Table of ContentsView AllTable of ContentsSpinal Flexion and Herniated Disc RiskFlexion of the Spine and DeformitySpinal Flexion and Spinal StenosisPrevention
Table of ContentsView All
View All
Table of Contents
Spinal Flexion and Herniated Disc Risk
Flexion of the Spine and Deformity
Spinal Flexion and Spinal Stenosis
Prevention
Whether you’re exercising, gardening, playing with your kids, or doing housework—any of these bending movements have specific names based on the direction that your spine goes while performing them. There’s flexion, or bending forward; extending, which is an arching back type movement; side bending, also known as tilting; and rotation, or twisting.
Let’s explore perhaps the most frequently performed spinal action of all: flexion. A familiar movement for most of us, spinal flexion is the act of bending forward. It’s what you’re specifically told not to do when lifting heavy items, gardening, and other manual tasks.
This article covers the effects of flexion on the body and how it relates to low back pain.
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Too much spinal flexion, or spinal flexion that is loaded—either because you’re carrying something with a substantial amount of weight, or you’re twisting your spine as you bend—may negatively affect yourintervertebral discs. It may even cause a herniated disc injury.
Aherniated discoccurs when the outer covering of a spinal disc, which is known as theannulus fibrosus, frays or breaks, and the disc’s liquid center (nucleus pulposus) leaks out.
If the nucleus pulposus happens to land on aspinal nerve root, as it often does, you’ll likely experience pain and/or other nerve symptoms, which are collectively known asradiculopathy.
Herniated disc injuries often get better with conservative care rather than surgery, and symptoms tend to dissipate once the disc material is resorbed into the body. Physical therapy can help but many people seek faster relief and opt for adiscectomysurgery.
Does a Herniated Disc Require Surgery?Herniated discs often improve on their own, or with pain management andphysical therapy. Providers often try conservative approaches for six weeks before considering surgery. Estimates on whether atype of spinal disc herniationwill spontaneously heal include:Bulging discs, 13%Protruding discs, 41%Extruding discs, 70%Sequestered discs, 96%There’s evidence to suggest that the more severe the herniation is in the short term, the higher the chance it will completely resolve. There’s also evidence that surgery provides faster short-term pain relief, though benefits were comparable to conservative treatments in the long run.
Does a Herniated Disc Require Surgery?
Herniated discs often improve on their own, or with pain management andphysical therapy. Providers often try conservative approaches for six weeks before considering surgery. Estimates on whether atype of spinal disc herniationwill spontaneously heal include:Bulging discs, 13%Protruding discs, 41%Extruding discs, 70%Sequestered discs, 96%There’s evidence to suggest that the more severe the herniation is in the short term, the higher the chance it will completely resolve. There’s also evidence that surgery provides faster short-term pain relief, though benefits were comparable to conservative treatments in the long run.
Herniated discs often improve on their own, or with pain management andphysical therapy. Providers often try conservative approaches for six weeks before considering surgery. Estimates on whether atype of spinal disc herniationwill spontaneously heal include:
There’s evidence to suggest that the more severe the herniation is in the short term, the higher the chance it will completely resolve. There’s also evidence that surgery provides faster short-term pain relief, though benefits were comparable to conservative treatments in the long run.
What to Expect From Herniated Disc Physical Therapy
We’re all subject to the force of gravity, which can compress the spine incrementally over time. In turn, this may lead to a chronically flexed spinal position, calledkyphosis. It’s the opposite of spinal extension, orlordosis.
Unless you are very mindful about your posture, you may not even notice your kyphosis until it becomes extreme or results in pain.Kyphosis also may be associated with other conditions, likeknee pain.
Sitting at the computer can lead to spinal flexion postural misalignment in the neck.Driving, carrying children, and evenfatiguealso can contribute to spinal symptoms.
In some cases, extraspinal flexion is desired. For example, if you havespinal stenosis, you may experience the classic symptom ofneurogenic claudication, when spinal nerves are compressed and cause leg pain.Generally, getting your spine into a flexed position helps relieve this pain and cramping.
It’s always wise to consult with your healthcare provider and physical therapist for the best positions and exercises given your individual condition.
You may want to consideracupuncture, as well. A March 2018 study published in the journalBMC Complementary and Alternative Medicinecompared medication, exercise, and acupuncture for managing lumbar spinal stenosis. Of the three treatments, acupuncture resulted in the most improvement—both for symptoms and physical functioning.
Acupuncture isn’t always recommended due to lack of consistent evidence that it’s effective, though. Other spinal stenosis treatment options apart from surgery and medication include:
However, lumbar spinal stenosis with neurogenic claudication remains the most common reason for back surgery in people ages 65 and older.
How to Do Spinal Extension and Flexion Exercises
Preventing Back Problems Related to Spinal Flexion
The easiest way to prevent back problems that arise from chronic spinal flexion is to keep your core, which includes your ab and back muscles, both flexible and strong.
A back exercise program should help you do this. In particular, yoga and Pilates not only strengthen muscles, but they also develop your spinal alignment. With these systems, you’ll exercise your back in all the directions your spine can move. Plus, their emphasis on balanced action and whole-body alignment may help re-establish an erect posture.
Yoga Poses to Prevent Back Pain
Strength exercises are often done with your back arched or twisted. Because arching, and to some degree twisting, are opposite actions to spinal flexion, exercises in these positions may counter habitual tendencies toward spinal flexion, which in turn, may reduce associated risks to your back.
Summary
Spinal flexion, the act of bending forward, is important for activities like lifting or gardening. But it can lead to spinal disc herniation and other injuries that typically develop over a long period of time. Certain behaviors, such as computer work, can increase the risk.
If you have back pain that eases with spinal flexion, it may indicate a condition such as spinal stenosis.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gugliotta M, Da costa BR, Dabis E, et al.Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study.BMJ Open. 2016;6(12):e012938. doi:10.1136/bmjopen-2016-012938Chu EC, Sabourdy E.Non-surgical restoration of L3/L4 disc herniation.Cureus. 2023 Jun 25;15(6):e40941. doi:10.7759/cureus.40941Taniguchi M, Ikezoe T, Masaki M, Kamitani T, Tsuboyama T, Ito H,et al.Coexistence of low back pain and lumbar kyphosis and the association with increased functional disability in knee osteoarthritis: results from a population-based cohort.Arthritis Care Res (Hoboken). 2022 Oct;74(10):1667-1675. doi:10.1002/acr.24580Seo J, Song C, Shin D.A single-center study comparing the effects of thoracic spine manipulation vs mobility exercises in 26 office workers with chronic neck pain: A randomized controlled clinical study.Med Sci Monit. 2022 Jul 8;28:e937316. doi:10.12659/MSM.937316Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-surgical interventions for lumbar spinal stenosis leading to neurogenic claudication: A clinical practice guideline.J Pain. 2021 Sep;22(9):1015-1039. doi:10.1016/j.jpain.2021.03.147Oka H, Matsudaira K, Takano Y, et al.A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study).BMC Complement Altern Med. 2018;18(1):19. doi:10.1186/s12906-018-2087-yWasedar V, Pangam B, Shete S, Belaval V.Complete resolution of lumbar disc sequestration with Ayurveda management: A case report.J Ayurveda Integr Med. 2023 Nov-Dec;14(6):100826. doi:10.1016/j.jaim.2023.100826Eliks M, Zgorzalewicz-stachowiak M, Zeńczak-praga K.Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art.Postgrad Med J. 2019;95(1119):41-45. doi:10.1136/postgradmedj-2018-135920
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gugliotta M, Da costa BR, Dabis E, et al.Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study.BMJ Open. 2016;6(12):e012938. doi:10.1136/bmjopen-2016-012938Chu EC, Sabourdy E.Non-surgical restoration of L3/L4 disc herniation.Cureus. 2023 Jun 25;15(6):e40941. doi:10.7759/cureus.40941Taniguchi M, Ikezoe T, Masaki M, Kamitani T, Tsuboyama T, Ito H,et al.Coexistence of low back pain and lumbar kyphosis and the association with increased functional disability in knee osteoarthritis: results from a population-based cohort.Arthritis Care Res (Hoboken). 2022 Oct;74(10):1667-1675. doi:10.1002/acr.24580Seo J, Song C, Shin D.A single-center study comparing the effects of thoracic spine manipulation vs mobility exercises in 26 office workers with chronic neck pain: A randomized controlled clinical study.Med Sci Monit. 2022 Jul 8;28:e937316. doi:10.12659/MSM.937316Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-surgical interventions for lumbar spinal stenosis leading to neurogenic claudication: A clinical practice guideline.J Pain. 2021 Sep;22(9):1015-1039. doi:10.1016/j.jpain.2021.03.147Oka H, Matsudaira K, Takano Y, et al.A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study).BMC Complement Altern Med. 2018;18(1):19. doi:10.1186/s12906-018-2087-yWasedar V, Pangam B, Shete S, Belaval V.Complete resolution of lumbar disc sequestration with Ayurveda management: A case report.J Ayurveda Integr Med. 2023 Nov-Dec;14(6):100826. doi:10.1016/j.jaim.2023.100826Eliks M, Zgorzalewicz-stachowiak M, Zeńczak-praga K.Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art.Postgrad Med J. 2019;95(1119):41-45. doi:10.1136/postgradmedj-2018-135920
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gugliotta M, Da costa BR, Dabis E, et al.Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study.BMJ Open. 2016;6(12):e012938. doi:10.1136/bmjopen-2016-012938Chu EC, Sabourdy E.Non-surgical restoration of L3/L4 disc herniation.Cureus. 2023 Jun 25;15(6):e40941. doi:10.7759/cureus.40941Taniguchi M, Ikezoe T, Masaki M, Kamitani T, Tsuboyama T, Ito H,et al.Coexistence of low back pain and lumbar kyphosis and the association with increased functional disability in knee osteoarthritis: results from a population-based cohort.Arthritis Care Res (Hoboken). 2022 Oct;74(10):1667-1675. doi:10.1002/acr.24580Seo J, Song C, Shin D.A single-center study comparing the effects of thoracic spine manipulation vs mobility exercises in 26 office workers with chronic neck pain: A randomized controlled clinical study.Med Sci Monit. 2022 Jul 8;28:e937316. doi:10.12659/MSM.937316Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-surgical interventions for lumbar spinal stenosis leading to neurogenic claudication: A clinical practice guideline.J Pain. 2021 Sep;22(9):1015-1039. doi:10.1016/j.jpain.2021.03.147Oka H, Matsudaira K, Takano Y, et al.A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study).BMC Complement Altern Med. 2018;18(1):19. doi:10.1186/s12906-018-2087-yWasedar V, Pangam B, Shete S, Belaval V.Complete resolution of lumbar disc sequestration with Ayurveda management: A case report.J Ayurveda Integr Med. 2023 Nov-Dec;14(6):100826. doi:10.1016/j.jaim.2023.100826Eliks M, Zgorzalewicz-stachowiak M, Zeńczak-praga K.Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art.Postgrad Med J. 2019;95(1119):41-45. doi:10.1136/postgradmedj-2018-135920
Gugliotta M, Da costa BR, Dabis E, et al.Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study.BMJ Open. 2016;6(12):e012938. doi:10.1136/bmjopen-2016-012938
Chu EC, Sabourdy E.Non-surgical restoration of L3/L4 disc herniation.Cureus. 2023 Jun 25;15(6):e40941. doi:10.7759/cureus.40941
Taniguchi M, Ikezoe T, Masaki M, Kamitani T, Tsuboyama T, Ito H,et al.Coexistence of low back pain and lumbar kyphosis and the association with increased functional disability in knee osteoarthritis: results from a population-based cohort.Arthritis Care Res (Hoboken). 2022 Oct;74(10):1667-1675. doi:10.1002/acr.24580
Seo J, Song C, Shin D.A single-center study comparing the effects of thoracic spine manipulation vs mobility exercises in 26 office workers with chronic neck pain: A randomized controlled clinical study.Med Sci Monit. 2022 Jul 8;28:e937316. doi:10.12659/MSM.937316
Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE,et al.Non-surgical interventions for lumbar spinal stenosis leading to neurogenic claudication: A clinical practice guideline.J Pain. 2021 Sep;22(9):1015-1039. doi:10.1016/j.jpain.2021.03.147
Oka H, Matsudaira K, Takano Y, et al.A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study).BMC Complement Altern Med. 2018;18(1):19. doi:10.1186/s12906-018-2087-y
Wasedar V, Pangam B, Shete S, Belaval V.Complete resolution of lumbar disc sequestration with Ayurveda management: A case report.J Ayurveda Integr Med. 2023 Nov-Dec;14(6):100826. doi:10.1016/j.jaim.2023.100826
Eliks M, Zgorzalewicz-stachowiak M, Zeńczak-praga K.Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art.Postgrad Med J. 2019;95(1119):41-45. doi:10.1136/postgradmedj-2018-135920
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