What You Can Do About It

The aims of self-treatment for segmental instability

The immediate aim when treating acute instability is to dampen the inflammation of the weak link so the nerve settles down. Initially, this involves relaxing the muscle spasm to let the pressure off the segment and allow a better circulation to pass through. Treatment in this phase is exactly the same as for the acute disc prolapse, with an emphasis on rocking the knees to the chest to open the back of the spine, which also starts introducing pressure changes through the flattened disc. It is then important to establish better movement patterns as soon as possible, so the spine does not keep skidding on the flaccid disc. Reverse curl ups start to strengthen the tummy and help switch off the long back muscles.

As soon as the pain is on the move, it is important to start treating the back 'normally' so the intrinsic muscles play a more active role knitting the loose link together. The natural ebb and flow of movement also helps pump the congestion away and stimulates proteoglycans manufacture within the sick disc. Toe-touching exercises should start as soon as possible so the spine gets accustomed to bending with segmental control, and together with squatting and the BackBlock they help puff up the disc to make it more tense. Encouraging the flattened disc to imbibe fluid not only takes pressure off the walls but gives the intrinsic muscles a better angle of pull to stabilise the segment. However, toe touching works the back hard when it is still quite reactive, and you need to do a lot of spinal rolling to break up the stiff soreness caused by this.

In the final stages of rehabilitation, the emphasis is on spinal strengthening so the weak link does not keep re-inflaming. This is done with horizontal intrinsic exercises off the end of a table. However, the muscular compression of the energetic unfurling action jams the segments together and can make the low back sore again. For this reason, the main intrinsic exercises should only be done once every week to ten days, although it is necessary to continue spinal rolling, rocking the knees and using the BackBlock, to disperse treatment soreness.

Beware! People with spinal instability problems often keep their back sore by doing too many spinal intrinsic exercises (both horizontal and vertical) too frequently and not doing enough 'appeasing' exercise afterwards (knees rocking and spinal rolling). In this regard, lazier patients often do better!

A typical self-treatment for acute instability

Purpose:

Relieve muscle spasm to relieve compression on disc, disperse inflammation of weak link, gap open the spinal segments to introduce pressure changes, strengthen tummy and switch off over-active erector spinae.

REPEAT BOTH EXERCISES 3 TIMES

Medication. Rest in bed. Repeat exercises every 2 hours. See Chapter 7 for information about bed rest and the purpose of these exercises and the correct way to do them.

For how long? Until acute leg pain has gone.

A typical self-treatment for sub-acute instability

Relieve muscle spasm to relieve compression on disc, disperse inflammation of weak link, gap open the spinal segments to introduce pressure changes, strengthen tummy and switch off over-active erector spinae, break up spinal impaction from muscle spasm, reestablish intrinsic muscles' segmental control, and decompress spine to promote disc regeneration.

Rocking knees to the chest

(60 seconds)

Reverse curl ups

(five excursions)

Purpose:

Rocking knees to the chest (60 seconds)

Reverse curl ups

(15 excursions)

Rolling along the spine

(30 seconds)

REPEAT THE THREE EXERCISES 3 TIMES

Segmental bridging

(up and down 2 times)

The BackBlock routine Step 1

Step 2 (30 sees) Stej reverse

(30 secs) Step 3 reverse curl ups X 15)

reverse

Squatting

(30 seconds)

REPEAT FINAL THREE EXERCISES TWICE

Repeat regimen every evening. If the leg pain returns, revert to acute regimen for several days, or until it ceases.

For how long? Until intermittent leg pain has completely gone.

A typical self-treatment for chronic instability

Relieve muscle spasm to relieve compression on disc, disperse inflammation of weak link, gap open the spinal segments to introduce pressure changes, strengthen tummy and switch off over-active erector spinae, break up spinal impaction from muscle spasm, decompress spine to promote disc regeneration, and re-establish intrinsic muscles' segmental control.

Purpose:

Reverse curl ups

(15 excursions)

Rocking knees to the chest

(60 seconds)

Rolling along the spine

(for 30 seconds)

BackBlock routine Step 1(60 sees)

Step 2(30 sees) S15 times)

Squatting ^

REPEAT ALL FIVE EXERCISES 3 TIMES

If you do not have leg pain do the following exercises ONCE per week/10 days

Repeat regimen three times per week, except for the intrinsics exercises which should only be done once per week to ten days. Expect the back to feel worse after intrinsics exercises but if it remains so for more than a couple of days, cut down to one session every two to three weeks.

Spinal intrinsics strengthening

(5-10 excursions)

If you do not have leg pain do the following exercises ONCE per week/10 days

Rolling along the spine

(30 seconds)

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