by David Wadsworth
In post 1 we talked about the anatomy of the discs, their nerve and blood supply (or lack thereof) and what types of injuries may occur to a disc. We also looked at how discs heal, and how long this takes – at least 6 months! In this post we’ll consider how to get your disc injury to heal as fast as is physiologically possible.
The original research on this topic was done in the 1970’s and has stood the test of time. Different postures, movements and lifting all increase the pressure inside the lumbar discs, which if repeated or excessive can gradually cause wear and tear damage (annular tears and structural weakening) of your discs, or prevent your injured disc from healing.
The diagram below shows the effect of different postures (with 100% being normalised to the load on your disc when standing upright with good posture). Lying down (where there is no vertical compression) maximally unloads the pressure on the discs, whereas sitting, especially slouch sitting, maximally loads the discs (approx. 150-300% load compared to standing!).
This has huge implications for anyone with disc pathology. First of all, it should now be obvious why driving to and from work and sitting all day for years on end causes discs to wear out prematurely!
If you have a painful disc, we discussed in post 1 how the disc heals by growing fragile capillaries that are easily torn in the first 4 weeks. Scar tissue slowly forms to heal the outer 1-2mm of the disc, and this takes about 6 months to become reasonably robust. It will never again attain the strength of a normal uninjured disc. Disc pain typically takes 2-6 months, and sometimes up to 12 months to settle down even if the healing hasn’t finished yet. So how do you unload the disc in the initial 6 month period to help it heal as fast as it can?
There are 3 key components to helping an injured disc heal:
How do you change your posture and movement patterns to unload a disc?
Lastly, TIME is a key component for disc healing. Be patient, do your rehab and follow the “disc precautions” listed above in terms of posture, movement patterns and lifting and things will usually improve slowly but surely. If they don’t DO talk to your physiotherapist.