The Cause of Disc and Back Pain

Tuesday, November 07, 2006

Healthline

A UK Times article featured a physician musing that as medical students they were not taught in school to identify the cause of medical problems, but to treat symptoms (and give electric shocks to decerebrate frogs). The cause of the problem would still remain.

He mentioned how you may go to the doctor with painful tonsils, and be given a "diagnosis" of tonsillitis. He educates the reader that "Tonsillitis, for example, is not a disease but a symptom - of something else that caused the tonsils to be infected." He continued with how you may go to the doctor with pain down your leg, and be given back a "diagnosis" of sciatica, which just means "pain down the leg" but not what is causing the sciatica. A disc may be pressing on the nerve, but what is making the disc press? The sciatica and the bad disc are the symptoms. They are not the cause. Unfortunately, he stopped there, and for treatment said to go back to your activities with light rest. Nothing about what caused the disc to degenerate (break down) or protrude (herniate or slip) in the first place.

Understand The Causes:

Bad sitting and bending are main causes of disc degeneration and herniation.
Rounded sitting (photo on left) compresses the space between vertebrae in front and opens the space between them in back and squeezes the disc gradually backward into that space.
Bad bending (right) levers the weight of your upper body plus whatever you are lifting onto your lower back discs, whether you keep your back straight or rounded.

Strengthening your back will not stop you from sitting and bending wrong. Stretches or massage that feel good for the moment will not stop you from sitting and bending in the way that rounds the spine forward, pushing and squeezing the discs until, finally, give break down and squeeze out to the back (herniate).

A bad disc is not the diagnosis. It is not the cause of the problem. It is the result of what is causing the disc go bad.

You can treat the disc pain with pills, exercises, massage, and shots, but not remove the cause. When you continue the cause, the pain often comes back. You can undergo surgery to remove the disc, but of you do not remove the cause and continue injurious sitting, lifting, and bending, you continue harming your other discs.

What to Do:

To stop the damage, stop the cause. Then it can heal.
Main causes are bad forward bending and sitting. The post Disc Pain - Not a Mystery, Easy to Fix explains.
The post Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending shows simple healthy bending.
The post Are You Making Your Exercise Unhealthy (and several others) shows how to easily fix unhealthy sitting.

It is easy to prevent and heal back pain when you simply stop the cause.

There is more help and information in my replies to many reader comments right under this post. Before asking more questions, see if your answers are already here.

Photos: Thanks to HealthLine staff who posed pretending to sit and bend wrong to help others.
No readers were hurt in the photographing of this post.
Drawings of Backman!™ © copyright Dr. Jolie Bookspan

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Read and contribute your own success stories of fixing pain with these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
See Dr. Bookspan's Books. Limited Class spaces for personal feedback. Top students may apply to get certified DrBookspan.com/Academy.

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Labels: fix pain, injury, leg strength, leg stretch, lower back, posture, sciatica, sitting, squat, upper back

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40 Comments:

At Wednesday, July 04, 2007 12:05:00 PM, Anonymous said…

Jolie,
I'm a spritely 23, and have yet to have had any back pain from my, until recently, chronic slouching. I came accross your site recently and have decided to change my ways. However, I'm not sure exactly how to sit properly. When sitting in a chair, is your back completely straight up or is the a slight curve in at the bottom. Sitting up with my best efforts (after the suggested stretches etc) tends to leave me with aching muscles down either side of my spine. Is this a sign of doing it correctly and my muscles learning to cope with their new found stress, or am I over compensating somehow? (There aren't really any pictures of correct sitting, just how not to!)
Thanks for all your amazing advice, you're doing wonders for the world of health!
At Thursday, August 09, 2007 12:01:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Dear Thomas, my reply previously posted was lost in a blogger update, I was told. Here it is again:

Thomas, thank you. Good questions. When sitting, keep a slight inward curve in the lower back. The left-hand photo in this post shows not doing this - the lower back is rounded outward. Important to be able to identify.

Nothing should hurt more. The stretches should feel better, then and there. If not, check how you do them. Keep me posted.

A few posts have detailed written information on sitting:
When Did Health Become Thinking Out Of The Box?
and
Are You Making Your Exercise Unhealthy?

There are illustrations on the free article about sitting on my web site. The best resource would be the book Fix Your Own Pain which has a whole chapter with diagrams on sitting comfortably in a healthful way. More than I can put in a 300 word post.

Lean your upper body back against the chair back, instead of pressing the lower back. Many chair backs are rounded so that you sit rounded in a bad way if you conform to the chair back. Major examples are in train, movie, and airline seats, but even in expensive ergonomic chairs. Pad the space in the lower back area with a small soft sweater or pillow. I will post details in future posts. There are many important topics to cover in this blog. Posts to come will cover healthy muscle use in sitting - with illustrations of what to do. Thanks for keeping the good suggestions coming.
At Sunday, February 10, 2008 8:08:00 PM, johnpm said…

Hello Dr. Bookspan, I posted this before, but it did not post so I am trying again.
I had two quick questions. I have noticed that your techniques are similar in some regard to Robin Mckenzie. He recommends a push-up type extension exercise in addition to the postural correction, what do you think of this? How about cervical traction for neck hernaitions? Secondly, I am 33 and have herniated disc in my neck as well as my back with siaticia (left shoulder and left front thigh) and I have been trying the exercises and posture correction for some time now (9 months) and have been very dilagent, but it seems thats the pain is worse in one extremity vs the other but rarely ever both. Have you heard of this and should this get better over time (I think it has improved some since starting, but still very bothersome up to a 4-5 out of 10 pain) I really do appreciate your input.

Thanks
John
At Monday, February 11, 2008 2:47:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Hello johnpm, The reason it may not be getting better is that doing a few exercises or McKenzie pushup extensions does not stop the cause, so cannot fix the problem. If you continue to do the things that push the disc out, it cannot heal, and the pain and problem continues.

My methods are different in that I urge people to think, and not just "do" a few exercises or corrections, or traction, or adjustments, or massage, or acupuncture, or shots, or any other treatment but to stop the cause of the herniation in the first place during all your daily movement. Then it can heal.

Use all the links in the post:
-See the mechanism of how a disc protrudes in Disc Pain - Not a Mystery, Easy to Fix.
-Have you stopped bad exercises, examples in Are You Making Your Exercise Unhealthy?
-Have you changed all bad bending to good, explained in Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending.
-Have you fixed a forward head, explained in Fixing Upper Back and Neck Pain.
-Click the label "upper back" under this post for more posts on upper back and neck.
Start with those. It should make a difference the same day. If not, check how you are doing them.
At Monday, March 24, 2008 9:00:00 AM, Anonymous said…

Hello jolie,
Just a couple more questions. How do you suggest someone look down (to look at a chart etc at work)without pushing the disc out more (or aggrevating symptoms)? Also the trap strech to the side that is painful seems to aggrevate my symptoms, do you suggest an alternative exercise. Thanks again
John Morcos
At Wednesday, March 26, 2008 1:00:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Hello John, don't worry. To look down comfortably - tip chin down in relaxed straight position instead of jutting the head and neck forward. That is healthy positioning for everyone - injured or not. No need to lean or hang the head or beck forward, or round the upper back to look down.

If the trap stretch hurts, you are probably doing it wrong. It is supposed to feel good and beneficial, even if there is stenosis or other issue along with the disc. Check if you pinch the neck to the side instead of getting a soft relaxing stretch along your side. Check if you are forcing or straining, holding your breath, leaning forward, rounding your shoulders, and so on. Are you doing it with your back and back of head against a wall so that you can tell if you are straight or bending forward? Important to remember is why you are doing it. Along with the pectoral stretch , the purpose is to make straight positioning feel natural so that you can stop the unhealthy forward head positioning that compresses the discs. Then you use the new straight positioning for daily life. The stretch itself does not fix a disc or other injury. If you stretch, then go back to injurious positioning, it is no mystery when pain persists. By applying the concepts (instead of "doing" a bunch of stretches and exercises) pain should reduce right away and the injured area can heal quickly.

In your comment to a different post, you mentioned you had trouble leaving a comment. The blogger software is slow sometimes. One thing to try is to click "publish" once then leave it alone and wait. Also, I am not the moderator, and it takes time, sometimes a few days, for the posts and my replies to go through.
At Thursday, April 10, 2008 4:11:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Hello again John,
I prepared a post for you and other readers asking about neck health at the desk. Click Tax Preparation Health.
At Thursday, April 10, 2008 8:14:00 PM, Anonymous said…

Thanks Jolie
At Sunday, August 03, 2008 3:24:00 AM, Anonymous said…

When I sit properly (compared to slouching) I get a strong pain in my scapula. What can I do?
At Monday, August 04, 2008 2:04:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Davide, Check my reply to Thomas in the comments above (Aug07) for healthier sitting. My replies to Anonymous and John above, also have info and links to pertinent Fitness Fixer posts.

If you get a new pain, then that is not sitting properly either. See if you are straining or tightening to sit rigidly or other unhealthy habit. Click Fix One Pain, Don't Cause Another.

Use the labels under each post to find related info, and enjoy browsing while sitting in healthful ways.
At Friday, August 22, 2008 10:37:00 PM, marinavelius said…

hello Dr. Jolie,
I have learned so much from your website, books and attending one of your classes. Unfortunately I could not attend the second class in the series because of a family obligation. During the first class you mentioned you would be teaching proper sitting in the second class. You stated one should be able to sit properly without expensive chairs, one could even sit properly on a barrel. Would you mind sharing how does one sits properly on seats or benches without backs?
thank you so much for all your help! I had suffered from hip pain for several years and was fortunate to come across you website as I was searching about posture exercises for my son (forward head habit to the max!) My persistent hip pain after about a month of doing several of the anterior hip stretches, piriformis stretch and iliotibial band stretch. thank you so much. i can sleep again on the previously affected side and am not waking up several times in the night in pain. God Bless you!
At Monday, September 22, 2008 6:20:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Marina, thank you for putting my class to such good quick use and fixing your pain. You were great to have in class. We previously invited you to attend again at no charge to get the information you missed. The class started again, and will run two more Saturday mornings - September 27 and Oct 4th, 9-11:30am at the same Temple U Center City location. Hope you can make it.

The two class text books, "Fix Your Own Pain" and "Health and Fitness - How to Be Healthy Happy and Fit for the Rest of Your Life" each have sections on sitting, described on my BOOKS page (for new readers). Until we see you in class, apply the principles in the book, and some of the posts about sitting - just use your own muscles to prevent painful slouching and sit up comfortably. Two posts with photos of nice sitting without chair back are Quick and Easy Strength and Balance Exercise and Household Fitness in the New Year. Bless you too, and sleep the sleep of the lamb.
At Friday, November 28, 2008 8:28:00 PM, Anonymous said…

Greetings:)

I had recently strained my lower back(ofcourse body building! lol)..

I had only waited 4 days and I decided I had to get back in there! It is very hard for me to accept a "time out" even of a day or so. However when I did that workout I really knew I had yanked something good.
The following week was filled with alot of struggling just to sit down or get up=P..
I had visited my doctor after 2 weeks as this was becoming just silly. However he just wanted to prescribe pain pills after lifting my legs while lying down, one by one and asking if I felt pain(answer, no).. So he said either ligament or severe muscle pull.
Anyway I was forced to stop lifting for a bit so I could let this heal. In the meantime I had run across your site and all the articles and I became intrigued.

I had realised how "poorly executed with bad posture" I had been doing things when lifting or running. Oddly as well, I realised how much "joint" popping I had.

I really poored over your material and am totally rethinking how I do things now. Since I kinda cannot lift really heavy weight at this time I started doing your stretches and exersices(nice ab exercise btw with holding something behind you/pelv tilt).

I had noticed a week or two into this that my back pain was going away(slowly but hey I am being carefull to avoid re-injury by doing way heavy atm)..

I have also noticed this. I had been a "traditional" stretcher with all kinds of bending in the past. I am avoiding it like the plague now. I am concious of how I pick things up and how that just delays recovery and aggravates the back at anytime for no reason.. The biggest change I have noticed is the "popping" in joints is going away! I now know that this is caused by improper positioning thanks to your articles! Day by day the pops have disappeared or lessened.

Ok my quick question is this. Since the doctor just thinks I tore a muslce or ligament severly and you mention in one article that it takes days or so to heal(I think it was "start healing), is there an approximation on how long a torn area heals? I am going on one month now and though it has improved dramatically it is still not 100 percent. However I am guilty of a few things along the way. One is that I coninued to lift ignoring the pain that tore into the "worse" pain. Two, I did not come across your site for another week after and did traditional "stretches" and did nothing to fix habits throughout the day till 2 weeks ago.. Lastly, a torn muscle does not seem to take well to high intensity interval training "normal jogs/sprints mixed".This seems to slow down healing and slightly re-pull the muscle).

So I think this stuff is wonderfull and I will incorporate it to life, however I am just overly curious how long to wait before "full blown" lifting again(but with more caution and your suggestions! Even the way to do a military press).. I am tired of re-pulling so should I just stick with the stretches and basic exercises here until the area is completely healed?

Guess that has me confused as doctors etc say to take it easy. I would love to get back to lifting in a safer way now, but I am very cautios at the moment. Premature very heavy/Re-injury just equals more down time away from what I love.

Thanks! PS regardless of the downtime I had learned quite a bit to incorporate from now on to avoid injury. I have again also love the fact that changing to these stretches and exercises has eliminated pops in joints.. That is a plus.

Dan
At Monday, February 16, 2009 2:19:00 PM, Anonymous said…

Hi Doc!

I am so glad to have found your site and techniques. I have been half-heatedly practicing and feel better and am more and more being convinced.

I have two herniated discs in my lower back. As I read your papers on reversing or turning around the mechanical problem I was led to a question I haven't been able to find an answer to.

From what I understand, a disc needs hydration and when it bulges further begins to degenerate. That was the explanation given for the term disease. If my discs are degenerating after losing its hydration and from the MRI's appear dark and unhealthy, how can corrected posture reverse and make those discs healthy again? Do they re-hydrate? If not, do they eventually move back to there normal placing and stay secure or are they permanently damaged? This is important fro me as I have been told they are never able to re-hydrate and the best solution is to "slow down" the process of degeneration.

Regardless of your answer, I will continue to practice your teaching as I find it has been more helpful than any physical therapist or ortho I have been to. Thanks again for bringing your studies out into the open!

Chris- Miami
At Sunday, March 22, 2009 9:53:00 PM, Anonymous said…

Jolie, I have been practicing everything you write above to help my pain. I feel like I have stress in my traps and neck. The pain changes from traps to neck and a little shoulder. I feel like it is uncomfortable to hold my own neck up. I am 37 and was very active until all this started (3 months ago.) I am sitting better and feeling less pain when I sit as the pain is the strongest when I sit for a while and when I sleep. Especially when I wake up. I toss and turn. Do you have any advise on how to sleep and not make the herniated disk in the neck worse. Do I use a cervical neck pillow? Do I sleep on my side? Back? Stomach? You web site is so informative and has helped me with my posture problems but I cannot find anything on the proper way to sleep with a neck and upper back discomfort. THank you so much for your post, Lisa
At Monday, March 23, 2009 3:25:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Lisa, glad you are reading. Make sure to get the concept - that you fix the source of the pain, not just do exercises, or sleep in a certain way. If you stop the source of pain all during the day, the area should quickly heal and the pain stop. It is not supposed to continue. If you still have pain, check what you are doing all day.

Sleeping like a mummy or stone without moving in one set way isn't healthy or the answer. I addressed this same question about sleeping many times in my books, my web site free articles, and Fitness Fixer posts. One is in the reply to "Lifeworks"" in the comments of Which Stretch Stops Back Pain by Making Neutral Spine Possible?. Another to "G" with ideas for sleeping and beds in the comments of Prevent Back Surgery.

After relieving trapezius problems with Nice Neck Stretch make sure not to go right back to hunching and tightening. Reminders about not tensing upper body when going about real life are in Which Ancient Exercise Gives Focus and Concentration? and Thanksgiving Health.

Also check my many replies above to the comments of this post with answers and things to check. Feel better!
At Monday, March 23, 2009 4:21:00 PM, Anonymous said…

Jolie, I have just a few more questions. I am an American living in Costa Rica with this unknown neck and trap discomfort. I am going to the USA in a few weeks and would like to know which book to order online so it will be there when I get there. I am the same Lisa in this blog. Which book will help my daily pain which comes and goes. How to sleep while in the middle of this out of nowhere pain cycle. I am not leaving here until April 10th and cannot find your books here For now, could you give me a few tips on what position to sleep? I also want to know if it is a herniated disk in the neck will the disk replenish itself with the liquid? Does running make this worse? I am afraid to do any physical exercise because it might make the stress feeling come back. I also do not want to pay for a MRI if I do not have to.
At Monday, March 23, 2009 9:22:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Lisa, I received your questions in the comments of another post - Fixing Upper Back and Neck Pain. Beside everything I wrote you above, check the things I wrote for you there.
At Monday, March 23, 2009 9:50:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Lisa, the book that covers fixing pain is "Fix Your Own Pain Without Drugs or Surgery." If you also want to get back to fun healthy life, the "Health & Fitness THIRD edition" is a good one to add. It covers fixing back and beck, plus all about healthy lifestyle, changing food and nutrition habits, health issues like osteoporosis and headaches, drugs, and supplements, and many other chapters about healthier happier exercising and living. You can get them from my web site www.DrBookspan.com/books.

Yes discs can heal - if you let them. It takes only a short time fo stopping the injurious body mechanics that makes discs break down and push outward (herniated). They are living body parts that can replenish with good habits. Once again, if you stop the tightness that makes pain in the day, then you can sleep in healthful position. If you are tight and using bad habits, then you will not be able to sleep in healthful position. Trying to force a straight
At Wednesday, June 17, 2009 3:40:00 PM, miked said…

Hello Jolie

I am going through a spot of trouble with a bulging disk and I live abroad where I have lots of communication problems. My doctor whose English is limited speaks to me in Latin with all the muscle names so it's hard going because I am no medical student. Hence I look a lot online for extra support.

I like your idea about swinging the hips upward because it does correct my lower back. I can feel it. But I noticed that when I do it my chest comes down and my head is actually a little lower than before. I am actually shorter by maybe 1/2 a centimeter. Is that right?

I also noticed it's really uncomfortable holding correct posture for more than a few minutes. My hips really want to slouch back down. What am I doing wrong?
At Thursday, June 18, 2009 1:04:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Miked, Like everything else that makes the world better, the success is to carry out the concept, not follow arbitrary gestures that make no sense and make things worse.

If you make your posture worse, as you have done, it is uncomfortable and not beneficial. Good that you noticed that.

The purpose of a small hip tuck is to make a large inward lower curve smaller so you are straighter, not to curl like a cashew nut.

Read the article above. To stop the sources that push a disc outward (herniated it), stop bad bending forward (curling like a cashew nut) - rounded sitting, bending.

When standing, some people allow slouching so that the small normal inward curve in the lower back becomes large. That is covered in many other posts about neutral spine.

Don't worry. Discs can health quickly and easily when you let them. That means stopping the sources, that are pretty obvious once you understand. Retrain your bending and sitting to healthy positioning instead of rounding forward and continually damaging the disc before it can heal.

Also know that a bulging disc on a scan is not always related at all to back pain. Many people have no pain at all and scans that show bulging disc. Others have a disc bulging on a scan but the pain is from unrelated things. Standing with too large inward curve to the lower back causes back pain. That pain stops immediately when you stop standing badly. All kinds of ordinary slouching causes back pain, as do many common medicines like drugs for cholesterol, depression, sleep, and many others. Posture and stretches stop that pain, you stop taking unnecessary medicines and the pain stops. Stop the source - that's the key. It does not mean doing less or standing like a cashew nut.

There are almost 600 Fitness Fixer posts at this writing. Click the links and enjoy getting better.
At Friday, June 19, 2009 11:46:00 AM, Jolie Bookspan, M.Ed, PhD, FAWM said…

For miked, part 2 - here are two short videos to help:

Use this one first to see fixing a too large arch in the lower spine without wrecking your upper body posture - Friday Fast Fitness - Neutral Spine in 5 Seconds.

This one shows how to learn to keep upper body straight while fixing lower body by standing against a wall - Fast Fitness - How to Feel Change to Neutral Spine.

Let us know how it goes.
At Sunday, June 21, 2009 3:44:00 AM, miked said…

Thanks a lot Jolie. I think i was just too aggressive with my correction. It's difficult to know when to stop and how straight is straight enough :)

One thing that concerns me is that when I straighten the lumbar area I feel pressure and slight pain on the disc (L5) as I straighten and then it clicks. After it clicks I am straight and the pressure/pain is gone, but if I do this many times throughout the day the area gets sore from all the clicking.

I assume the clicking is because while my back is over-arched something slips out of place and when I correct posture the click is my spine falling back into place. But if I do it often I must be causing trauma to the area. This can happen aver few minutes.

So what should I do? Damned if I do and damned if I don't.
At Tuesday, June 23, 2009 2:17:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

miked - Change to healthy position one time. Then no constant irritating "re-dos." That is a common problem with people paying for constant "adjustments" then letting things go to heck.

Use healthy bending and movement habits. Have you stopped the causes of disc and back pain in the article you replied to? Read all the other articles that explain more, free. Gotten my book that has it all in one place, step by step?

More on how to know neutral spine in Prevent Main Factor in Back Pain After Running and Walking and all the links in replies above.
At Thursday, June 25, 2009 2:45:00 AM, miked said…

Easier said than done Jolie :)

I find it takes effort to correct my posture and it lasts a few seconds/minutes and once I relax I am back to my bad old ways. I read all your other posts and I guess the reason is my hip flexors are tight so I will be doing lots of hip stretches and trying not to bend my back when I need to bend down.

I noticed many people have asked you a question about how to maintain the hip tuck when walking/running but I didn't see any replies from you on that topic. That would be my next question too :)

Thanks for a great resource. I feel like I should send money :)
At Thursday, June 25, 2009 4:38:00 AM, miked said…

oops I just found this. apologies.

http://www.healthline.com/blogs/exercise_fitness/2008/03/spotting-back-pain-during-running-and.html
At Friday, June 26, 2009 2:06:00 AM, miked said…

I bought your ebook, so I'll let you know if it works out :)
At Friday, June 26, 2009 4:04:00 AM, miked said…

By the way, some advice for you for a change. The ebook publisher option is for printing off. People with bad backs don't like sitting at the computer reading ebooks. I spent the whole morning pasting screenshots into into MSWord to be able to print it. That was a real bummer.
At Sunday, July 05, 2009 10:01:00 AM, Unknown said…

Hey Jolie, me again. Tell me if I am a bore and I will stop writing. I am reading your book. I didn't know you broke your back. That's harsh. Congratulations to you on getting back into such good shape :)

A question from me. I've been trying your technique a few weeks now and I have a couple observations.

I think the reason I have lower back pain is that before I was aware of posture I was over-stretching (to the point I could touch my nose onto my knees). I think that is what caused the L5 disk bulge. The point is I compressed my spine at the front and must have caused a protrusion at the back.

My questions this: When I tuck my hips after a night's sleep I feel some pain until I warm up, probably because I am causing the lumbar region to curl forwards and I push the disk backwards and aggravate my existing problem (rear protrusion).

I also noticed that if I work hard on keeping the hip tuck in place for some time, I actually get sore and I get that pleasurable aching relief when I bend forwards.

Am I over doing the tuck, or under doing it? Maybe my posture was ok in the first place and I just damaged my back from the stretching regime and I don't need to correct it now?
At Tuesday, July 07, 2009 2:25:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

Chris from Miami, discs do rehydrate and recover. They are living parts of your body. Like other injuries, they can heal - if you let them. Many times when scans show dry or bulging discs, the pain is not even from the discs, but the usual unhealthful movement. Keep good daily life movement. Discs and muscles heal and you can quickly get your life back.
At Tuesday, July 07, 2009 2:51:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

For Mike,
7 "Mikes" are writing in different posts. I don't know if it's you asking the same question, which of my books you have, which technique you tried, and no one here is named "hey."

You say you don't know if your posture is OK or not, but you are correcting it? From what? To what? If you don't know and are trying random things, maybe you will have random results?

You say if you work hard at it, you get sore. Are you using muscles for the first time or straining in wrong ways?

Are you over doing the tuck, or under doing it? Can you put your back up to the computer and hit the print screen button so we can see?

Without x-ray vision, it sounds like you are pushing your hip forward and not tucking (correcting to neutral) Pushing it forward makes a larger arch, not a reduction until neutral.

First know what is neutral, what you are doing to make things hurt, and what you need to correct. If you are the same Mike who is writing about discs, have you done the things I have already written to you to stop the cause of disc pain - bad bending, bad sitting, and the rest? Random tucking isn't a disc fix.

You are right that constant forward stretching is known to push discs outward. I see yoga and Pilates patients in droves for this. They can't understand why they hurt since they "do" their stretching and say it's ok with their back straight (it is bad load on the discs all the same when touching toes bent over, bent or straight). They also feel better to bend over because they are overarching during their other moves. They think their yoga fixes that with bad forward bending, and wind up with two injuries

The books Fix Your Own Pain and Health & Fitness THIRD ed cover all of this in detail. The Ab Revolution is mainly to understand and change swayback. That book has one page on sitting and one on discs. Stretching Smarter shows changing stretches to helpful functional ones. There are more answers in the many replies above, in the article links, and in the books - www.DrBookspan.com/books.
At Wednesday, July 08, 2009 1:53:00 AM, miked said…

I guess I have more than one google identity. Mike, Miked - they are all me. Sorry, in Bulgaria where I live, "hey" is very friendly (not rude). It just means hi.

The book I bought was the Ab Revolution.

Yes I am really trying to avoid bad bending and sitting. If you'd like a video of me "correcting" my posture, no problem. I don't see an option to add it to my post though.
At Friday, September 18, 2009 3:05:00 PM, MICHAEL said…

Dr Bookspan I am a 57 year old male that has lower back pain in si joint area. I have been incorporating your health bending suggestions such as lunges and squats to replace bending. I would like to get back to running but this injury keeps me from running so i have to bike instead. what suggestions can you offer?
At Friday, September 18, 2009 3:45:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

To MICHAEL, Good work using healthy bending. The combination of "SI pain" and running usually means that the source of the pain is too much inward lumbar curve when standing and other upright activity. Do you notice this pain most when upright (walking, standing, running)? Does it feel better to bend over or lift one leg in front? These point even more to overarching (hyperlordosis) as the source. It is often misdiagnosed as disc, when it is not discs at all. Or other times, it also pinches already herniated discs. To see why and what can help, start with Prevent Main Factor in Back Pain After Running and Walking. Then see Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?. My several replies and answers to Miked (same person Mike) commenting to this article above, cover aspects of reducing a too large lumbar curve to neutral.
At Tuesday, September 22, 2009 9:47:00 AM, MICHAEL said…

Dr Bookspan in my previos post i neglected to respond to your questions.

Do you notice this pain most when upright (walking, standing, running)? Does it feel better to bend over or lift one leg in front?

I used to walk to and from work about 1.5 miles each way and the ache in my lower back, if it wasn't already starting up, usually started after about a 1/2 mile or so of walking. When i bend over i can feel it in the si joint area. I guess the act of bring a leg up in front changes the tilt of your pelvis from anterior to neutral thus helping the situation and I would say that doing this does alleviate the symptoms.
At Tuesday, September 22, 2009 3:40:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

To MICHAEL, good work noticing that neutral spine (reducing the over-arch) stops the pain. The idea is to hold neutral when standing and walking - during real life. Makes no sense to walk in unhealthy overarched position then need to bend over or raise one leg or take pain remedies. Prevent the cause. Use the links provided to if you need to learn more.
At Wednesday, September 23, 2009 8:06:00 AM, MICHAEL said…

To MICHAEL, good work noticing that neutral spine (reducing the over-arch) stops the pain. The idea is to hold neutral when standing and walking - during real life. Makes no sense to walk in unhealthy overarched position then need to bend over or raise one leg or take pain remedies. Prevent the cause.

holding neutral spine is easier when standing or walking on level surface. It gets a lot tougher when walking uphill or running. I added a number of exercise from "The Ab Revolution" to my daily routine such as hand stands and various other ones in your book. The one on pg 73 is especially tough as I cannot get my leg parallel to the floor and my foot straight like you do but i try and over time perhaps I can master this move.I hope to be able to return to regular running as I limit myself two 15 min sessions on the treadmill per week as I am very conscious of how my back responds to the running. I used to run 50-60 miles per week and raced regularly. I try to run with good form by maintaining neutral spine. This takes a conscious effort as it is a departure from my normal form which was leaning a bit forward.I hope that over time i will run with good form more easily
At Tuesday, October 20, 2009 1:44:00 PM, MICHAEL said…

Dr Bookspan said:
To MICHAEL, good work noticing that neutral spine (reducing the over-arch) stops the pain. The idea is to hold neutral when standing and walking - during real life. Makes no sense to walk in unhealthy overarched position then need to bend over or raise one leg or take pain remedies. Prevent the cause.

I am really focusing on the hip region because i believe my range of motion is poor in this area. The question is how much work should i be doing daily to get results (improved range of motion that is noticeable and hopefully a resolution to the si joint pain)
Some of the hip stretching i do consists of lunges w/ hip tucked under, back leg knee on floor front leg knee bent with front foot on floor tuck hip under and lean forward to get stretch. fig 4 stretch where you slide raised leg in direction that raised foot is pointing, lay on back with legs at 10 oclock and 2 oclock raising 2 oclock leg and bringing it over to 10 oclock leg a vice versa.

ps i also do side and front planks a hand stand for core.
At Saturday, December 26, 2009 7:18:00 PM, Kate Morgan Jackson said…

Hi Dr Bookspan,

I am a 48 year old woman, up until about 2 weeks ago in good health. I awoke one day with significant pain around the area of my left shoulderblade. Since that day the pain has traveled back and forth across my upper back -- sometimes to the middle, sometimes to the right. Sometimes it is achy, sometimes it is a sharper pain. It is worst in the morning and sometimes wakes me up. It is best when I am moving around. Ice and heat relieve it very temporarily, as do painkillers, but when they wear off it comes right back. I suspect it has something to do with how I am working with my computer -- we recently moved offices (3 months ago) and my computer set-up changed, and I also write a blog at night, so I am at the computer probably for at least 6-8 hours per day, and now that I have read more about this, I can definitely see that for all that time, I was hunching over the keyboard (and with the laptop on the blog, also looking downwards at the screen.) I've since cut my computer time down to a couple of hours a day and fixed my set-up, but that hasn't given me any relief yet. I'm also wondering if that is really the underlying cause, since the pain has come on so suddenly - I was fine one day and in significant pain the next. My primary care doctor saw me briefly and said it was probably a muscle strain that could be treated with physical therapy (and I am scheduled to start that in a week, with a chiropracter who also provides that service) but I would be grateful for your opinion as well. Simply reading this blog has given me hope that this will get better. Thank you so much...
At Monday, December 28, 2009 9:05:00 PM, Jolie Bookspan, M.Ed, PhD, FAWM said…

For Ms. Kate Morgan Jackson, Start with my replies already here to Reader John about sitting and his neck, then go to Fixing Upper Back and Neck Pain.

From your blog site self-photos, I see you crane your neck considerably doing your photography. No mystery your upper body would hurt from that. After understanding why a forward head hurts the upper back while sitting at your desk using the link above, then check Fourth Group Functional Training Exercise, Functional Upper Back Stretch to see how to look up without pushing the chin forward. As you are a new mother, you may like Mothers Day and New Parents Back and Neck Savers.

No need to cut down on computer time or give up anything you love. No therapy is needed if you use healthy movement for your real life. Use all the links in the posts I have given you until you can fix it all yourself. My books tell more too. Glad my articles have already given you hope, now use them to give you healthy movement changes that fix your pain quickly and easily. You will know if you are doing my methods right when you feel the positive difference right then.

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