HOW TO PREVENT LUMBAR DISC BULGES

My primary goal for sharing health tips is to maximize the long healthy life of my patients and other loved ones. I hope you will be youthful, energetic and active into your late 80s and 90s. The number one thing that I wish I had known earlier in life that would have improved my health is understanding how to protect my lumbar spine discs. But it is too late for me, mine are gone, all I can do is share what I have learned the hard way in hopes you will have a healthier life.

My Story of Bulging Lumbar Discs at an Early Age

I destroyed my discs at the young age of 17 and then finished the job at age 34. Many of you know I bulged my discs as a teenager bending over at the waist (not using my legs) 768 times a day during the summer to pick up an irrigation pipe and then walk with it for a number of yards and then run back to pick up another one. Mistake #1, I did this job for too many hours, mistake #2, I didn’t use my legs, I just bent over at the waist and lifted. Then as a 34-year-old I torqued my back at high-speed wake boarding and just kept going because I was having too much fun. Mistake #1, too much rotation to the spine as I cut across the wake, mistake #2, when I did feel my back hurt, I interpreted it as just a pulled muscle, and I told myself it would heal later, so I kept boarding for hours on a newly re-bulged disc. The truth is, most back injuries damage the disc, not just the muscles, I should have stopped before damaging it further. There were other times that hurt the disc as well, like when I helped move a piano with 2 other guys, they were on one end, I was on the other, then we went down some stairs, and I was up top bent over. Mistake #1 Never move something heavy without PLENTY of help, I should have insisted we not move it without 6 guys there at least, it’s just not worth it. Mistake #2 again being in a poor lifting position due to the stairs.

Once the discs were bulged at age 17 and then ruptured when I was 34, the disc collapsed, and I lost the shock absorbing material that keeps the vertebrae from banging together and keeps them separated so there is room for the nerves to come out from the spinal cord. I even lost 2 inches of height. It was very painful and made it hard to sleep for a year, I gave up running, and many sports I loved. Then 20 years of bone on bone resulted in bone spurs (spinal stenosis) that began to squeeze the nerves that go down my leg (sciatica) and even the spinal cord. I had to have a surgery. Usually, people live to their 80s before needing this kind of surgery, but I damaged my discs at such an early age. Now my back will never be the same and it will be a handicap of sorts for the rest of my life, dictating what I can safely do and not do.

The Image below to the left is my x-ray before disc replacement surgery. Notice the red arrows pointing to the intervertebral foreman (the holes where my nerve roots come out.) Compare the top to the bottom three, especially the bottom one. Then the blue arrows pointing to the disc height. Compare the top to the bottom three.

Image to the right is the CT scan of my 3-disc replacements, made of Titanium and plastic. Yes, they are mobile, but they have no cushion. I am better off now, but nowhere near what I would be if I had taken better care of my spine. Let this be a cautionary tale.

How To Keep Your Discs Healthy Throughout Life

1. Don’t lift very heavy objects without help. Yes, you are strong enough to lift VERY heavy things…I am not as worried about you hurting your muscles, I am more concerned with hurting the disc between your vertebrae which can be injured regardless of your brute muscular strength.
2. Use proper lifting techniques, such as using legs rather than using the back. Keep a neutral curve in your back and avoid twisting as you lift.
3. Don’t jump off of things jamming your spine, such as off the roof or out of the back of a truck. Just get down the slow, careful, boring way and prolong the life of your discs so you can use them doing things far more fun than jumping out of a truck.
4. When sitting for long periods, use lumbar support, don’t slouch. Slouching puts a prolonged tug on the posterior aspects of the discs, the very parts that tear when a disc bulges. Often it isn’t one heavy lift that bulges a disc, but years of strain.
5. When sitting for long periods take breaks to stretch and lay down for a few minutes.
6. When sitting for long periods, use a fabulous cushion to sit on (like the one I use at my office made by the purple bed company. I have them for patients for $120 if you want one. These reduce the compression on your shock absorbers (lumbar discs). Just come try one, you won’t believe how much pressure they take off your back.
7. Build the core muscles. Core muscles are the tiny deep muscles that support the spine, such as the multifidus, and the transverse abdominus. Most of these muscles are too deep to see or touch. Core muscle strength helps stabilize the back when you do lift and prevents the spine from being torqued. Building the core doesn’t tend to be a good treatment for an acute disc bulge but it is a fabulous prevention and important to build after a disc has healed.
8. Keep key muscles flexible, such as the hamstrings, quads and low back muscles.
9. Don’t smoke. Smoking reduces blood flow to the spinal discs, which results in the discs degenerating prematurely.
10. Maintain a healthy body weight. If we are heavy, it loads the discs excessively and wears them out sooner. Also, excessive weight tends to be up front and shifts the center of gravity so that there is unbalanced load through the spine.
11. Even good footwear and possibly orthotics can help. If you have good support through your feet, it will translate to your back.
12. If you have a true anatomical leg length difference (one is over 6 mm longer than the other, which is true for 7% of the population), maintain a shoe build up or heel lift to not only protect your hip, and pelvis, but also reduce the torque on the spinal intervertebral discs.