frequently asked questions

question : What is the difference between a bulging lumbar disc and a herniated lumbar disc?
answer : There is a tremendous inconsistency in the literature between the following names

• herniated lumbar disc
• ruptured lumbar disc
• bulging lumbar disc
• slipped lumbar disc
• protruding lumbar disc

Unfortunately there is not much consistency in the way a herniated lumbar disc is  read on from scan to scan.  Therefore, what may appear as "ruptured" on one report, might have been considered "bulging" on another.  That is why most specialists treating back pain, but especially neurosurgeons, who will use the information to make a surgical decision, review all the films themselves. 

question : My doctor told me that I have degenerative changes in my spine.  I have no pain.  Should I be worried?
answer : After the age of 20, most people start to show signs of aging in their spines.  This is just a fact of life.  Therefore, it is very common to find degenerative changes in the spine in many adults. The lumbar disc, as it ages, loses moisture and dries up.   This is another reason that we should be motivated to take good care of our backs.

question : I don't eat anything, and I still can't lose weight!
answer : Please see the pages on this site regarding weight loss.  We will be putting more information regarding specifics on nutrition.  But we have to remember that if our bodies burn 2000 calories per day, and we only consume 1800 calories, we will eventually lose weight.  The results won't be overnight, but they will happen.  I am not suggesting dropping back on your food, and in fact, you may need to increase your food consumption.  It is possible to send your body into a "starvation mode" by eating too little.  But you must eat right.  And don't forget the exercise.

question : I have wanted to start exercising at a local gym.  I walked into the gym the other day, and walked right out.  I felt very intimidated, like everyone was staring at me.  I am a woman, 5 feet 3 inches tall, and 210 pounds.  I have always been self conscious, and going into the gym with so many fit people made me feel more self conscious.  I can't afford to buy the weights for my house.  What can I do?
answer : Thank you for expressing your feelings so honestly.  You may feel intimidated by all the "fit" people in the gym, but I'll bet that each and every one of them had, at one time, some degree of a weight problem.  But everyone has to start somewhere.  There was a client who was in her seventies, and was completing her BS in college because she never had the opportunity to when she was younger.  Was she ostracized by the rest of the class?  No, she was the class hero!!  And so will you.  Virtually no one will think less of you for trying, and most everyone will have great respect.  You are not competing with anyone else, but only with yourself.  That's the beauty of exercise and weight lifting, it's you versus gravity.  I don't know of a serious weight lifter alive who hasn't had to have fellow gym colleagues rush to his/her rescue because they were pinned under a weight they couldn't handle.  That teaches humility very quickly.  And, another important point to remember.  If your body fat percentage is 40, is is easier and quicker to drop to 30, than is the journey from 15 to 11.  That means people will be complementing you on your achievements and success before you will even have the time to wonder whether anyone is noticing how heavy you are.
One last point.  I am glad you didn't buy weights for the home.  Get a trainer, or train with someone experienced in weight lifting.  Proper form is essential.  Don't start off with the wrong form and an injury.  And HAVE FUN!  Soon you will be experiencing the RUNNERS and WEIGHT LIFTER'S HIGH.

question :  I am a 34 year old woman, and have had low back pain for several years.  Is there a problem with wearing high heels?

answer :  As much as I would like to say there is no problem, high heels are not good for the lumbar spine.  What they do is force you to walk with the pelvis arched forward, causing a hyperlordosis (backward bending) of the lumbar spine (see "back care" on this site).  This disrupts the normal curves of the spine, placing additional strain on the low back.  Perhaps moderation would be best.  Try moderate sized heels, and wear them for only several hours before taking a break.

question :  I underwent an L5/S1 lumbar disc removal.  Before surgery, I had severe weakness.  My surgeon pointed out to me that I couldn't walk on my toes at all, and he said I lost my ankle reflex.  The pain was improving before surgery, but my foot remained weak.  Now, 6 months after surgery, the strength is improving, but I have a burning pain in my calf.  Even having the sheets on my leg bothers it at night.  My surgeon took another MRI scan, but nothing was found.  What can I do?  Please help me.

answer :  It sounds like you had severe damage to a nerve root, the S1 root, prior to surgery.  You describe pain in the leg, and severe weakness.  The weakness remained severe, but the pain started to improve.  It is possible that the pain was improving because the nerve was becoming more damaged, and "dead."  Now, some of the strength is returning, which means the nerve is beginning to heal.  The burning pain you are feeling is most likely what is known as a dysesthesia.  This can happen when a severely damaged nerve tries to heal itself.  This may be treated temporarily by medications from your doctor.  Ultimately nerve blocks can be tried, and if nothing else helps, you may potentially be a candidate for a spinal cord stimulator in the future.

question :  I have had a lumbar fusion three years ago.  I travel occasionally for business.  Will I set off the metal detector in the airport?

answer :  Since the 9/11/01 attack, the sensitivities of the detectors at the airports have been turned up.  It would be very reasonable for your surgeon to provide you with a note stating that you have instrumentation placed within your spine, which may set off the detector.