Tag Archive for: bulging discs

Tips and Solutions for Morning Back Pain

May 30, 2024/in Movement/by Carrie Jose

One of the most common complaints from chronic back pain sufferers is back pain first thing in the morning.

For some folks, it rears its ugly head on occasion and appears out of nowhere – as if they’ve “thrown their back out”. For others, it’s like Groundhog Day – they go to bed feeling great but wake up every morning feeling stiff and achy.

Why does this happen? Shouldn’t your back feel better after a good night’s sleep?

Back pain impacts people in different ways and at different times of the day. When it comes to morning back pain – while the easiest thing to blame is your mattress – some of the more common causes of morning back pain include poor sleeping position, insufficient exercise, and bulging discs.

Let’s go through each one and talk about tips to help minimize them.

Poor Sleeping Position

The sleeping position that aggravates you is going to depend on the underlying cause of your back pain. Sometimes sleeping on your back with legs elevated is what makes your back feel worse in the morning – even if it feels amazing while you’re in this position. For others, sleeping on their stomach is the thing that wreaks havoc on their spine. The most back-friendly position is to sleep on your side. Side-sleeping allows you to put your spine in a neutral position – which is where you get in the least amount of trouble. It’s really challenging to achieve a neutral spine when you’re on your back or stomach. If it bothers your hips or shoulders to sleep on your side – I recommend placing a pillow under your waist as well as your head – and if needed – also one between your thighs.

Insufficient Exercise

Another common culprit of morning back pain is insufficient exercise. A lack of regular physical activity can lead to weakened muscles and reduced flexibility, both of which can contribute to back pain. When your muscles are not strong enough to support your spine properly, your back is more susceptible to strain and discomfort. Incorporating regular exercise into your routine, especially exercises that strengthen your core and back muscles, can help reduce morning stiffness and pain. Activities such as yoga, Pilates, and even daily stretching can improve muscle tone and flexibility, thereby offering better support to your spine and reducing pain.

Bulging Discs

This is the most common reason I see for morning back pain. Your vertebral disc has three primary functions: 1) to absorb shock; 2) to help hold the vertebrae of your spine together; and 3) they contribute to the mobility in your spine. The interesting thing about vertebral discs is that they are made up primarily of water. Over the course of a normal day – and over the course of life – your discs will compress and decrease their water content. At night, your disc literally re-hydrates and can gain up to 17-25 mm of height.

While this may be beneficial to someone whose arthritis is to blame for their back pain, it is not beneficial for someone suffering from a bulging disc. Remember when I mentioned that your disc is partially responsible for mobility in your spine? When you have a bulging disc – that bulge restricts your mobility. If it fills up with fluid overnight – you’re going to wake up feeling a lot more restricted and in a lot more pain. Unfortunately, there is no quick fix I can reveal for you on this one. The best advice I can give you is that if you’re waking up every morning in a lot of pain and you’re afraid to move – there’s a good chance you’re suffering from bulging discs, and you should see someone who can help you with this.

If you’re waking up every morning with back pain, then hopefully this information helps you have a better understanding as to why it might be happening. Before you consider spending loads of cash on a new mattress – give one or more of these solutions a try and see if it helps. Because the good news is that 80% of the time there is a natural, movement-based solution that can address your back pain successfully. If you’re not having success with eliminating morning back pain on your own – then consider enlisting the help of a physical therapy specialist who is an expert in these kinds of solutions – and who can properly diagnose your back pain.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get a free copy of her guide to back pain – click here.

3 Reasons You’re at Risk of a Herniated Disc

February 28, 2023/in Back Pain, Movement/by Carrie Jose

A herniated disc can occur in any part of our spine. However, we often see it happening in the lower back.

This condition has also been known as a bulging, protruding, or ruptured disc. 80% of people will experience lower back pain at one point in their life – and for some this may be from a herniated disc.

Anyone can develop a herniated disc, but certain factors may increase that risk.

Here are three reasons you might be at a greater risk of developing a herniated disc:

1. You’re sitting For Long Periods

When we sit for too long, the burden of our weight is placed abnormally on our spine. This can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution?

Limit your sitting to half-hour periods. Have a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. If you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. I give this advice to every single client I have who comes to me with back problems. It’s one of the easiest ways for the average person to prevent a debilitating back problem over the long term.

2. You’re bending too much

Did you know that the average person bends or flexes forward between three and five thousand times per day?

That’s a lot of bending over time and eventually something will give – and it tends to be a disc in your lower back. Our spines crave balance, but unfortunately, our modern-day lives are designed to have us bending forward more than we should. Sitting in front of a computer, putting shoes and socks on, driving, house and yard work, even brushing our teeth are all daily activities that involve bending forward in some way.

To combat this, we need to make a concerted effort to extend instead of bend. A really simple exercise you can do every day is to stand and extend your spine. Place your hands on your lower back for support and then arch back as far as you can go. Repeat this 10 times, at least once per day. If you’ve never arched your back like this before, it may feel stiff or even hurt a little at first. But with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days.

3. Your Age

Age is one of the most significant risk factors for developing back problems.

As we age, our muscles naturally weaken, including those in our back. This can make it harder for us to support our spine and maintain good posture.

Making sure that you are maintaining a proper nutritional diet is very important. It will aid in avoiding injuries like a herniated disc. When our bodies are supplied with the vitamins and minerals they need – your bones and supportive structures are supported to work at their best.

As we get older, we may become less active, which can lead to unwanted weight gain and weaker muscles. This can cause a strain on our back and increase the chances of having a herniated disc. It is generally recommended to be active for around 150 minutes per week. Staying mobile and strong will delay the wear and tear on our bodies as we age.

The good news is – the majority of herniated discs can be completely resolved without surgery.

Are you local to Portsmouth, NH and looking to get help with your pain NOW? CLICK HERE to request a Free Discovery Session with one of my Specialists. They’ll ask you all about what’s been going on – and figure out if we would be a good fit to help.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

Tips to Fix Morning Back Pain

January 11, 2022/in Back Pain, Lifestyle, Movement, Physical Therapy/by Carrie Jose

Morning Back Pain? Things you can do.

One of the most common complaints from chronic back pain sufferers is back pain first thing in the morning.

For some folks it rears its ugly head on occasion and appears out of nowhere – as if they’ve thrown their back out. For others it’s like ground-hog-day – they go to bed feeling great but wake up every morning feeling stiff and achy.

Why does this happen? Shouldn’t your back feel better after a good night’s sleep?

Back pain impacts people in different ways. Both the location of your pain as well as the time of day you feel your worst can be indicators of where your back pain is coming from and what’s going on.

Some of the most common causes of morning back pain include:

Poor sleeping position
A crappy mattress
Bulging discs

Let’s go through each one and talk about tips to help morning back pain.

1. Poor sleeping position

The most back-friendly position is to sleep on your side. Side-sleeping allows you to put your spine in a neutral position – which is where you get in the least amount of trouble.

It’s really challenging to achieve a neutral spine when you’re on your back or stomach. If it bothers your hips or shoulders to sleep on your side – I recommend placing a pillow under your waist as well as your head – and if needed – also one between your thighs.

2. A Crappy Mattress

Over the course of my career, I’ve probably been asked at least 1000 times what the best mattress is to sleep on. The answer is “it depends”. Your most important concern should be to find a mattress that you feel comfortable on and that gives you the best night’s sleep. This is different for everyone. Some prefer soft and plush, while others prefer firm and supportive.

But here’s the thing – if you don’t have an underlying back problem then the surface you sleep on will be irrelevant. In most cases, I find that when a mattress aggravates your back, it’s a sign that you’ve got a back problem brewing that needs some attention.

That being said – for those that do suffer from generalized, chronic back pain – a firmer, more supportive mattress is going to be your best bet.

3. Bulging Discs

This is the most common reason I see for morning back pain.

Your vertebral disc has three primary functions:

Absorb shock
Help hold the vertebrae of your spine together
Contribute to the mobility in your spine

The interesting thing about vertebral discs is that they are made up primarily of water.

Over the course of a normal day – and over the course of life – your discs will compress and decrease their water content. At night, your disc literally re-hydrates and can gain up to 17-25 mm of height. While this may be beneficial to someone who’s arthritis is to blame for their back pain, it is not beneficial for someone suffering from a bulging disc.

Remember when I mentioned that your disc is partially responsible for mobility in your spine? When you have a building disc – that bulge restricts your mobility. If it fills up with fluid overnight – you’re going to wake up feeling a lot more restricted and in a lot more pain.

Unfortunately, there is no quick fix I can reveal for you on this one. The best advice I can give you is that if you’re waking up every morning in a lot of pain and you’re afraid to move – there’s a good chance you’re suffering from bulging discs, and you should see someone who can help you with this.

If you’re waking up every morning with back pain…

then hopefully this information helps you have a better understanding as to why it might be happening. Although a crappy mattress could be the reason, I caution you not to default to that. More often than not, there’s an underlying problem in your back that needs to be addressed.

But the good news is that 80% of the time there is a natural, movement-based solution that can address your back pain successfully without relying on pills or procedures.

Are you experiencing back pain and looking to get help without pills or procedures?

Request to talk to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.

Considering Back Surgery? Read this First

December 20, 2020/in Back Pain, Movement as Medicine, Physical Therapy/by Carrie Jose

Approximately 500,000 Americans undergo back surgery to relieve their pain every year, and according to the Agency for Healthcare Research and Quality (AHTQ), this costs approximately $11 billion annually. The worst part — it turns out only 5 percent of these people actually need back surgery. And for many folks — the pain just ends up coming back.

So why are we spending so much money on back surgery when the majority of people don’t actually need it?

First of all, back pain is not fun. It can be excruciating, debilitating, and can have a significant impact on your life and happiness. If you’re told surgery will fix your problem (and it often does take your pain away in the short-term), why wouldn’t you choose this option?

Well, if you knew the facts, you might be willing to hold off on a surgical “quick fix” and investigate options that are less risky. The research shows over and over that 80% of the population suffers from “non-specific low back pain,” meaning, it’s not from something structural like a tumor, broken bone, or deformity. The research also shows that non-specific low back pain does NOT benefit from surgery! The better solution for the majority of back pain sufferers is correctly prescribed movement followed by regular exercise to maintain your strength (especially your core) and postural endurance.

So again, why are we spending so much money on back surgery when the research and data clearly show it’s not the best course of action for the majority of back pain sufferers?

There are a few reasons. First, most of the time we just don’t know any better.

Back pain is typically diagnosed with imaging (X Rays and MRI’s). Although these highly specific tests are critically beneficial after a major trauma or accident, or when you suspect something more serious is going on (like a tumor or broken bone), they are not the best way to diagnose non-specific low back pain. That’s because these tests are designed to show you everything – including all the normal, age-related changes that occur in your spine such as arthritis, degenerative discs, stenosis, and even bulging discs.

The truth is that 60-80% of people walk around with these findings in their spine all the time and have absolutely zero pain.

That means that your back pain is likely coming from something else, typically, a bad movement pattern or habit. Poor posture and movement habits can exacerbate a bulging disc or stenosis, and this is where the confusion comes in. Surgically “fixing” your bulging disc or stenosis will not correct your poor habits. That’s why so many people suffering from back pain get surgery only to find their pain comes back several months or years later. What you need to do is find the true cause of your low back pain and attempt to address that first before ever considering something like surgery.

The second reason back surgery is so common and over-prescribed is because it does a great job at taking pain away quickly where conservative therapy often fails. Conservative therapy really can help you get rid of back pain and keep it gone – but it has to be done correctly. And sadly, there are many well-meaning therapists, trainers, and movement professionals out there that lack the expert knowledge to get it right. If you don’t get the correct conservative treatment for your back pain, you’ll assume it didn’t work, and will be more apt to get surgery.

So how do you know you’re getting correct and effective conservative treatment? Quite simply, it will work, and fairly quickly!

Remember, 80% of all low back pain responds to the right conservative treatment. You’ll notice obvious improvement in your back pain within 2 weeks. If you fall into the 20% where conservative treatment doesn’t work as well, it will be pretty obvious to a back pain expert almost immediately. In our office, for example, we have special movement screens and tests that we perform on everyone to determine if you’re in the 80% or the 20%. If you fall into the 20%, we know right away and can send you to your doctor, or a surgeon, for one of those highly specific tests to see what’s really going on.

The take home point is this: If you currently suffer from on and off back pain, have tried every treatment you can think of, and are just tired of it because it really hurts – I completely understand why back surgery would be an attractive option for you right now.

But please consider the facts and research first before you make the decision to go under the knife. Back surgery has its risks, and there is no going back from the unimaginable happening. If you have back pain that you’re ready to solve for good — sign up for a FREE 30 minute Discovery Session with one of our specialists today!

Neck Pain During Crunches? Here’s Why & How to Avoid it

October 11, 2020/in Neck and Shoulder Pain, Pilates/by Carrie Jose

Abdominal crunches are one of the most popular “ab exercises” around. It’s a movement that emphasizes upper abdominal strength. You start by lying on your back, typically with your hands behind your head and knees bent. You then lift your head and chest off the floor, “crunching” your upper body into a C-shaped curve.

Over the years, many “experts” have dismissed this exercise, claiming it’s ineffective for core strengthening. While I agree that it shouldn’t be the ONLY core exercise you do — the crunch does have its place. I work on this a lot with my private clients, because it’s a functional move that when done correctly, will help you sit up from the floor with more ease and with less risk of injury. And of course you see variations on this movement all the time in Pilates, which is a key part of our practice and our efforts to help people recover from back pain.

I often hear that people don’t like crunches because they’re uncomfortable or hurt your neck. But when you’re doing a crunch, you want to make sure you’re feeling it in your abs… NOT in your our neck. Here are the biggest problems I see with crunches and how to tell if it’s a technique problem or a neck problem:

You’re not actually using your abs

This sounds pretty obvious, right? But a lot of people have trouble figuring this out. During our Pilates 101 class this week, one woman experiencing neck pain appeared to be doing the move correctly — but she couldn’t feel it in her abs, only in her neck.

It’s because she was using her neck and chest muscles to curl her upper body into the crunch instead of initiating the move from her belly (abs). My tips to correct this were to pull her lower belly in toward her spine and the front of her ribs down toward her belly button. Then, keeping this shape locked in, use her breath (exhale) to help her initiate and start the curl from her abs.

Sometimes people don’t have the abdominal strength yet to perform a crunch from lying flat. If that’s the case, you won’t be able to do this correctly no matter how well you follow my cues. If you think that’s your problem, place a small pillow under the back of your head. This gives you a head start into the curl. Once your abdominals get stronger, you can try doing the crunch with your head starting from the floor again.

Your neck is in the wrong position

When you’re doing a crunch, you want your neck to be slightly curled (chin toward chest). Most people either curl their neck too much, or not enough. If your chin is touching your chest, you’re curled too much. And if you feel your chin and neck jutting forward toward the ceiling, you’re not curled enough. Either of these positions could lead to neck problems down the line if not corrected.

The ideal position for your neck is to begin with a slight nod of the chin (like you’re nodding “yes”) and then keep it there. The rest of the curling motion will come from contracting your trunk and abs. As you curl up, I recommend keeping your eyes focused on your belly and keeping a tennis ball’s distance between your chin and your chest.

Sometimes your hand and arm position can be what causes your neck to be in the wrong place. If your hands are behind your head, be sure you’re not using them to pull your neck forward. Your head should be gently pressing into your hands and your elbows should be at a 45 degree angle from your body. Your abs do the rest.

You have an underlying neck problem

In our practice, we specialize in neck and back pain. When you’ve got an underlying neck problem, doing crunches isn’t a good idea until the underlying problem is resolved.

Let’s say you have a small bulging disc in your neck that you weren’t aware of or that you thought was fixed. The curled position of your neck during a crunch can exacerbate this problem, even if you are using your abs correctly and following every tip I just mentioned above.

Some clues that you might have an underlying neck problem could be pain that shoots into your shoulder blade or numbness and tingling down your arm. You might experience these symptoms during the movement, or even up to several hours after.

Either way, symptoms like this could be a sign that there is more to your neck pain than simply incorrect crunch-technique or weakness in your abs.

If this is happening, it’s a good idea to get it checked out by a movement/mechanical specialist like the physical therapists in our practice. The good news is that we can help your neck feel better even if you do have a problem like bulging discs — and you can get back to doing crunches again without any neck pain.

You can also check out our FREE guide to neck and shoulder pain right here!

It comes right to your email inbox and explores seven easy ways (plus a bonus section!) that are PROVEN to help you ease neck and shoulder pain quickly – without pain medication, procedures, or surgery.

If you have any additional questions or want a more personalized assessment, sign up for a FREE Discovery Session with us! It’s a quick, no-obligations opportunity for you to see if working with us could be the best decision for your health.