Question
I'm 66 and in excellent health. I'm a daily runner (5+miles a day) and lift weights 3 days a week.  About 2 weeks ago I bent over and was greeted with what I can only describe as excruciating low back pain. It was right in The middle of my lower back and I don't know if I would describe it as a cramp or a pinch type pain. Whichever though, I literally couldn't move and the pain was unbearable. As I tried to move, the pain began to subside, kind of like a cramp does. I went to a chiropractor twice and he applied cold with stimulation. I've also been using ibuprofen. I've reached a point now, after two weeks, where this is still present But I only get this acute pain, cramp or whatever it is shortly after I get up in the morning. I might just move the wrong way and "boom," there it is and it stops me in my tracks. As the day goes on however, I don't get it and I can function somewhat normally but carefully. I'm still running daily with no problem or pain but range of motion is less. Wonder what you think. I'm wondering if I've broken a bone or ruptured a disc....but no leg pain or numbness. Thanks

Answer
Don ~

You are describing classic symptoms of an acute disc herniation. A herniation can best be described as a bulge or bubble where the soft moist interior of the disc protrudes through a tear or weak area of the fibrous exterior. In this case a picture truly is worth a thousand words so if you'll click on YouTube it will take you to a video I've recently posted that will make this clear.

It's easy to suppose that a disc would be either herniated or not herniated but actually in the early stages this bulge comes and goes minute to minute, and position to position, and if you move the wrong way and it pops out it "dings" the nerve and "boom" it stops you in your tracks as you have said. Think about smacking your elbow where the "funny bone" which is actually the ulnar nerve is located. As the bulge becomes more constant (slow continous pressure rather than sudden immediate pressure) and that pressure remains on the nerve for a long enough time in exactly the wrong place symptoms progress to include the distribution of the nerve which in this area could include leg pain or numbness. Symptoms of a broken bone don't ordinarily come and go in this way.

Again, a picture is truly worth a thousand words and I would certainly recommend an MRI because if the herniation is confirmed the question now becomes why did it suddenly herniate? Absent trauma the usual diagnosis is degenerative disc disease where a disc has gradually begun to dry out weakening the outer walls and like an automobile tire that is gradually going bald it one day goes flat for "no reason". Alarming as this sounds understand that degenerative disc disease is not fixed and ranges from very early to very advanced. Naturally, the earlier it is detected and dealt with the better the prognosis.

First, get an MRI leading to an accurate diagnosis. In the past, a patient suffering from degenerative disc disease was usually given pain medication or steroid injections, instructed to refrain from physical activities, referred for physical therapy, and when they weren't progressing they were sent for spinal surgery or simply told to learn to live with it. Modern medical science now has a better answer - non-surgical spinal decompression.

AUTHOR BIOGRAPHY
Dr. Michael L. Hall, D.C. practices at Triangle Disc Care in Raleigh, North Carolina specializing in Spinal Decompression for the treatment of acute and chronic neck pain and back pain due to herniated, degenerated discs. This is a conservative procedure for patients suffering with bulging or herniated discs, degenerative disc disease, posterior facet syndrome, sciatica, failed back surgery syndrome, and non-specified mechanical low back or neck pain.

For more information call 919-571-2515, click on www.triangledisc.com or email [email protected] . Type "Free eBook - 101 Things I Need to Know about my Bad Back" into the subject line.