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MeasuringLumbar Disc Height Change with Exercise

Loss of lumbar disc height is a major concern with people with low back pain. With either dehydration or aging we tend to lose height of the intervertebral discs. This changes their structure and how they function. This may lead to increased number of damaging tears thatcan result in lumbar disc herniations. There have are several treatments trying to increase the height and function of lumbar spinal discs.

Traction or decompression therapy has been thought to increase blood flow to the discs to help bring more nutrients and water to the area. By creating a negative pressure more fluid runs into the area to help with healing. Our normal static standing or sitting posture compresses the disc, and pushes the fluid away. The discs operate on a passive system that requires consistent movement of fluids. Spinal discs rely on compression and decompression throughout normal walking movements to supply the necessary nutrients.

One of the problems with static positions is that we are not allowing blood flow or nutrient flow to the lumbar discs. We are constantly compressing thatarea. Think of standing on a wet sponge. The constant body weight is pushing fluids out of the sponge. If we are to stand on the sponge for two seconds and then release our foot pressure for two seconds, re-compress for two, and then release for two provides consistent movement of fluids in and out of the sponge. Static postures do not allow for that fluctuation of fluids in and out. Static loading pushes fluids out, without allowing fluid to flow back into the disc.

The study looked to measure exercises that are thought to increase lumbar disc height. The participants first were placed in a static sitting position designed to push fluids out of the lumbar disc and produce a smaller disc height. They then held either a flexed or extended position for 10 minutes to allow fluids to come back to the discs for hydration. Creep could be described as the term for allowing fluid to seep back into an area much like water creeping back into the sponge.

The test showed that holding a static hyperextended position while laying on your stomach or a flexed position while on your back produced temporary recovery of the spine height after a sustained loading position.

These are exercises that are commonly shown and performed in a chiropractic or physical therapy office. Study such as these help confirm why we perform these exercises. It also may give an indication that thesecould be great exercises to perform on your own to help maintain lumbar disc height. But more studies would have to be performed to see if this would provide a therapeutic maintenance affect.

The following article discusses back pain and exercisesfor back pain. The abstract is below for your reading. More information on low back pain and exercise videos for strength and endurance.

More information on therapeutic treatments utilizing Physical Therapy or Chiropractic can be directed to Google+.

Journal of Manipulative and Physiological Therapeutics

Volume 32, Issue 5 , Pages 358-363, June 2009

Changes in Spinal Height Following Sustained Lumbar Flexion and Extension Postures: A Clinical Measure of Intervertebral Disc Hydration Using Stadiometry

S. Christopher Owens, ScD, PT, Jean-Michel Brismée, ScD, PT, Patricia N. Pennell, ScD, PT, Gregory S. Dedrick, ScD, PT, Phillip S. Sizer, PhD, PT, C. Roger James, PhD

Received 1 August 2008; received in revised form 3 April 2009; accepted 6 April 2009.

Abstract

Background

Decreased intervertebral disc height can result in diminished load carrying capacity of the spinal segment. Clinical means of assessing postures able to rehydrate the discs were investigated.

Objective

The purposes of this study were 3-fold: (1) to determine if our test protocol using a commercially available stadiometerdemonstrated findings consistent with prior laboratory-based protocols; (2) to determine if hyperextension in the prone position and trunk flexion in the supine position caused increased spine height after sustained loading; and (3) to compare the effects of hyperextension in the prone position and trunk flexion in the supine position on spine height changes after a period of sustained loading.

Methods

This study used a pretest, posttest crossover design. Ten women and 11 men (mean age, 24± 2.6 years) participated. Subjects held either 10 minutes of hyperextension in the prone position or 10 minutes of trunk flexion in the supine position in the recovery phase. Spine height was measured using a commercially available stadiometer. Spinal height change was determined from measurements taken after loaded sitting and measurements taken after hyperextension in the proneposition and trunk flexion in the supine position.

Results

A 1-sample t test indicated no significant difference existed between our mean height change after 5 minutes of sitting and previously published validated findings. A paired t testindicated significant increase in height after both supine flexion and prone extension lying (P< .0001). The mean height gain was 3.11 mm using prone extension and 3.19 mm using the supineflexion protocol. A paired t test indicated no significant difference between these 2 recovery positions (P = .927).

Conclusion

The stadiometermeasurement protocol demonstrated that hyperextension in the prone position and trunk flexion in the supine position were easily effective positions for the temporary recovery of spine height after sustained loading. These findings lay the foundation for future research into the viscoelastic creep properties of the intervertebral disk under loading and therapeutic conditions.