It doesn’t happen overnight. You have exhausted your Google searches and You Tube videos and now the over the counter have stopped working. The pain gradually gets worse until you can’t ignore it anymore. You need to do something about the pain in your back that is now radiating down your leg (or maybe it is numbness, or even tingling, either way it is NOT normal). You see your PCP, then off to an ortho who recommends a discectomy. You are now thinking “What is a discectomy?!?”

Before we dive into what a discectomy is, let’s start with the disc. Discs are 80% water with a gelatinous center surrounded by a very tough outer layers of crisscrossing fibers, much like a steal belted radial tire. Functionally the disc is a spacer between each vertebrae (back bone) to act as a shock absorber and because of its height, creates a space for the nerves as they exit the spine into the body. This complex system allows us to protect the nerves while at the same time giving us flexibility to move around. One of the reasons discs become problems are because of posture. Remember, they are 80% water, therefore are subject to the laws of fluid dynamics. Fluid dynamics dictate fluids go from high pressure to low pressure and path of least resistance. The disc is 80% water meaning that if you were to bend forward and stay there for a really long time, there would be more pressure at the front of the disc than the back. The disc glides backward but hits a tough ligament and has to choose to go left or right. When it does this it takes up the same space as the nerves living there, often pressing on them. A discectomy is when the surgeon trims the bulge and removes it from the space for the nerves. This takes the pressure off of the nerves allowing them to function normally and not be as irritated/painful/numb/tingly. However you will still have some postsurgical swelling so you may still have some lingering symptoms afterward until that swelling has resolved. The other issue is that nerves are primadonnas, meaning everything has to be perfect otherwise I don’t want to work. I nerves love their nice round shape in order for them to work properly. So depending on how long your nerve has been pinched will determine how quickly and how well it bounces back to its nice round shape. Case in point would be a garden hose going across the driveway. Turn the water on water flows nicely out the other end but then you come along and you park your car over top of it and floated down to a trickle. Same thing with the nerves part something on top of it and it’s going to get a little grumpy. If you move the car the next day then the hose bounces back to a nice round shape and water started flowing again. However if you move that car two years later and the hose stays in a cramped position then you’re still going to get a trickle even though there is no weight on it. This means the sooner you take care of your pain/numb/tingling, the better your recovery will be. Now, like I mentioned before, a lot of these problems are caused from prolonged bad posture over the course of many years. This is where physical therapy has value and can intervene to help give you the core strength that you need in order to maintain a healthy spine and reduce your need for surgery.

If the above situation describes you, do not suffer in silence! I will be having a free zoom presentation on low back pain and sciatica on Saturday, June 13, 2012 at 10 AM. Email me at charles@dudleypt.com for more information about getting your back pain sciatica cured without pills injections or surgery.

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