It is believed that a herniated disc is one of the causes of lower back pain. Is this really true? Experience shows that this is not always the case.
An article about how a herniated disc is often not the source of pain in the lumbar spine.
Lower back pain is one of the most common phenomena among adults. At the same time, lower back pain occurs most often in people of working age (from 30 to 50 years).
Official medicine considers intervertebral hernia to be one of the causes of lower back pain. The way the herniated disc itself is described in textbooks really looks like a terrible thing and can involuntarily scare a person.
Let’s take a look at the statistics a little. It will give us an idea of how things are with such a “beast” as a herniated disc.
Here, Incidence Rates: The incidence of herniated discs is estimated to be between 5 to 20 cases per 1,000 adults annually. This condition is most commonly observed in individuals aged between their third and fifth decades of life, with a male-to-female ratio of approximately 2:1. (this is according to the source: https://www.physio-pedia.com/Disc_Herniation).
And here’s more: Surgical Interventions: In terms of surgical treatment, over 200,000 surgeries for lumbar disc herniation are performed annually in the United States, highlighting the condition’s impact on healthcare systems. (this is according to the source: https://www.caraccidentherniateddisc.com/statistics).
Here’s how it affects the population’s ability to work.
Low back pain caused by a herniated disc has a significant impact on disability and quality of life in the United States. Here are some key statistics:
– Disability: Back pain, including that caused by a herniated disc, is the second leading cause of temporary disability. In the United States, up to 15% of all disability each year is due to back pain.
– Loss of workdays: Research suggests that 90 million workdays were lost in the UK in 1999 due to back pain, highlighting the scale of the problem. We believe that specific data for the United States may show similar trends and rates. (taken from sources: https://consilium.orscience.ru/2075-1753/article/view/92721/ru_RU ).
Not much fun, is it?
Let’s take a look at how official medicine presents the processes that cause pain with a herniated disc.
Here are the main mechanisms that cause pain with a herniated disc:
1. Compression of nerve roots
A herniation is a protrusion of the disc beyond its normal boundaries. If it presses on the spinal nerve roots (most often the sciatic nerve), pain occurs that radiates to the lower back, buttock, thigh, leg.
2. Inflammation and swelling
The damaged disc releases inflammatory mediators that cause irritation and swelling of the nerve tissue, increasing the pain syndrome.
3. Reflex muscle spasm
In response to nerve irritation, the muscles of the lower back can reflexively contract, causing tension and chronic pain.
Here are some of my own observations.
- With compression of the roots, not everything is so clear. A disc herniation rarely compresses the roots, moreover, the compression of the roots by a herniation itself does not cause pain, but causes the so-called symptoms of “loss”: the disappearance of the sensory or motor functions of the roots (this can be seen during an external examination, and also partially confirmed using electroneuromyography). Compression of the root or trunk of the nerve usually causes paresthesia (unclear sensations in the innervation zone of the compressed root or nerve trunk). For example, with compression, say, of the left lumbar root L4 leads to the following: sensitivity decreases, numbness appears in the front of the thigh and knee with a transition to the inner surface of the shin and foot. That is, if there is a case of obvious compression of the root (say, the same lumbar L4), then during the examination a specific area of decreased sensitivity on the leg will be clearly defined. Often this rarely happens in practice. But radiating (giving off) pain along the leg is quite common.
- Inflammation and swelling. This may well happen, but only in such advanced cases as “sequestered disc herniation”, that is, when a fragment of the disc herniation breaks off and because of this, this fragment is perceived by the immune system as a foreign substance. But most often, the disc herniation simply protrudes into the spinal canal and does not even affect the nerve roots (which come out of the spinal cord).
- Reflex muscle spasm. It must be admitted that muscle spasm does occur. But here I, as the author of the article, will allow myself the boldness to state that muscle spasm does not arise from irritation of compressed roots, but from the muscles themselves (sick muscles: muscles can also hurt and, unfortunately, they hurt not so rarely).
I think that the overwhelming majority of cases of lower back pain are well explained by the views set forth by medical scientists Janet Travell and David Simons, who studied the role of muscle-fascial trigger points in the occurrence of pain, including lower back pain. They proved that the cause of chronic back pain is often not only spinal damage (hernias, osteochondrosis), but also tense muscles.
How do muscles cause lower back pain?
- Trigger points
These are areas of tense muscle fibers that remain in a spasmodic state.
They can cause local and referred pain (for example, lower back pain radiating to the buttock or thigh). - Chronic muscle tension
Long periods of sitting, stress, and poor posture lead to overstraining of the lower back muscles (for example, the quadratus lumborum, lumbar, and gluteal muscles). - Radiation of pain
Trigger points in the lumbar, iliopsoas, quadratus, and gluteal muscles can mimic the symptoms of radiculitis or a hernia. - Impaired circulation
Spasmed muscles compress blood vessels, impairing blood flow and causing pain, fatigue, and stiffness.
According to Travell and Simons, muscle trigger points are an important cause of chronic lower back pain. (taken from: Janet Travell and David Simons’ book “Myofascial Pain and Dysfunction: The Trigger Point Manual”, 1992).
A small conclusion: I`d like you, my dear reader, to change your thinking and look at the problem of “low back pain due to a herniated disc” differently. In short, try to treat your sore lower back muscles!
Be healthy!
