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Massage Today
May, 2009, Vol. 09, Issue 05 >> Back Pain

Simultaneous Disc and Ligament Injuries

By Ben Benjamin, PhD

Question: If someone has a low-back disc injury but also shows signs of ligament injuries, can we treat them with friction therapy? And will the treatment help?

Answer: It's fairly common for a person with a disc injury in the low back to also have injuries in the low back ligaments. It's sometimes difficult to distinguish how much pain and discomfort is coming from the disc lesion and how much is coming from the ligaments. If the ligaments in the low back and sacral areas are painful on palpation, it is very likely that these structures are contributing to the person's pain.

After the client has seen a physician about the disc problem, you can propose an experiment where you work on the ligament injuries to see if it helps. Very frequently this treatment lessens the intensity of the pain by as much as 50 percent.

Woman suffering from neck pain. - Copyright – Stock Photo / Register Mark Sometimes the therapist's role is to make the client feel as comfortable as possible as they wait for the disc issue to resolve. Often, pain caused by a disc problem resolves on its own over a period of a year or so. The extruded portion of the disc gradually dries up and is reabsorbed by the body, which allows the pain from the nerve-root compression to diminish and disappear. This is a good argument for waiting before considering a surgical intervention. Recent research has shown that after about two years, a high proportion of those who had disc surgery feel no better than those who did not have the surgery. 

Whenever you work on a person with a disc injury, be sure to keep the low back in a neutral position. Avoid bearing down on the low back and experiment with having a pillow under the client's abdomen during the treatment. This will prevent the low back from going into slight extension, which might irritate the nerve root. Also experiment with treating the person in a side-lying position. I suggest giving eight to 10 treatments and then reassessing if the treatment is diminishing their pain and making them more comfortable.

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