This is a post that was motivated by a 26yr old runner who I treated recently. He had reached out because of being "diagnosed" with 4 disc bulges in his spine and was told he shouldn't run anymore. He had been experiencing back pain for ~ 6 months. No trauma. He had stopped working out at the behest of his primary care physician due to possibly "making things worse". All he wanted to do was get back to running.
Ya'll, this is terrible and one of the more frustrating things I am seeing with our medical system.
I state this fact at least a couple of times daily. Disc bulges are found in 87% of the general population. For reference a study in 2015 found 73.3% of asymptomatic males in their 20's with no back pain had disc bulges on their MRIs. If you are reading this you likely have one. That's ok. That's normal. If you have a spine then that spine is constantly taking on normal stress everyday. If you have back pain then a disc bulge is not why you have pain. I will state this again, a disc bulge is not why you have pain. If someone has told you this then you are being given non evidence based info.
There is much more to the story about this 26 yr old. He had just recently moved to the area. He had a very bad breakup with his girlfriend. He had developed anxiety/depression. He had put on 20 lbs recently. He had only been sleeping 3-4 hrs per night recently. His new job was a large source of stress. He had even started to notice some erectile changes due to anxiousness.
Takeaway - disc bulges were not the reason for his pain. We had to address his sleep issues, his anxiety/depression, and focusing on good quality nutrition. PT alone was not going to "fix him". I have a secret - there was not a "special exercise" for him. We just got him moving. We started a return to run regimen.
If you have back pain then move. If you are a runner experiencing back pain then keep running. Don't stop. Modify perhaps but don't stop. This runner got back to running normally after a few months. He likely still has disc bulges. Who cares. Treat the person and not the image.
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