You bent over to put on your shoe, or to pick up your kid’s toy. You’re not really paying attention to your form, you’re just trying to get it done. There’s a catch in your low back and can’t stand back up straight. The pain is searing, burning, and all the muscles in your low back are spasming. You know you’ve “thrown out” your back but not really sure what that means. Sitting is intolerable, sleeping is impossible, and all you know if you need relief. As you start to hobble around you notice a shift in your torso over to one side where your hips are hanging out in left field and your core and shoulders are way over in right field.

Wondering how to get help, what to do to relieve the 10 out of 10 pain and not sure if you should see your primary care, orthopedist, physical therapist or chiropractor? Don’t worry, read on for a great solution you can try on your own and our approach in the clinic when these kinds of patients crawl through out door.

Make sure to get assessed by a professional to get a clear diagnosis and if it is a disc herniation with a compressed nerve then in this acute phase we always start with Mckenzie Method after ruling out all the red flags.

What is McKenzie Method?

McKenzie Method was developed by Robin McKenzie, a physical therapist from New Zealand. The core of his method was to provide relief to patients experiencing signs and symptoms from a herniated disc. Whether in the low back or neck, he came up with a series of progressive exercises to help decrease radicular symptoms into the arms or legs and eventually decrease the herniation.

What is a herniated disc?

If we were to hold a disc from a spine, we would feel it has a jelly-like consistency. Think of a jelly donut, just contained in a thick casing of ligaments. If you were to continuously squeeze it between your hands on one side, the jelly will eventually push out on the other side. Essentially, that is what is happening in our spine.

Compression of the disc from above and below, sudden injury, or general wear and tear of our bodies over time can cause the disc to push into its outer, protective ring. This bulge, as we call it, can push on surrounding nerves and limit certain movements. The goal is to bring the disc back to its center. What McKenzie Method does is move the spine in the opposite direction from the mechanism of injury.

Centralizing the Disc

If a bulge is pushing posteriorly, then bending forward, sitting, and trying to go from sit to stand will increase pain. Walking and standing naturally puts our lumbar spine into an extended position. Since extension of the lower back is the opposite of being hunched over, or flexed, it helps to alleviate the disc bulge. It actually drives the pressure of the disc forward, creating a suction and can pull the disc material back into the disc.

Depending on the severity of the bulge, we can help you figure out the best exercises to start with and progress to, not only to centralize the disc, but also help strengthen the muscles surrounding them. Depending on the direction of preference that minimizes any symptoms in the legs, this is the direction we will have patients mov into. During the acute phase, the first seven to ten days of a new injury, we recommend going into the direction your body prefers 20 reps, every hour on the hour. So if you have a lumbar disc herniation that is driving posterior, then gentle cobra extensions 20 reps every hour on the hour. Start low and easy and gradually build up as the pain minimizes.

Urban Wellness Clinic Approach

We take this commonly recognized condition and help you find the root cause by not only utilizing the McKenzie Method, but by gaining a better understanding of how your body works overall. Whether a sudden injury or due to compensation patterns in the body from old surgeries or improper posture, we can not only alleviate the herniated disc, but provide you with the tools necessary to maintain proper spine health going forward. Curious what will happen at your visit with us at Urban Wellness Clinic?

We focus on a solid assessment and we always ask the right questions to rule out the red flags. Some of the questions you may be asked if you are seen by a practitioner at Urban Wellness Clinic are:

Have you had significant injury to your back recently?

Do you have a history of low back pain?

Have you had any loss of bladder or bowel function?

Any changes in urination or bowel movements?

Have you ever been diagnosed with cancer?

Have you experienced unexplained or unintentional weight loss?

Do you have an abnormal immune system (due to disease or medications)?

Do you use intravenous drugs?

Have you had a fever recently?

Once we have ruled out all the red flags and get a clear diagnosis, we have a whole toolbox of tools to help relieve your back pain. We are obsessed with getting the root cause and learning what is working for different people out there, because no one technique helps relieve all pain. We have taken thousands, maybe even tens of thousands of hours of continuing education not only in chiropractic but also physical therapy technique, some tools that are outside the traditional physical rehabilitation box. We use whatever works while staying evidenced based.

McKenzie Method (MDT): An in depth evaluation of movement patterns to understand the direction of the disc bulge. Depending on your acute or chronic symptoms, a specifically targeted progression of movement will be demonstrated and taught to you.

Dynamic Neuromuscular Stabilization (DNS): Disc herniations can be a result of weakened structures surrounding the spine. In lumbar spine disc herniations, a contributing factor can be the lack of core strength and stability, poor breathing habits, which leads to over utilization of our low back musculature for stressful breathing patterns.

Active Release Technique (ART): This powerful massage technique is the gold standard in soft tissue release. It helps reduce the muscle spasm associated with a disc herniation and release entrapped nerves.

Chiropractic Adjustments: Your treating physician can also perform manual spinal manipulation safely to the spinal joints to help ease the tension being placed on surrounding spinal structures. Sounds scary when you are in an immense amount of pain from the lumbar disc herniation. A recent study found that NSAIDS were not effective for low back pain. American College of Physicians recently changed their guidelines in the treatment of low back pain after reviewing 150 studies. For low back pain that occurred recently and lasting less than 12 weeks, they recommended people try: heat, massage, acupuncture, spinal manipulation, as with chiropractic care.

Usually after the initial acute phase which is one week to ten days along with doing the prescribed exercises, people will feel the edge taken off their pain. Sometimes even a 50% decrease in pain.

If you have questions about your low back pain or want to chat with one of our practitioners, feel free to reach out hello@urbanwellnessclinic.com or call us at 212-355-0445.

In Good Health,

Dr Emily Kiberd