments. The reason why I do this is because most of these daily operations are unconscious, meaning the back pain sufferer isn’t aware that they are doing them.
So, anyway, as he was laying on the floor, showing me some exercises that his physical therapists (yes, “s”, meaning quite a few) have given him, (which did I mention, FAILED to give him relief), I noticed that when I asked him to stand up, he tried to perform essentially a full sit up to the seated position.
So what?
Well, in this case, this patient has had spinal surgery, and a disc fusion, which means that flexion of the spine is a big “no-no”. That and due to the fact he was in pain, his abdominal muscles were not activating very well. Getting up from a lying position in this manner should DEFINITELY be avoided.
I taught him, as I recommend to ALL back pain sufferers, to turn on their side, and push themselves up to a seated position in order to get up.
Your back will thank you a TON for this! I promise!
–Sam Visnic
Lower Back Pain in Sitting vs. Standing
Does sitting really cause back pain? In my opinion…NO!
Here are two different scenarios:
- Hurt more standing and get relief upon sitting
- Hurt more sitting and get relief upon moving around or standing
What are the possible reasons for these situations:
In number one, bad posture and muscle imbalances may be causing the pain. Particularly when there is excessive anterior pelvic tilt, such as when the psoas and/or quadriceps muscles are too tight, pain in the standing posture can be present.
Another issue that can be the cause of pain while standing, especially when there is no pain for a short time, then the pain gradually comes on, is due to ischemia. That is, lack of blood flow to muscles. This is usually due to the type of situation that I just described about anterior pelvic tilt, but there can definitely be biochemical causes of ischemia.
Either way, in this situation, you are likely to say “When I get off my feet, whether that be sitting or laying down, my pain goes away.”
In the number 2 situation, there can also be issues with ischemia, particularly if you have a desk job and sit “hunched” over a computer for 8 hours per day!
Another potential reason is that there may be a structural problem with the spine itself. When a disc bulge is present, sitting can make you feel worse than standing. Why? Because pressures on the spine are significantly higher during sitting than standing.
When I work with patients with disc bulges, I suggest that if possible, they transition their sitting work stations into standing work stations. Yes, it does suck to stand all day, but it’s FAR less painful, and can dramatically speed up the healing process.
The other thing that can cause you to have more pain in the sitting position that relieves upon standing is either spinal disc degeneration, or spinal stenosis. Both of these situations can be related, since they both involve loss of height in the spinal discs, thus increasing pressure on the nerves that exit the spine.
However, just as well, you can have no pain in the seated position, but still have one of these conditions. I have seen patients with other types of spinal derangements, who have no pain sitting, because they sit in such a way that does not increase the pressure on the area that which is dysfunctional!
Bottom line…
Neither is “bad” for you if you have back pain, but either of which CAN make you hurt more depending on what is causing your pain.
–Sam Visnic
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