The intervertebral disc annulus can be shielded by the facets. This is important for the patient to understand to help motivate exercise strategies to relieve their back pain.
Researchers have seen in studies that bending the spine backwards (extension) helps resist compression of the spine discs 1 especially when the disc has already lost some height. 2 3 When crafting exercises, and if the facets are not considered a pain generator, bending backwards, especially in the unloaded position, can be an effective strategy to help heal discogenic pain.
Several mechanisms have been proposed on why extension-based exercises aid in the reduction of back pain. One likely path is the direction the nucleus moves as the spine is bent backwards. It has been shown in several studies that the nucleus moves away from the posterior annulus in spinal extension 4 5 6 7 8 9
Dynamic Disc Designs Corp. is the only spine modeling company that demonstrates these findings in a dynamic spine education platform. The Professional and Academic LxH models allows clear visualization of the nucleus as the model moves through 6 degrees of freedom. Patient education that motivates and drives compliance through knowledge to improve clinic outcomes for spine.
- Adams MA, McNally DS, Chinn H, Dolan P. Posture and the compressive strength of the lumbar spine. Clin Biomech 1994;9:5–14 ↩
- Adams MA, Hutton WC. The effect of posture on the role of the apophyseal joints in resisting intervertebral compressive forces. J Bone J Surg Br 1980;62: 358–62. ↩
- Donelson R, Silva G, Murphy K. The centralization phenomenon: Its usefulness in evaluating and treating referred pain. Spine 1990;15:211–5. ↩
- Beattie PF, BrooksWM, Rothstein JM, et al. Effect of lordosis on the position of the nucleus pulposus in supine subjects. Spine 1994;19:2096–102. ↩
- Fennell AJ, Jones AP, Hukins DWL. Migration of the nucleus pulposus within the intervertebral disc during flexion and extension of the spine. Spine 1996;21:2753–7. ↩
- Schnebel BE, Simmons JW, Chowning J, Davidson R. A digitizing technique for the study of movement of intradiscal dye in response to flexion and extension of the lumbar spine. Spine 1988;13:309–12. ↩
- Schnebel BE, Watkins RG, Dillin W. The role of spinal flexion and extension in changing nerve root compression in disc herniations. Spine 1989;14:835–7. ↩
- Shah JS, Hampson WGJ, Jayson MIV. The distribution of surface strain in the cadaveric lumbar spine. J Bone Joint Surg Br 1978;60:246–51. ↩
- Shepherd J. In vitro study of segmental motion in the lumbar spine. J Bone Joint Surg Br 1995;77:161. ↩