Question
Dear Dr. Biggs,

Thank you for all the wonderful answers you have provided on allexperts.com.  I am constantly learning from them.  I am a twenty years old female and have disc bulging in L3-4 and L4-5.  I think it might have been caused by an overly back stretch in my ballet class about one and half years ago.  The stretch went like this: I was lying on the floor facing down and my teacher curled up my upper body by pulling back on my shoulders.  I did feel pain during the days following the injury and the pain came back for a while several months ago during the summer.  Over the past four months, there were several times when I felt tingling pain in my lower back when sitting at my desk, each lasting for several seconds.  I want to ask for your suggestions about what to do to help alleviate my bulging discs.  Also, I am still doing ballet as a hobby (I don抰 stretch my back anymore) and I do vinyasa yoga three times a week.  Are these activities friendly to my back problem?  Are there things that I should not do or should be very careful about when doing ballet and yoga?  Thank you so much!

Jessie


Answer
Dear Jessie,

I am sorry to hear about your injury while doing what you love... dance. That has to be a frustrating thing for you.

First of all, how did you get the diagnosis of a disc bulge at L3-L4 and L4-L5?  Did you have an MRI to confirm the diagnosis? I am going to assume that you did, OK? (by the way, an MRI is the gold standard for diagnosing spinal disc problems...)

Disc injuries typically occur over time and with repeat offenses, although singular, substantial injuries can definitely case disc problems.

The interesting thing about your problem, Jessie, is that most disc injuries are caused by spinal flexion injuries, not typically spinal extension injuries.  You say that you think that you might have been injured when an instructor was helping to stretch you while laying on your stomach, and arching your back up and backward. This is an extension injury, which typically causes more of a facet joint injury and pain.

I always like it when people continue, as much as possible, in the activities that they enjoy.  I am OK with you doing dance and yoga, but you need to take extreme caution with performing any extreme lower back flexion, or bending forward.

Core muscle strength is the key to help you deal with the lower back condition. Abdominal and lower back muscle strengthening should be your primary focus. Flexibility is second. You should make sure that the quadriceps femoris and hamstring muscles are long, flexible, and well toned.

Jessie, disc injuries have a tendency to be permanent and repetitive, so it is important to find things that help and then to stick with them for the long term. If you seek the help of a chiropractor, I would be careful not to have hard, aggressive, side posture adjustments. In my office, I would teach exercises, and I would consider using decompression traction and activator or low force adjusting techniques.   Here is a link to some exercises that you might try. http://eastmesachiropractor.com/index.php?p=97781

Another important thing to remember when you are doing exercises is that if it increases your pain, stop doing that particular exercise and try doing something else.  Pain could indicate that you are hurting yourself some more.  In your case, in particular, you should be watching for an increase in back pain and anything that causes pain, numbness, or tingling sensations in either leg.

I hope, Jessie, that you are able to find some things that give you relief and that allow you to stay active and do what you like to do. Good luck!

Keith Biggs, DC
http://www.eastmesachiropractor.com
http://www.biggschiropractic.blogspot.com