• Low Back Muscle Spasm or a Lumbar Disc herniation?

  • Low back muscle spasm and lumbar disc herniation go hand in hand.  But how is one to tell if it is only a muscle spasm or something else? 

    Signs It Is A Lumbar Disc herniation, not merely a muscle spasm.  

    1. Sudden onset, NO mechanism of injury.

    Simple things like: rolling out of bed, picking up a pencil from the floor, putting your socks on, tying your shoes, reaching for an object, bending to wash your face or unload the dishwasher.  All these are simple things we do every day.

    2. Antalgic posture.

    You are bend forward at the waist or to the side.  Trying to straighten up causes more pain.  Antalgic posture is when your body positions you in a way to avoid pain and to protect your discs from further damage/herniation.  Imagine a disc is a balloon filled with water positioned between two vertebras.  When we are balanced the pressure is in the middle of the balloon, so it flattens out evenly.  It also maintains even space between the vertebras, which allows them to tip on one another in all directions.  In antalgic posture the disc becomes wedged and within a short period of time the muscles go into spasm to prevent it from further wedging and herniation by restricting your mobility.  I call this a natural brace. 

    3. You feel pain when laughing, coughing, or having a bowel movement, or during intercourse.   All these cause an increased pressure in the spinal canal which in turn puts pressure on the disc and can cause or aggravate disc herniation that were asymptomatic previously. 

    4. Medication does not help relief the pain.  Ibuprofen of pain medication alleviates the pain only marginally or not at all.

    5. Massage, heat or stretching makes the pain worse. All of the above increase blood flow to the area.  When there is an inflammation, which is soup of blood and inflammatory chemicals, increasing the blood flow causes more inflammation, swelling and pain.

    6. Sitting makes the pain in the back worse, standing and walking make it better. Sitting puts pressure on the front of the disc and pushes the fluid and the nucleus posterior-towards the back. Standing helps the body get to the natural lumbar curve and distributes the weight to the joints not the discs. Walking pumps fluid in and out of the discs allowing for the inflammation to disperse.

    Simple at home tests you can do to distinguish disc herniation from low back muscle spasm.

    Straight-Leg Raising test. Lie down and extend your knee with your hip bent. If it produces pain or makes your pain worse, this may indicate a herniated disc.  If your lower back pain is on one side, let’s say the right side, raising the right leg will increase the pain in the lower back.

    Straight Leg Raise Test
    Straight leg raise on the same side of the pain increases the pain

    Well-Leg Raising test.  If you have pain on the right side of the lower back, raising the left leg will increase the pain on the right lower back.  

    Bending forward test.  Bending forward at the waist increases pain in the lower back.

    Bending forward at the waist increases pain in the back

    Now that you have assessed your back pain based on the signs above and the tests what should you do?  Assume it is a disc not a simple muscle spasm.  Remember you will have muscle spasm, however that is secondary to the bigger problem, disc herniation. 

    What you should do.

    1.  Ice for 20 minutes on very hour and a half 2-3 times per day.  Do not put heat, take a hot bath, run hot shower over the back for prolonged time for the first 72 hours at least.
    2. You can apply pressure while breathing into the low back muscles.  You can use a tennis balls in a sock and lay over them in your bed, NOT on the ground.  Roll from side to side for 4-5 repetitions.  Repeat every 30-40 minutes.
    2 tennis balls in a sock

    3. Baby cobra, pelvic tilts, palliative on the stomach position.

    4. Get out of bed properly to avoid low back pain and avoid twisting when sleeping on the side.

    5. Sit properly in a neutral pelvis position. Alternate sitting to standing every 20-30 minutes.

    Disc herniation is very common.  Most people have them without knowing and are able to function and live without pain.  When aggravated however low back pain due to herniated disc is very unpleasant and can be debilitating.  If the pain causes bowel and/or bladder dysfunction or extreme weakness in the legs go to the nearest emergency room.   

    As always check with your trusted chiropractor if chiropractic adjustment can help.  As always choose chiropractic before medication and surgery and visit our website, like us on Facebook, Instagram or call us for an appointment.