Bulging disc and sciatica

[KnottedYet]

A herniation (which is a bulge) can be pushed back into place.

A rupture (torn annulus) cannot. A rupture with fragmentation is a surgical candidate. A rupture with leakage is painful as all heck because the disc goo is caustic. Those leaking discs are obvious to the clinician, and they also respond mechanically. If you move one way, it leaks more. If you move another way, the tear is pinched shut and the leak stops.

Folks with tears don't have much fun because they have to spend about 3 days pretty much in one position (the one that pinches the tear shut). It's not a matter of just repeating a motion over and over agan, it's more like holding a cut shut and waiting for it to clot. They have to take 3 days off work and have help at home for 3 days.

Flexion is not inherently bad. McKenzie MDT uses flexion all the time. Some bulges require some flexion to go back into place. (anteriors and often laterals) Some posterior bulges with lateral components get WORSE with any extension. There are no blanket rules because every herniation is unique and the forces every person's body experience are unique.

After the derangement is resolved for a week, the back needs to return to full range of motion in both flexion and extension every day or the repair will never remodel into something tough and elastic, and will likely bust loose again. Flexion is important, and not inherently evil.

Berkeley, I'm sorry you've had such a rough time. Is it possible for you to go back to PT and see only one therapist for continuity of care? I would (of course) recommend you see the cert. MDT. Did the cert. get to see you often enough that they could tell if you had a responding direction? Did you try the 3 days in the responding position? Of course, if it's already been 8 months you've only got about 4 more before it spontaneously resolves anyway. (ruptures have a natural history of about a year)

Ered - I'm sorry to have hijacked your thread. When I was talking about flexion not necessarily being a bad thing I was NOT suggesting you leap onto your bike and go for a ride, I was only talking about the direction of spinal motion and its effect on disc pressures. I was also not suggesting you bend over and do potato-pickers...