The Bulging Disc and Back Pain...

The Bulging Disc and Back Pain…

Linda came to the office with her MRI report in hand. The report revealed minimal disc bulges in her lower back from lumbar 2 to lumbar 5, and degenerative bony ridges from lumbar 5 into sacral 1. 

The good news was that she did not require surgery or have a more serious condition like a herniation of the discs or spinal stenosis (a narrowing of the spinal cord). The bad news was that she was in constant pain and had a limited range of motion throughout her lower back.  

Linda had been suffering with right-sided back pain for the past fourteen months. She experienced daily pain varying anywhere from a dull ache to sharp and shooting pain. Linda had to limit any bending or twisting, and had even giving up exercising on her stationary bike because of the pain. 

The doctor had prescribed anti-inflammatory drugs and muscular relaxants along with physical therapy. The physical therapy had helped reduce the stiffness in her low back, but did not help with her pain levels.  

Linda wanted to be able to stop taking her anti-inflammatories and her pain medications as she felt they were affecting her health adversely. But without a  solution, she was still in too much pain and discomfort to stop.

Intake

During our intake, Linda was anxious and concerned that she would suffer from stiffness, pain, and limited range of motion in her lower back for the rest of her life.  Linda was a 42-year-old single mother with an 11-year-old son to support. She had endured a contentious divorce several years back and had been given sole custody of her son, which left very little time for self-care or exercise. 

Linda was forced to juggle childcare with her busy work schedule. She had no support system from her family for backup childcare, and she was tense and exhausted most evenings. Her job in finance required long periods of time sitting at the computer as well as a 45-minute commute on the train to and from work in the city three days a week. 

I noticed as we spoke that she had forwardly rolled shoulders with a forward head alignment, which compromised the health of her lower back. The weight of her rounded shoulder and forward head placed her lower back in an over-stretched position creating stress on her muscular skeletal structure, particularly in the lumbar spine. This set the stage for the beginning of her disc issues.

How did the Back Pain Begin?

Linda believed that the heavy computer she carried back and forth to work was the culprit that led up to the painful episode fourteen months earlier. She worked from home in the suburbs two days a week, requiring her to lug her large work computer back and forth from the city on a weekly basis. 

One morning, preparing to leave for the office, she twisted her torso when lifting her heavy computer and noticed a painful twinge in the right side of her lower back. The pain persisted throughout the day and by that evening she was unable to sleep because of the stabbing pain in her lower back. The rest is history.

What is a Bulging Disc?

A bulging disc occurs in the spinal cord, most often in the lumbar spine (the lower back). These discs are composed of soft, gelatinous material inside, surrounded by tough cartilage on the outside. The discs serve as a cushion for the vertebra of the spine. A bulge occurs when a disc shifts out of its normal radius. It is usually the tough outer layer of cartilage that gets displaced or flattened down. 

A herniated disc tends to be a more serious condition. This occurs when there is a crack in the tough outer layer of the cartilage of the disc, allowing the soft inner gelatinous material to protrude out of the disc. Bulging or herniated discs both can cause pain and dysfunction in the muscular skeletal system if there is compression of the nerve.

Homework

We had to get to the root cause of Linda’s pain. The lack of daily exercise and poor alignment had lead to a weakening of the spinal ligaments and joints and predispositioned her to disc problems.

First, her alignment needed to be addressed and improved upon. We discussed proper neck, shoulder, and hip position when sitting and standing. It became very important to bring proper alignment into her work place as she sat at her computer, and equally important to carry and lift her computer and any other heavy objects with good form. 

She eagerly bought an ergonomically engineered office chair for her home,

started taking stretching breaks during her workdays at the computer, and started daily exercise. She was given core exercises to strengthen her back and abdominals. She also began cycling on her home exercise bike again, at first for only ten minutes at a low resistance and then increased the intensity, duration, and frequency as she became stronger. 

She found that if she did her back exercises in the morning and evening and used her bike several days a week, the pain in her lower back lessened significantly. Linda also found the “MELT” method -- using a soft foam roller to relax her tight spinal muscles -- was very useful in her recovery.

Chinese Diagnosis

I diagnosed Linda with chronic “stagnation of qi and blood.” This is characterized by a severe, stabbing pain that becomes worse with inactivity and better with light exercise. She found that sitting, standing, or lying down for extended periods of time made the pain worse. The affected area was tender to the touch and there was also marked rigidity and stiffness of the back muscles and an inability to flex, extend, or rotate at the waist. 

The Treatment

We began acupuncture treatments once a week for twelve weeks, and then every other week for four more weeks until Linda was pain free. Afterwards she came in for maintenance treatments every six to eight weeks.

I placed acupuncture points locally to increase blood circulation, reduce inflammation, and decrease muscle stiffness and tightness. Distal acupuncture points were also used to help move blood and qi throughout the meridian of the spine, starting at the base of the cranium and ending at points near her ankles. Needles were also placed next to the lumbar vertebrae to encourage the disc to heal. 

Moxibustion, an burned herb (mug wart), was used to warm the acupuncture points to further increase blood circulation and relax the tight musculature. Cupping was also utilized to reduce blood stagnation and to relieve the tight muscles and fascia around her lower back -- lessening the pull on the vertebrae and discs. 

At the end of the acupuncture sessions, sometimes tui na (medical massage) was used to help further reduce the tight knotted fascia throughout her spinal muscles. Linda also used a moist heating pad in the evenings for twenty minutes to help relax her tight muscles and to further encourage good circulation and blood flow. 

End Results

Linda was able to stop all pain and anti-inflammatory medication. She is careful about maintaining her core strength, flexibility, and her cardiovascular health. She has learned how to work at her desk with good alignment and take well-deserved stretching breaks throughout her workday. But most importantly, she is now pain free.

Working with Linda was a pleasure as she was highly motivated to incorporate all that she was learned during our treatments into her daily life. She would have struggled with ongoing back pain if she had not taken responsibility for her own health. It takes commitment and discipline to maintain radiant health and Linda has them both. 

2013…Year of the Snake

2013 is the year of the black Snake begins on February 10th shortly after the New moon in Aquarius, the humanitarian of the zodiac. This 2013 year of Snake is meant for steady progress and attention to detail. Focus and discipline will be necessary for you to achieve what you set out to create. The Snake is the sixth sign of the Chinese Zodiac, which consists of 12 Animal Signs. It is the enigmatic, intuitive, introspective, refined and collected of the Animals Signs. Ancient Chinese wisdom says a Snake in the house is a good omen because it means that your family will not starve.

Oh my aching lower back and hip…

Oh my aching lower back and hip…

Back pain can sideline the strongest of us. When an ache becomes a chronic pain, even something as small as a single step can feel like too much. Here is one woman’s story of coming back from the sidelines to recover from a seemingly endless amount of pain, and how acupuncture helped.

Mindy’s Pain

Mindy came to my office after suffering for one year from bursitis in her right hip and referred tightness and soreness in her low back. She had made all the rounds with the medical doctors and had all the tests and procedures needed to diagnose bursitis of the hip. At the end of the day she was told to take over the counter anti-inflammatories and have physical therapy sessions twice weekly. 

Even with the anti-inflammatories and physical therapy, the pain was unbearable. Too much walking, standing, or sitting caused the hip to ache, which then referred into the right side of her back and into her right knee. She had difficulty getting up and down from seated positions. She walked with a limp and could not get comfortable sitting, standing, or lying down. Her sleep was disturbed because her hip pain woke her throughout the night. She had a 24/7 pain cycle that kept her very stressed, anxious, and depressed.

After months of painful physical therapy did nothing to relive the hip and back pain, Mindy’s doctor resorted to injections of cortisone shots into her aching hip. But this proved ineffective as well. Her doctor told her to take her medications daily for the pain and that she should “be happy that she didn’t have arthritis in her hip.” She felt dismissed and discouraged with this “recommendation.”

Why Acupuncture?

Through the entire ordeal Mindy had also been receiving massage therapy. While this helped her relax, it did nothing to relieve the pain. After months, her massage therapist recommended that she try acupuncture for her chronic hip and back pain. And that was how Mindy ended up in such a desperate state at my office. 

The year of pain and suffering had taken its toll on Mindy. She was losing hope in returning to her “normal” life. She was an articulate, youthful 62 years old when we met and she had lived a very active, full life up until the hip and back pain had sidelined her. Happily married with two grown children and two grandchildren, her life was full with family, friends, and travel.  

Before the pain she adored spending time with her young grandchildren that were only a train ride away. Her daughter relied on her to help with the children and up until the chronic pain, Mindy was always up to the task. It frustrated her that she could no longer go to the park with her grandchildren or get down on the floor to play with them -- not to mention that she could not longer walk around NYC without hip and lower back pain. 

Before the pain she often volunteered her time, going to third world countries to participate in building homes and structures in depressed communities. The builds were very physically and mentally demanding, lasting for several weeks at a time, and were impossible for her to even consider with the pain. She had cancelled all her upcoming builds due to her physical problems and this felt like the beginning of a long life of pain, suffering, and inactivity.

As we sat and talked during our initial intake, I noticed that she was sad and lacked confidence that she would ever have the physical ability to live her former full life again. She usually walked three miles up steep hills every weekend with friends, which was a great source of exercise, fun, and social connection for her. But with her hip pain, this was out of the question. The pain was taking away, little by little, all the things in life that were rewarding and brought her pleasure.

The Goal

Mindy had always been a powerhouse, full of life and passion. She constantly was helping and giving back to her family, friends, and communities around the world. Although she had little hope that she would regain her old life, she had some dreams.

She hoped that she would be able to go on a build again, to give back to the communities she so cared about. She hoped to play with her grandchildren with ease, rejoin her friends on the weekends, and start enjoying her normal day-to-day activities again. 

I made no promises or guarantees except that I would do everything in my power to help mend her hip and back. This is when I wished for my magic wand, to wave her back to her former active self.

The Diagnosis

Mindy’s Chinese Medicine diagnosis was “qi and blood stagnation” as well as “cold damp bi” (pain) syndrome. This was an acute condition that had persisted for the past year, now turning her condition into a chronic one -- much tougher to resolve.

Bursitis is a painful condition that affects the small fluid sacs, call bursae, that cushion the surroundings bones, tendons, and muscles around the joint spaces in the body. The bursae reduce friction on the joints during movement and it is when these bursae become inflamed that bursitis occurs. The symptoms are stabbing, shooting pain and stiffness around the effected joint. Movement makes the pain worse. Bursitis in the hip joint is very common and is usually due to overuse or repetitive movement.

This was the case with Mindy. She had been working with a personal trainer for several years and he had recently added a routine of repetitive squats and lunges that had lead up to the bursitis of the hip. She stopped all physical training when she began seeing me, as even the physical therapy was causing more pain.

The Treatment

We began our acupuncture treatments with a focus on reducing her hip inflammation and reducing the muscle spasms in her low back at the sacrum and buttock area on the right side. She came twice weekly for the first month and then when her symptoms lessened, we continued with weekly treatments. As the inflammation became less and less, we added gentle stretching exercises to encourage better range of movement and blood flow to the effected joints. 

After six weeks of treatment, Mindy was able to ride on her stationary bike for twenty minutes at a very low resistance. After three months Mindy was ready to increase her exercise routine. She wanted something more engaging than the stationery bike that bored her to no end. This was when I suggested the mini trampoline.

Bouncing to Health

Before she began the mini trampoline workouts, I scheduled a home session so we could go over proper form and establish a safe workout schedule. Her excitement and motivation to regain her strength and fitness was the force that helped her achieve this goal. After six months of working together she was back with a vengeance. 

Not only was she rebounding on her mini trampoline, but she had also incorporated strength training into her routine. Mindy was a little apprehensive about taking classes at a local Pilates gym, but she went in in spite of her fear. These strength classes have done her a world of good for both her bodily and mental confidence. She now has her muscular strength back as well as her cardiovascular strength -- all without pain. 

This past summer Mindy took part in a build where she endured heavy lifting, lots of walking, and extreme heat -- all without hip or back pain! She is back to “full speed ahead” in her active life, enjoying all her roles as grandmother, wife, world traveler, and woman extraordinaire. 

Mindy continues to amaze me with her interest and zest for life. It’s patients like Mindy that make my work so rewarding. Her spirit, inner strength, and belief in herself made all the difference in her healing.