Various back questions

by Ola Löfberg
(Sweden)

Hello, I've read your "Back sufferers' bible" and come up with a couple of questions:

1. I understand that spinal rolling can be good for stiff sements, but why do you recommend that (or any mobilizing) as a treatment for segmental instability? Wouldn't that just make the segment more instable?
(I'm cautionously suspecting that what I got as a 5-years-post-disc-prolapse, from information I've gathered)

2. How do I begin with spinalrolling when my lower back is like a rod? (It's like rolling a cube)

3. Can a delaminated disc relaminate given time and good treatment? I know my MR shows my, originally big, prolapse, now quite back as it were (with the exception of dehydration an slight less height)

4. To get back to proper sitting: should you train little by little, although you feel discomfort and musclespasm starts to set in after 10min, OR should you avoid sitting as much as possible until you are so good so you can do 25min directly?

Comments for Various back questions

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Jun 22, 2013
 Question answered
by: Sarah says

Dear Olaf

1. Re decompressing an unstable segment: Good question and you are also probably right in that your prolapse at an earlier date can lead to instability. This happens because the disc literally loses its stuffing and the pressure can drop by up to 45%. However, it is important to get the segment moving for two reasons. Firstly, you want a little bit more fluid in the disc, if you can get it, because a bit more fluid makes all the difference in terms of pressure. Secondly, getting it moving again activates, or should I say, requires the control, of the deep spinal muscles, multifidus. Even if the disc does not regenerate, having control of it makes you much more comfortable because it allows the long spinal extenses to switch off and this means that your back doesn't feel stiff as a board from the base to the top.

2. RE spinal rolling being hard: You just have to start! You can do preparatory rocking the knees to your chest and this helps break up the brittleness but more effective will be learning to walk down your legs to bend forward and making your back bend. This too activates multifidus in the most important and essential way and just as important will be trying to incorporate this into your daily routine. The bending will provide muscle cover over the weak link.

3. I am not sure what you mean by delamination. But the outer 1-3 mm of the disc (the outer annulus) has a blood supply and a nerve supply, and as such, has excellent self-healing qualities. The runaway disc nucleus reabsorbs over time (you say yours has) and the outer layers of the annulus fibrosis can mend over any radial split and this will protect sensitive outer layers from any pressure from within. Then, your job is to get the outer layers that are sensitive more compliant and you can do this by performing the modest three step pressure change therapy [BackBlock regime]. You can download the academic papers on this (co-written by me, Adams and Stefanakis) on the latest post in 'What's New' on www.simplebackpain.com about this very thing. The subject is 'disc healing'.

4. Little by little get used to sitting again but make sure you read everything I have written about it on www.simplebackpain.com and make sure that you have a pillow stuffed into the small of your back to help maintain the lumbar inward curve while you are completely relaxed.

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