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Sports Medicine

Back problems

08/30/2006

Question:

I am 25 years old, and I have had back problems since high school.

I finally had an MRI and received my official results. The test showed that I have 2 bulging discs and one herniated disc that is compressing a nerve root. Also, my doctor said that the herniated disc apparently is dry and should contain more liquid, which he said was early sign of disc degeneration.

I had been running prior to this last time my back acted up. Every once in awhile, the pain will go down into my hip and leg. I want to stay physically healthy, but my back is preventing me from doing so.

Unfortunately, my insurance will not cover any physical therapy right now. I realize that I need to have this done, but in the mean time, what kinds of stretches or exercises can I do to help my back? Would low impact exercises help? Any suggestions you can give me would be helpful. Thank you.

Answer:

It is surprising if your insurance company paid for an MRI scan for diagnosis, but will not pay for a frequently recommended treatment such as Physical Therapy. In addition to a therapeutic exercise program, usually a number of different types of treatment interventions are used together for maximum benefit, including several different medication categories, manual therapies such as therapeutic/medical massage, possibly a back brace, and possibly spinal injections.

Stretching exercises may be helpful if tightness is present. Strengthening exercises may be helpful if weakness is present. Exercise programs for low back pain often begin with a person identifying the "neutral" position of their lumbar spine, then performing progressively more difficult trunk stabilization or "core" strengthening exercises to improve the person's ability to dynamically maintain this neutral spine position. Leg pain in particular must be avoided/minimized. A general conditioning program is also important to help improve stamina, reduce or control body weight, and improve mood... this may or may not need to be low impact, depending on how symptoms respond to a particular aerobic exercise program.

Ideally, you'd be evaluated by a Physical Therapist, who could help design a rehabilitation exercise program specific for your needs

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University