Linda came to the office with her MRI report in hand. The report revealed minimal disc bulges in her lower back from lumbar 2 to lumbar 5, and degenerative bony ridges from lumbar 5 into sacral 1.
The good news was that she did not require surgery or have a more serious condition like a herniation of the discs or spinal stenosis (a narrowing of the spinal cord). The bad news was that she was in constant pain and had a limited range of motion throughout her lower back.
Linda had been suffering with right-sided back pain for the past fourteen months. She experienced daily pain varying anywhere from a dull ache to sharp and shooting pain. Linda had to limit any bending or twisting, and had even giving up exercising on her stationary bike because of the pain.
The doctor had prescribed anti-inflammatory drugs and muscular relaxants along with physical therapy. The physical therapy had helped reduce the stiffness in her low back, but did not help with her pain levels.
Linda wanted to be able to stop taking her anti-inflammatories and her pain medications as she felt they were affecting her health adversely. But without a solution, she was still in too much pain and discomfort to stop.
During our intake, Linda was anxious and concerned that she would suffer from stiffness, pain, and limited range of motion in her lower back for the rest of her life. Linda was a 42-year-old single mother with an 11-year-old son to support. She had endured a contentious divorce several years back and had been given sole custody of her son, which left very little time for self-care or exercise.
Linda was forced to juggle childcare with her busy work schedule. She had no support system from her family for backup childcare, and she was tense and exhausted most evenings. Her job in finance required long periods of time sitting at the computer as well as a 45-minute commute on the train to and from work in the city three days a week.
I noticed as we spoke that she had forwardly rolled shoulders with a forward head alignment, which compromised the health of her lower back. The weight of her rounded shoulder and forward head placed her lower back in an over-stretched position creating stress on her muscular skeletal structure, particularly in the lumbar spine. This set the stage for the beginning of her disc issues.
How Did the Back Pain Begin?
Linda believed that the heavy computer she carried back and forth to work was the culprit that led up to the painful episode fourteen months earlier. She worked from home in the suburbs two days a week, requiring her to lug her large work computer back and forth from the city on a weekly basis.
One morning, preparing to leave for the office, she twisted her torso when lifting her heavy computer and noticed a painful twinge in the right side of her lower back. The pain persisted throughout the day and by that evening she was unable to sleep because of the stabbing pain in her lower back. The rest is history.
What is a Bulging Disc?
A bulging disc occurs in the spinal cord, most often in the lumbar spine (the lower back). These discs are composed of soft, gelatinous material inside, surrounded by tough cartilage on the outside. The discs serve as a cushion for the vertebra of the spine. A bulge occurs when a disc shifts out of its normal radius. It is usually the tough outer layer of cartilage that gets displaced or flattened down.
A herniated disc tends to be a more serious condition. This occurs when there is a crack in the tough outer layer of the cartilage of the disc, allowing the soft inner gelatinous material to protrude out of the disc. Bulging or herniated discs both can cause pain and dysfunction in the muscular skeletal system if there is compression of the nerve.
We had to get to the root cause of Linda’s pain. The lack of daily exercise and poor alignment had lead to a weakening of the spinal ligaments and joints and predispositioned her to disc problems.
First, her alignment needed to be addressed and improved upon. We discussed proper neck, shoulder, and hip position when sitting and standing. It became very important to bring proper alignment into her work place as she sat at her computer, and equally important to carry and lift her computer and any other heavy objects with good form.
She eagerly bought an ergonomically engineered office chair for her home, started taking stretching breaks during her workdays at the computer, and started daily exercise. She was given core exercises to strengthen her back and abdominals. She also began cycling on her home exercise bike again, at first for only ten minutes at a low resistance and then increased the intensity, duration, and frequency as she became stronger.
She found that if she did her back exercises in the morning and evening and used her bike several days a week, the pain in her lower back lessened significantly. Linda also found the “MELT” method — using a soft foam roller to relax her tight spinal muscles — was very useful in her recovery.
I diagnosed Linda with chronic “stagnation of qi and blood.” This is characterized by a severe, stabbing pain that becomes worse with inactivity and better with light exercise. She found that sitting, standing, or lying down for extended periods of time made the pain worse. The affected area was tender to the touch and there was also marked rigidity and stiffness of the back muscles and an inability to flex, extend, or rotate at the waist.
We began acupuncture treatments once a week for twelve weeks, and then every other week for four more weeks until Linda was pain free. Afterwards she came in for maintenance treatments every six to eight weeks.
I placed acupuncture points locally to increase blood circulation, reduce inflammation, and decrease muscle stiffness and tightness. Distal acupuncture points were also used to help move blood and qi throughout the meridian of the spine, starting at the base of the cranium and ending at points near her ankles. Needles were also placed next to the lumbar vertebrae to encourage the disc to heal.
Moxibustion, an burned herb (mug wart), was used to warm the acupuncture points to further increase blood circulation and relax the tight musculature. Cupping was also utilized to reduce blood stagnation and to relieve the tight muscles and fascia around her lower back — lessening the pull on the vertebrae and discs.
At the end of the acupuncture sessions, sometimes tui na (medical massage) was used to help further reduce the tight knotted fascia throughout her spinal muscles. Linda also used a moist heating pad in the evenings for twenty minutes to help relax her tight muscles and to further encourage good circulation and blood flow.
Linda was able to stop all pain and anti-inflammatory medication. She is careful about maintaining her core strength, flexibility, and her cardiovascular health. She has learned how to work at her desk with good alignment and take well-deserved stretching breaks throughout her workday. But most importantly, she is now pain free.
Working with Linda was a pleasure as she was highly motivated to incorporate all that she was learned during our treatments into her daily life. She would have struggled with ongoing back pain if she had not taken responsibility for her own health. It takes commitment and discipline to maintain radiant health and Linda has them both.