Disk Herniations and Muscle Spasms

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Elena

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I am a new graduate...May 2007, to be exact, and my first gig is at a chiropractor's office. I have two clients that have got me completely stumped. Sadly, I dread being booked with them, because I feel ineffectual and frustrated throughout the session. But I digress....

Both clients have herniations in a lumbar disc. One client has severe inflammation in the ESG's on both sides of the injury and extending upwards and downwards several inches. Both have incredibly hypertonic muscles all up and down the back, in QL's, ESG'S, and rhomboids. The DC has asked me to focus on relaxing the muscles so he can get adjustments out of the rest of the back. However, the client with inflammation can hardly even tolerate my touch, even the lightest, and if I get anywhere near the injury, the muscles begin to jump and spasm. The other client asks me to do deep work, but as I'm applying pressure, his muscles too begin to spasm. I can visually see them moving beneath the skin! I tried O/I work, but that seemed to be more painful than he could handle. I'm stuck! I feel reduced to vascular flush and effleurage, which doesn't seem to be doing anything to reduce the hypertonicity.

Any suggestions?!?

Natasha
 


My first thoughts are to try some myofascial work. Not the deep kind like some do, but more on the gentle kind like Barnes. The area is protecting itself as much as possible and you will need to get through those layers very gently. Deep work is contraindicated as it could cause the area to lock up even more.

Some very mild stretching will help to loosen them up also. Perhaps your DC or you have some that you can give to the patients to do at home. Also recommend ice to them, off and on for a few hours every day for a while if possible is a big help. It may be cold, but in the long run it will be their friend more than they know. Explain to them how it will reduce the swelling and inflammation, and under NO CIRCUMSTANCES are they to use heat at this time. This kind of problem takes TIME, lots of time. Be patient, and tell them to do likewise. Keep up with the DC also to see how things are going.

Hope this helps.
 


I am just recovering from a herniated disk at L4 and I had severe spasming in my back and quad. I tried several different practitioners (including 3 chiropractors, an osteopath, acupuncture, a JB MFR trained PT, and a MT) before I got some relief. Nearly everyone helped when I was ON the table. As soon as I stood up (well, sort of stood up, lol), the spasms would return.

The most help was from the third chiropractor, who also said NO HEAT under any circumstances (I was using heating pads as it felt good.), and apply ice several times a day. He does other stuff besides chiropractic but the most help seemed to be a lot like JB MFR, only much deeper. He got me mobile again in one appointment. Oh boy, when he stripped those quad muscles, the pain was something else, but it worked to loosen them.

If you are going to do JB-type MFR, don't just look at where the pain is. You have to look for the restrictions and release those first. They might not be where the pain is at all.
 


I agree with the two previous people, ICE ICE ICE, as often as they can and for as long as they can. You might even suggest that they bring some ice packs and put them in a cooler in the car. That way when they leave your office they can ice up immediately.

It does not mater what the issue is there will often be pain during the initial treatments on your table. I find I have to work VERY light initially. This is to make sure that I am not You mentioned a great deal of spasm when you worked certain areas. Muscles often will spasm as they unwind or release guarding that has been around for a long time. Many of my clients have commented that the initial spasm was very painful, but after it worked its self out the pain was almost gone, and they felt much better when they stood. I want to be clear though, when the spasm started I DID NOT STAY AT THE SAME PRESSURE LEVEL, I backed out to a very light touch and just sort of rode out the spasm. I am sure you will get more comfortable once you have worked on a few more bodies, but for now just work in within your comfort level, and trust your skills.
 


I've had this condition a couple of times and tried everything, nothing really worked except ice and four or five days of bedrest then the pain would go away. It's ridiculously delibitating but it usually does go away in time. I had a buddy get it on Christmas Day, went to a famous chiro out here the next day and wound up in the hospital for a week. Adjusting someone with a herniation can be tricky and can often make it worse.

The advice I can give you is don't be too hard on yourself if you can't "fix" someone in this condition. The best you can usually do is attempt to make it not quite as bad and often that means directing you energy to other parts of them to quell the stress this causes. At least that's been my experience.
 


Thank you for all the replies!

Yikes, I wish I had checked the replies before I left for work today. I have been using heat :( as it seemed to be the only thing that would stop the muscle spasms. I was using ice packs before, but it seemed like the spasming was worse. Then I was doing contrast, (3 min ice, 1 min heat x3, end with ice) but that didn't seem to be doing anything. So today I tried just heat. He said he felt better when he got up, but I hope it did not make things worse for him later in the day!

I meet with him again Wednesday, and will go back to ice only, and try the MFR. I have not been doing a lot of work around the herniation site, as he can barely tolerate much touch there at all. The herniation is at L5, but even his rhomboids are super tight and prone to spasms. He is a construction worker by trade (and that's where he was hurt, as well) so I think his body probably needed a lot of work BEFORE the injury.

The DC keeps pushing Biofreeze. Is it okay to use biofreeze AND ice?

Again, thanks so much for the replies! There's just only so much you can learn in school. Nothing beats real world experience!

Natasha
 


from the Biofreeze website: ( http://www.biofreeze.com/faqs_healthcare.php#faq_16 )

Q: Can Biofreeze be used with ice, heating pads, tape or wraps?

A: Biofreeze should not be used with external heating pads as it may cause blistering. You can use Biofreeze with ice to extend the benefits of cryotherapy. Only breathable wraps are recommended for using with Biofreeze.

I don't have any personal experience doing this, however, so I can't vouch for any effects, improved or otherwise.
 


Thanks, frenchwoman! I feel slightly sheepish that I didn't think to look there myself... :oops:
 


Again thank you for all the replies. I wrote your suggestions and tips down in my notebook, and will review it before my clients on Wednesday. It is very difficult for me to do work I know is causing my clients pain and spasm, but I know, and they have said as much, that they are willing to do what they have to to see some improvement.

Also, thanks for the anecdotal advice...both clients are very frustrated at their slow progress levels, and I haven't really had enough (okay, any experience) with this issue to assure them in any way. I'm fairly sure that at least for one, the frustration with the injury is contributing negatively to the state of the rest of his muscles. The slower the progress, the more frustrated, the more frustrated, the more he tenses and stresses about it, which causes more pain, more frustration, slower healing...!

Any of you who've experienced this condition first hand try acupuncture to any relief? Or anyone have any experience with anyone who has?
 


I agree with Elsewhere, Not really a chiro fan in this instance. If the nerve is impinged more damage can be done. Most massage, physio and ice/heat application can just be a placebo effect! Can people just get better over time as long as no further treatment aggravates the condition?
 


Eh, no worries, Selkie. Besides, one look at your avatar and you'd be forgiven of just about anything.. :smt055
 


I agree with dodab, Marion, and others. Chiros have a great track record when it comes to herniations within a certain range. If the herniation is past that range, a DC can still help, and I would still give it my best shot, it's just that the odds are a bit slimmer. I would also do some biofeedback. My husband and I have a hand-held machine (it's not a TENS unit, it's different) that has a specific mode designed to take away pain and another mode designed to heal the tissues on a cellular level to decrease inflammation MUCH faster than it would on its own. My husband actually has a herniated disc and he does chiro and biofeedback for it. I do not work the area directly, as ppl are right, that's contraindicated, but I do help to loosen up the fascia, and also the surrounding muscles so that they don't start compensating too much and adding to the problem (not to mention generating even more pain, soreness, and trigger points!)

And please please don't feel bad if you can't help this person. I went through this same thing for several years, and it took me a long time to realize that I was simply not going to help everyone. For some people, the cause of their problem is something different than we've been trained to deal with. For others, they might actually be subconsciously attached to their pain because it gets them some other benefit from surrounding family members or an excuse not to work or something. And yet others might be something completely different. It's really hard for us to know. We just have to give each person our best during the time we have, with the skills we have, and let whatever divine energy or force you believe in do the rest. If the client doesn't get better, please don't assume it's something you should've known or should've done or whatever :)

Hugs,
~Jyoti
 


Just by coincidence I just got done working on a lovely lady with this problem which is weird because I usually only see guys with this problem (okay some ladies addicted to high heels but generally guys.) Anyway, I could sense she had some real emotional stuff just under the surface beyond her obvious furstration with the pain. She dialogued throughout our session and since a good deal of my training was in body/mind therapy I encouraged it. I worked around the area, located ground zero and charted it's trajectory and did some of the stuff I have found effective in treating this including side postures. But the focus seemed to keep coming back to what she was saying about the pressures in her life and her fears.

I ended with still point manuevers and unwindings and it triggered a huge wave of emotional release. She sobbed and sobbed. She really needed to do that. It was a huge relief for her and she said she felt amazingly better. She sure looked different when she left.

You never really know what's going to work but treating the whole person beyond the symptoms can often bring interesting results.
 


Wow, elsewhere, thanks for sharing that story!

That is SO TRUE how our minds, bodies, souls, spirits, histories, memories, etc, are all so intertwined! I don't want to hijack the thread out of the disc herniation realm, but I wanted to share this along the same line as elsewhere's story: I remember some throbbing headache that just would NOT go away, no matter how much gentle trigger point work, deep tissue, static friction, etc we did. It was only when we did some myofascial release that I *emotionally* released, and poof--headache gone...after about an hour of unsuccessful (but usually very effective) clinical work :)

Hugs,
~Jyoti
 


I am huge into essential oils and liniments for situations wherre you can't work much (due to irratation). BUT they need to be reapplied countless times for a few days so the client must take some home.

Not an ice user..... ice will seforum.xxxnant the qi and complicate things later. That's a whole other post though. :D
 


softhearted:
Not an ice user..... ice will seforum.xxxnant the qi and complicate things later.
I am so glad you mentioned this! I have shied away from ice because I thought I remembered hearing something like this from one of my instructors. I couldn't find a reference for it anywhere, and the chiro I work with is an ice nut (ice for E-V-E-R-Y thing, argh!) I know that ice reduces nerve pain and inflammation (which reduces overall inflammation) but moist heat brings in the local circulation and facilitates healing. I usually opt for heat because of this, or at least compromise with a vascular flush. I am guessing in this instance (disc herniation) keeping inflammation down (and thus further nerve impingement) is of highest priority? (This may be a whole new post, as you said...in which case, I'm totally willing to make it one!)

The chiropractor is treating both of these clients very aggressively...traction and exercise...one of the clients has started seeing a PT who told him he would have to "aggravate the condition a little in order to test spinal ROM." :?: These treatment efforts don't feel right to me, but what do I know? The DC has pushed me to do PIR/AIS on one of the clients....I have not, because my gut screams at me that this is not the appropriate action AT ALL. Actually, the DC has stopped referring one of the clients for massage as of this week, because he believes she is "faking it." Gah! Now I'm just venting, but I KNOW this woman isn't faking it. She may be holding onto her pain for one reason or another, but there is not a piece of me which believes she is faking it! I think the DC is just frustrated and trying to blame her because he hasn't made any progress with her. In her last few sessions with me, she has spent the first 15 or so minutes just wanting to talk to me, to share about her injury and frustration with lack of progress, and to try and explain things to me after which she asks me to try and explain it to the DC.

elsewhere, yes, thank you for sharing that story. I think repressed emotion has a huge amount to do with one of my client's pains, as I mentioned above. Sadly, the environment I'm working in is really the last place I'd want to work towards that with a client. I think it's time to put in my notice...

Natasha
 
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  30. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน2 girls ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ5124 Dundas St W Etobicokeโ˜Ž๏ธ416-817-3366๐Ÿ‘ Table Shower Sea Salt Bath Body Scrub๐Ÿ˜˜ Japanese girl Nina โค๏ธ Natural Big Boobs 38 DD ๐Ÿ˜˜Pink Mini Nipples Hot body slide, super enjoyable๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ very provocative service๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜, professional super Luna deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธYou are welcome to make an appoint
  31. DareDevil:
    ARIA WELLNESS โ™ฅ๏ธโ™ฅ๏ธADDRESS: 360 HWY 7, UNIT #6, RICHMOND HILL,647-222-5683 โ™ฅ๏ธโ™ฅ๏ธ(PHONES CALL ONLY, NO TEXT'N AVAILABLE) โ™ฅ๏ธTODAY'S Schedule!โ™ฅ๏ธ Loaded lineup with Beautiful Girls : New Girl Apple, Young RMT Student Helen, Magical Mia and Work out๐Ÿ‹๐Ÿšด๐Ÿ’ช Babe Amy! SPECIAL PROMO 30 MINS 2 GIRLS $70 ๐ŸŒน๐ŸŒน**TODAY'S PICK OF THE DAY IS ๐Ÿญ๐ŸฌHELEN AND APPLE๐Ÿฌ๐Ÿญ**
  32. EMSpa_schedule:
    Tomorrow's sneak peek: On Wednesday May 14, 2025, our attendants will be Carla โค, Cici ๐Ÿค—, Opal ๐Ÿค—, Sandy ๐Ÿ˜˜ and Yoyo ๐Ÿฅณ. Call us at โ˜Ž๏ธ(905) 479-6668โ˜Ž๏ธ to book!
  33. SL East Spa:
    ๐Ÿ’†โ€โ™€๐Ÿ’–Tuesday ๐Ÿ’œ Ultimate destination for Asian massages๐ŸŽ‰ Two fab spots: SL Richmond Hill & SL West Oakvilleโœจ Your passport to paradise with 9 enchanting girls fr China, HK, Japan & Korea โ€” ๐Ÿ†• Aliyah, Lucy, Yui, new Jojo, Coco, Cici, busty Amber, Kelly & Jasmine โ€” ready to pamper you๐ŸŽ๐Ÿ Ring us ๐Ÿ“ž647-695-6354 or text us ๐Ÿ“ฑ647-578-8169โœจ 160 East Beaver Cr., Unit 12, RichmondHill ๐Ÿ’ฐWhere Eastern charm meets Western comfort - your bliss awaits๐Ÿ™Œ
  34. Lilyspa1:
    Lily Spa : ๐Ÿ’ฐ๐Ÿ’ฐ100 hh all in๐Ÿ’ฐ๐Ÿ’ฐ โค๏ธโค๏ธ SuSu ( Asian )Slim , ๐Ÿ˜๐Ÿ˜Porn Service ๐Ÿฉท๐ŸฉทElena 22, Latino French, 36 DDD and ๐Ÿ‘๐Ÿ‘ASS, ๐Ÿ’‹๐Ÿ’‹Vicky 22, Philippine mixed White , very open-Minded , ๐Ÿ˜ˆbbbj , DFk ๐Ÿ”ฅDuo ๐Ÿ”ฅ,โ˜Ž๏ธ 6475318288
  35. Spa in Markham:
  36. BlueXado Therapy & Spa:
  37. Pink Flower Spa:
  38. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  39. Annie Spa:
    ๐ŸŽ‰๐Ÿ’ANNIE SPA๐ŸŽ‰๐Ÿ’ โœ…7-1001 SANDHURST CIRCLEโœ… ๐Ÿ‘ŒSCARBOROUGH ON M1V 1Z6๐Ÿ‘Œ โ˜Ž๏ธ (647) 891-9688โ˜Ž๏ธ โ˜Ž๏ธ (416) 291-8879โ˜Ž๏ธ (FINCH & MCCOWAN) OPEN 9:30am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅ๐Ÿ”ฅ ๐Ÿ”ฅGORGEOUS NEW YOUNG ASIAN GIRLS - TODAYโ€™s ROSTER INCLUDES: ๐Ÿ”ฅ Yumi๐Ÿ˜˜๐Ÿ’‹A striking new tall gorgeous Korean model with long, flowing reddish-brown hair cascading down her back and a slender, elegant figure that exudes grace and poise. Yumiโ€™s natural confidence and allure, make her approa
  40. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน2 girls ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ5124 Dundas St W Etobicokeโ˜Ž๏ธ416-817-3366๐Ÿ‘ New โ—๏ธ New girl Anna dainty and cute! Sexy body Hot body slide, super enjoyable๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ very provocative service๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜, professional super Luna deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธYou are welcome to make an appointment at any time or walk in the back door with plenty of p
  41. wonderspa:
    ๐ŸŒบWonder spa,(9421Jane st unit127)call416-5000-800โ˜Ž๏ธbest massage in vaughan,Tuesday RMT available,๐Ÿ’„sexy very young girl Mimi,natural c cup,very good looking amazing massage nice body slide,really popular ๐ŸŽlong hair Lucy Q smile,very good strong to relax oil ,back walk,more experience ๐Ÿ˜ปvery popular girl,more experience,must try๐Ÿ”ฅ๐Ÿ”ฅ
  42. Golden Sunshine Spa:
    โœจClick on our Username and FOLLOW US for updates and special services ! โœ… Click Here Today๐ŸŒธAkame๐ŸŒธChristina๐ŸŒธXuka๐ŸŒธLynda๐ŸŒธIsabella Call us โ˜Ž 905 - 265 - 2158โ˜Ž๏ธ Your ultimate service awaits! โœจ
  43. ForeverWarden:
    Tuesday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Cindy, Tracy & Vivian. Cindy is a slim beauty, 5โ€™4โ€, natural C Cups. Her massage is nice, her services will drive you wild & her finish is a dream come true. Tracy is an incredibly cute & pretty Japanese/Taiwanese mixed spinner, about 5โ€™1โ€ and 100 lbs. She is very popular for her exotic massage & services.
  44. AliceSpa:
    TUESDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—”, 4915 Steeles Ave. E, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿต๐Ÿด-๐Ÿฌ๐Ÿด๐Ÿต๐Ÿด. 3 Young Beauties Today at Alice Spa. Open 10am to 9pm: ASHLEY (12pm-9pm) is a beautiful slim Korean student, snow white skin, 5'2, 100 Lbs, natural C Cup, pink nipples, baby face & voice, can accomodate bbbj cim cof rim dfk, excellent services. CLOUDIA (11:30am-9pm): is Vietnamese, young, petite 5'2" & 96 Lbs
  45. wilson holistic centre:
    new girl works at ๐Ÿ’‹535 Evans Ave today ๐Ÿ’•๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-531-6969โ˜Ž๏ธโ˜Ž๏ธ
  46. HolidaySpa:
    Tuesday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: EMMA, JENNY & CINDY. EMMA is a very beautiful slim Chinese honey with C Cups, beauty face, & nice services to drive you wild. Jenny has a medium build, nicely curvy with a slim waist, pretty face, and very flexible skills. Jenny will make you very happy. CINDY is slim
  47. SugarLoveSpa:
    Tuesday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: CHRISTINA, MIMI, JENNY & TIFFANY. 1270 Finch Ave W (at Keele St), Unit 18. North York. CHRISTINA is Spanish, C Cups, 5'3", tall & nice curves, very open minded. MIMI is a slim & busty Asian/Euro mix beauty, 50Kgs & 1M60. Mimi has a very versatile range of services. JENNY is a sweet & young Korean girl with C Cups. Very versatile services.
  48. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Click Here Meet๐ŸŒธNina๐ŸŒธAnna๐ŸŒธXukaCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  49. bnwellness_wilson:
    We have 4 young girls are working today, young pretty Mia 25โ€™s with curve body and young Taiwanese Victoria slime 25โ€™s open mind, young sexy Sophia with curve body 30โ€™s and cute GFE Lina are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  50. Red Rose Spa:
    ๐ŸŒธ We have 11 hot brown girls today ๐ŸŒธ MONICA, ANGEL, SONIA, PRIYA, AMANDA, PAOLA, PREETI, KIRAN, ANGELINA, MONIKA, SALMA ๐ŸŒธ 2588 Birchmount ๐ŸŒธ 2 Invergordon ๐ŸŒธ 647-702-8800 ๐ŸŒธ Please visit for a great erotic massage
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