[quote]acidhell wrote:
I was advised to go under the knife in the future (microdiscectomy) but i refused of course. ( after all the research i ve read on pubmed, i conclude surgery is definately not a good option esp. in my case).[/quote]
First I want to say I ditto just about everything Bushy has said.
Regarding microdiscectomy studies, I found only two good ones when I looked 5 years ago. Results showed that surgery patients achieved a certain level of pain relief a bit sooner than than controls. Also slightly higher percentage of surgery patients achieved “complete” pain relief. Furthermore, the treatment protocols followed by the control group were NOT leading edge. To me it was a no-brainer to skip this surgery. At the same time, a friend with a severe herniation and causing sciatica and leg weakness, who was told she HAD to have the surgery, decided to skip it and is now doing fine.
You asked a couple questions about the cause of the pain. Some disc injuries cause pain; some don’t. You can’t tell by looking at the structure what pain the patient will feel. Acutely, I believe a lot of pain is caused by the compensations like muscle spasms. (For me the muscle spasms were impossible to reduce, though if I were in the same position now I’d ask my doctor for stronger pain meds and I’d take more of them.) Chronically, pain is caused by more long-term compensations and also pain sensitization. Psychosocial factors are associated with chronic back pain, but I haven’t seen research that shows a causal role or how that would work. Mental stress definitely ramps up the pain, probably by increasing overall muscle tension.
[quote]
I ve researched the stuff, and i believe most of the back pain is related to hypertonicity and or inhibition of certain muscles (your brain cant recruit them properly).[/quote]
I had these same issues.
Hypertonicity following spinal injury is not fixed by stretching. If you do convince the muscle to lengthen/relax temporarily through some sort of isolated static stretch, the CNS will roar “No way” a few hours later and lock it down harder.
Instead – do soft tissue work. I did a lot of self trigger point therapy following the book by Claire Davies (also recommended elsewhere in the thread). Addressing some trigger points in the QL was all but miraculous.
For inhibited muscles, I recommend 1) the exercises in Stuart McGill’s book; 2) some of the moves in the Maximum Mobility DVD; and 3) Pete Egoscue’s book Pain Free.
Also, overall activity that doesn’t put too much stress on the spine helps convince the CNS to work these things out. I did a lot of walking, but I’m not surprised that sprinting is really helpful. Anything where your spine has to be stabilized and where there’s no danger of compression+flexion.
However, you must also stop any lifting activity that exacerbate the injury. Otherwise, believe me, it can and will get a lot worse. Stuart McGill’s book shows some exercises to avoid. Some of them are no great loss to your program, but others, particularly all the great leg ones, probably need to be modified in form and loading. When you have pain/hypertonicity/inhibition, I believe that you shouldn’t do them at all until there’s some healing and those issues are fixed. This is because compression+flexion causes disc injuries, and particularly when some muscles are inhibited and others are hypertonic, even with the most careful attention to form, your lumbar spine can for a split second flex, too fast for you to notice but enough to keep causing trauma to the disc. And to even more discs.