Wellness By DPT - Dr. Kevin Hohmann

Spinal Clarity: Disc Bulge, Herniation, and Extrusion Explained

productsbydpt@gmail.com — Sun, 15 Sep 2024 11:40:26 GMT

Spinal Clarity: Disc Bulge, Herniation, and Extrusion Explained

Welcome to the low back pain blog, where we will discuss the difference between a disc bulges, herniation and an extrusion.

If you're checking this page out, odds are you or someone you know has been diagnosed with a discogenic condition. Disc herniations are a very common condition that affect over 1 million people per year in the United States!

Now its important to note, that not everyone will be symptomatic, however, the people that do have symptoms know how painful and limiting this injury is.

I wanted to create numerous forums and programs to help people with discogenic conditions because I know how painful and limiting this injury can be.

At the clinic I see roughly 25 patients a week for discogenic injuries including: disc bulges, herniations, and extrusions.

I like to break down the difference between the aforementioned pathologies, explain what is happening at a physiological level and how we can manage and correct them.

Lets start by understanding the difference between the big three:

Disc bulge:

A disc bulge occurs when the entire disc protrudes outward, but the outer layer (annulus fibrosus) remains intact. The bulging is generally more diffuse and less localized compared to a herniation.

Symptoms: May not always cause symptoms. When symptoms occur, they can include mild to moderate back pain and discomfort.

Example: Imagine a balloon that’s being inflated. As the balloon expands, the entire surface bulges outward, but the outer layer of the balloon is still intact. Similarly, a disc bulge affects a broad area but doesn’t break the disc’s outer layer.

Disc herniation:

A disc herniation happens when the inner gel-like core (nucleus pulposus) of the disc pushes through a tear or crack in the outer layer (annulus fibrosus). This protrusion can press on nearby nerves.

symptoms: Can include sharp pain, radiating pain into the limbs, numbness, and weakness. Symptoms depend on the location of the herniation and the nerves affected.

Example: Picture a jelly-filled doughnut where a tear in the doughnut’s side allows some of the jelly to ooze out. This localized protrusion of jelly represents a disc herniation, where the inner core pushes through the damaged outer layer.

Disc Extrusion:

Disc extrusion is a more severe form of herniation where a significant portion of the inner disc material (nucleus pulposus) escapes through a tear in the outer layer (annulus fibrosus). This often results in the displaced disc material being separated from the main body of the disc.

Symptoms: May cause more intense symptoms, such as severe pain, significant nerve compression, and possibly loss of function or sensation in the affected area.

Example: Think of a balloon filled with water. If you puncture a hole and a large amount of water escapes, it represents disc extrusion. The disc material escapes through a tear and can move away from the main disc body, causing potentially severe symptoms.

How can we manage the symptoms?

Now that we know the difference between the three, how can you manage and treat these injuries?

There are three main ways to treat this injury:

Conservative care through lifestyle modifications and exercise
Injections/steroids
Surgery

I n my experience most people can make lifestyle modifications, exercise and avoid certain movements to abolish their pain and get back to their daily activities.

So lets get into how to make these changes and what you will need. First, its important to understand that lumbar spinal flexion occurs when we lean forward rounding our back. Spinal extension is the opposite, its when we arch our lower back.

For these injuries we want the spine to go into extension to gradually push the disc back into place and prevent it from poking out even more.

I want you to think, when are your symptoms the worst? Is it when your sitting for a while on the couch/in a car, bending down to pick something up, or even just rolling around in bed? That is because those are spinal flexion movements! We want to avoid those, so an easy solution is to place a lumbar roll or a towel roll behind your lower back when sitting. This will force your lower back to have the support it needs in extension, thus preventing the disc from translating out of place. It is also important to engage your core when bending and rolling and strengthen specific muscles that provide stability to the spine.

I designed a 12 week program that solely focuses on discogenic injuries with progressive periodization of exercises. The exercises are geared towards an extension bias while focusing on strengthening your core, hips and low back muscles. Learning how to engage them while doing everyday life activities will abolish your pain and allow you to get back to your prior level of function.

Go check out the disc herniation program and get started, and remember this is a community, if you have questions we are all here for one another!

From Stiffness to Strength: Navigating Osteoarthritis with Confidence

productsbydpt@gmail.com — Sat, 14 Sep 2024 21:54:40 GMT

Welcome to our forum on osteoarthritis! Here, we’ll break down what osteoarthritis is in straightforward terms and provide examples to help you understand what it is, how it might affect you and how to manage your symptoms.

1. What is Osteoarthritis?

Osteoarthritis is a common type of arthritis where the cartilage in your joints breaks down over time. Cartilage is the smooth tissue that cushions the ends of bones in your joints, allowing them to move easily. When this cartilage wears away, it can lead to pain, stiffness, and swelling in the affected joints.

2. How Does Osteoarthritis Develop?

Osteoarthritis often develops slowly and gets worse over time. It can be caused by a variety of factors, including aging, joint injuries, and repetitive stress on the joints.

Example: Think of your car’s tires. As you drive, the tread wears down gradually. If you keep driving on them without proper maintenance, the tires become less effective and eventually wear out. Similarly, your joints can experience wear and tear that leads to osteoarthritis.

3. Common Symptoms of Osteoarthritis

Pain : Joint pain that worsens with movement and eases with rest.
Stiffness : Especially noticeable in the morning or after sitting for long periods.
Swelling : Sometimes, the affected joint might become swollen and warm.
Decreased Range of Motion : Difficulty moving the joint fully.

4. Who is at Risk?

Anyone can get osteoarthritis, but certain factors increase your risk:

Age : It’s more common as you get older.
Weight : Extra weight puts more stress on your joints.
Injury : Past joint injuries can lead to osteoarthritis.
Genetics : If your family members have had it, you might be more likely to get it too.

Example: Think of carrying a heavy backpack. The more weight you carry, the more pressure it puts on your shoulders and back. Similarly, extra body weight can put additional stress on your joints, increasing the risk of osteoarthritis.

5. Managing Arthritis: Effective Strategies and Personalized Programs

Now that we’ve explored what osteoarthritis (OA) is, who is at risk, and the common symptoms, let’s dive into how to manage it effectively.

Well, there are a plethora of conservative measures we can use. The most important one is movement. I like the expression “motion is lotion”, while it is cheesy it's accurate! Movement for a joint is like WD-40 for a rusty hinge. It gets the joint moving easier, brings new nutrients in, and flushes out old dead inflammatory cells.

Majority of my patients ask me what should I be doing to reduce the pain? What exercises are good for arthritis and what are bad?

Now I don’t believe any movement is considered “bad” just less desirable. Every movement has its place, which is specific to the patient. Let's talk about movements to avoid if you have arthritis.

Avoid heavy impact exercises such as running on pavement, jumping with poor landing mechanics, and compressing the joint.

To manage arthritis pain effectively, consider incorporating strategies that unload the joints and promote joint health. Our “Managing Your Arthritis Pain” programs are designed specifically to guide you through:

Low-Impact Exercises: Discover exercises that are gentle on the joints but effective in maintaining mobility and strength.
Joint-Friendly Movements: Learn how to perform movements that support joint health without adding unnecessary stress.
Personalized Plans: Whether arthritis affects your knees, hips, or any other part of your body, our tailored programs provide specific exercises and techniques for your needs.

Don’t let arthritis hold you back. Explore our programs and find the right strategies to manage your arthritis pain effectively. With the right approach and support, you can maintain an active and fulfilling life.

Feel free to reach out with any questions or share your experiences. Together, we can navigate the challenges of arthritis and discover ways to feel better every day!