5 Common Mistakes to Avoid with Bulging Discs and Herniations

Understanding Disc Bulges and Herniations

Up to 85% of people will experience back pain at some point in their lives. While most cases resolve within a few days, some are caused by a disc bulge or herniation and take longer to heal. These conditions occur when the gel-like center of the disc (the nucleus pulposus) gets squeezed out, putting pressure on the surrounding nerves and causing pain that can radiate down the leg, commonly known as sciatica. It's important to note that disc bulges are very common. Studies show that 29% of people in their 30s and up to 84% in their 80s have disc bulges without any associated pain. This highlights that not all disc bulges or herniations are cause for concern, but they are more prevalent than one might think.

Mistake #1: Prolonged Inactivity

One common mistake when dealing with a disc issue is stopping all exercise and physical activity. While initial rest is understandable, prolonged inactivity can lead to further problems. The spine's muscles, such as the paraspinal muscles and muscular slings connecting the abdomen, back, and legs, need movement to function properly and facilitate healing. Walking is particularly beneficial as it helps maintain proper spinal alignment and posture while gently pumping inflammation out of the affected area and bringing in fresh, nutrient-rich blood. Avoiding activity can weaken muscles and ligaments, exacerbating the problem and increasing the likelihood of future back pain episodes.

Mistake #2: Overstretching

When dealing with a disc issue, the natural inclination may be to stretch the muscles causing pain, such as the hamstrings or calves. However, this can do more harm than good. Stretching the leg forward can tighten the sciatic nerve, pushing the disc bulge or herniation further into the surrounding tissues and exacerbating inflammation and pain. Instead of traditional stretching, techniques like neural flossing, which gently mobilizes the nerve, may be more appropriate. It's important to consult with a healthcare professional to determine the best course of action for your specific condition.

Mistake #3: Dehydration

The discs in our spine are hydrophilic, meaning they attract water. At night, the discs absorb water and swell slightly, which is why we're a bit taller in the morning. Throughout the day, gravity and movement push this water out, and proper movement replenishes the discs with nutrients and flushes out waste products. If you don't drink enough water, the discs can become dehydrated, making them less resilient and more susceptible to injury. Drinking a large glass of water first thing in the morning can help ensure your discs are well-hydrated and better equipped to handle the stresses of daily life.

Mistake #4: Obsessing Over MRI Results

MRI scans can be useful in diagnosing and confirming disc issues, but they should not be taken as gospel. The interpretation of MRI results can be subjective, with different radiologists and clinicians potentially arriving at different conclusions. Additionally, the technology and algorithms used to produce the images can vary between MRI machines and manufacturers. It's important to remember that the presence of a disc bulge or herniation on an MRI does not necessarily mean it is the sole cause of your pain. Many people have bulges and herniations without experiencing any symptoms. Instead of obsessing over the MRI report and worrying about surgery, focus on implementing appropriate exercises and lifestyle changes to manage your condition.

Mistake #5: Ignoring the Bigger Picture

When dealing with a disc issue, it's easy to become laser-focused on the specific problem area, such as the L5-S1 disc. However, it's important to consider the bigger picture and how other factors may contribute to your condition. For example, hip stiffness and a continued flexed posture can put additional stress on the L5-S1 disc, leading to a bulge or herniation. Addressing underlying health and postural issues through targeted exercises and lifestyle modifications can be just as important as managing the disc problem itself. By avoiding these common mistakes and taking a holistic approach to your recovery, you can better manage your disc condition and reduce the risk of future episodes of back pain. If you have specific concerns or would like personalized guidance on managing your back pain or scoliosis, send me a message via the Contact Us page or connect with me directly via email, Instagram, or Facebook. We can create a tailored plan to help you achieve your goals and live a healthier, pain-free life.
  1. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Pain#:~:text=An%20estimated%2075%2D85%25%20of,and%20pain%20improves%20without%20surgery.
  2. https://pubmed.ncbi.nlm.nih.gov/25430861/
Adding Health To A Long Life, Why Muscles Are Key
Aging is an inevitable part of life, but the way we age might be more in our control than we think. Muscular weakness has long been associated with declining overall health as we age but muscular strength can reverse it. A recent study of 1275 older adults has shed new light on the relationship between muscular strength and aging (1). The intriguing findings suggest that maintaining solid muscles may be vital to slowing biological aging.

The Link Between Muscular Weakness and Aging

The researchers state, ""There is a large body of evidence linking muscular weakness, as determined by low grip strength, to a host of negative aging-related health outcomes. Given these links, grip strength has been labeled a ''biomarker of aging."" When most people think of aging, they consider it in terms of the number of years they have lived, also known as their chronological age. However, biological aging, which refers to the changes that occur in our bodies over time, can be different from chronological age.  Biological age is a more meaningful measure of aging as it is modifiable and varies from person to person. We can gain insights into disease risk and overall health by measuring biological age.

How do we measure biological age?

Scientists have recently developed epigenetic clocks to give you an idea of your body's biological age. For example, imagine we are studying identical twins who were both 40 years old, but one was overweight, never exercised, drank excessively, and had a history of high stress. By contrast, the other ate well, managed stress, and had a regular exercise regime; an epigenetic clock should be able to look at the DNA of the ''hard living'' twin and notice that their body had aged faster than the other. 

How do they do that?

These clocks analyze patterns of DNA methylation, and by comparing an individual's DNA methylation pattern to a reference population, researchers can estimate their biological age. There are even clocks such as the PhenoAge clock, which have proven to be accurate predictors of remaining life expectancy and disease risk. To learn more about epigenetic clocks, check out my interview with Dr Morgan Levine, the inventor of PhenoAge, here.

What does this have to do with grip strength?

Muscular weakness has been linked to various adverse outcomes associated with aging, like diabetes, cognitive decline (e.g., Alzheimer's disease), and early all-cause mortality. This study aimed to see if there was some connection between what the epigenetic clocks showed and what the grip strength test showed. Only some people can access epigenetic testing, so measuring grip strength would be an excellent proxy. It was remarkable that they discovered that increasing muscular strength contributes to a slower pace of biological aging. So what does this mean? It really underscores the importance of regular physical activity, including strength training, in our lives. This is important because nearly all my clients over 50 have no regular weight training routine. They are usually 2-5 lbs if they lift weights, which is needed. Four key takeaways:
  1. Exercise for Longevity: Incorporating strength training exercises into your fitness routine can be a powerful tool in promoting a longer, healthier life. If you don't know how to do that, there are many resources for personal trainers on the internet and in person.
  2. Quality Over Quantity: The focus should not just be on adding years to your life but on adding life to your years. Strong muscles may contribute to a more active and independent lifestyle as you age. Do we stop playing because we get old, or do we get old because we stop playing? 
  3. Preventative Medicine: By taking steps to maintain and improve your muscular strength now, you can stave off age-related health issues in the future. Add to the bank now to help protect yourself in the future. 
  4. Lifestyle Medicine Approach: Don't forget that a balanced diet, mental stimulation, and social engagement are also important factors in healthy aging. A lifestyle approach to well-being is vital if you want help with lifestyle medicine.
Studies like this highlight the significant link between muscular strength and biological aging. Maintaining solid muscles plays a vital role in slowing the aging process. If you want to age gracefully, stay active, and put a health span into your life, then incorporating regular strength training into your daily life should be a crucial part of your future. Sometimes, you need a coach to help set you on the right path.  If you want to talk to me about your specific situation, please get in touch with me via the Contact Us page, and we'll see if we can make ''your lifestyle your medicine''.
  1. https://pubmed.ncbi.nlm.nih.gov/36353822/ https://youtu.be/PPoaG0HwVxI https://youtu.be/PPoaG0HwV
Unleashing Your Body’s Healing Potential: Insights from Psychoneuroimmunology and Biohacking
I wouldn't say I like the word biohacking. For some reason, it feels harsh; it sounds like we are breaking some natural law to create a change in the body.  However, they don't do this when I speak to doctors and researchers in the biohacking community.  I think that the word bio-harmonizers would be more fitting. With this in mind, I recently had the pleasure of speaking to Dr. Olivia Lessler on my podcast about her journey into medicine and her current approach to optimizing people's wellness through psychoneuroimmunology.  Rather than simply prescribing medications, Dr. Lessler looks for the root cause of her patients' ailments and empowers them to take an active role in their healing. When she was at medical school, this shift in perspective went against the trend. Still, it led her to delve deep into the science of the mind-body connection, exploring how our thoughts, emotions, and lifestyle choices can profoundly impact our physical health.

The Limitations of Traditional Medicine

Like most doctors, she is curious about the cause of disease rather than how to treat its symptoms. She noticed that the conventional medical approach often falls short when it comes to addressing the complex, multifaceted nature of chronic conditions. Frustrated by the "guidelines to write prescriptions," she recognized the need for a more holistic, personalized approach that goes beyond treating symptoms. The rise of functional medicine and, to some extent, biohacking has brought a wealth of new testing and assessment tools to the table.  Some functional medicine Doctors live by the mantra of "test don't guess," but others say that testing can lead to over-prescription, even if the prescriptions are more natural remedies.  Dr. Lessler is in the latter camp, emphasizing the importance of first addressing the fundamental aspects of health - sleep, diet, movement, and mindset - before diving into extensive (and expensive) testing.

Unlocking the Power of Psychoneuroimmunology

Psychoneuroimmunology is the science of how the mind can influence the body's immune and nervous systems. This field of study reveals the intricate connections between our psychological state, physiological responses, and overall health. For example, inflammation can be a double-edged sword. It's a necessary protective mechanism in the acute stages but can become chronic and harmful if left unchecked. Dr. Lessler helps her patients modulate their inflammatory processes through lifestyle interventions rather than relying solely on anti-inflammatory supplements or medications, which can create a sense of helplessness and mistrust in the body. 

The Importance of Epigenetics and Lifestyle Factors

Contrary to the common belief that our genes dictate our destiny, Dr. Lessler agrees with Dr. Levine, a Yale geneticist whom I interviewed back in Episode 6. She emphasizes the power of epigenetics—the way our environment and lifestyle choices influence gene expression. She cautions against overreliance on genetic testing, which can often lead to a deterministic mindset and unnecessary interventions.   For those of you who are new to epigenetics, I'll give a quick, personal example. My mother has diabetes, as did her aunt.  This means my genetics might predispose me to being diabetic. However, if I choose not to eat the same way my mother did, I wouldn't have the same environmental triggers acting on my genes. Thiswould mean that even though I have the potential to be diabetic, my lifestyle wouldn't encourage it. The same applies to many situations in which we think that it's inevitable that we will develop something our parents or grandparents had, but actually, nature is giving us a massive clue and telling us exactly what to do or not to do to avoid what most would consider fate.  Dr. Lessler encourages her patients to focus on the fundamentals: optimizing sleep, nutrition, movement, and mindset, as all these things have a positive effect on our DNA. By addressing these core aspects of health, she has witnessed remarkable transformations in her patients, even in those with complex, chronic conditions.

Practical Tips for Optimizing Health

When it comes to specific recommendations, Dr. Lessler offers the following insights:

Sleep

  • Aim to align your sleep-wake cycle with the natural rhythms of light and temperature.
  • Limit exposure to blue light in the evenings and consider using blue-light-blocking devices. I wear Swannies and think they are great.
  • Incorporate relaxing rituals, such as a warm bath, to help signal your body that it's time to wind down.
As I live in a hot country, I do the opposite and go into cold water. It works a treat!

Nutrition

  • Focus on nutrient-dense, whole foods that align with your cultural and personal preferences.
  • Avoid processed, oxidized oils and prioritize healthy fats like those in olive oil, nuts, and avocados.
  • Pay attention to how you eat, not just what you eat - mindful, parasympathetic-dominant eating can make a significant difference, or in other words….chew your food!

Movement

  • Incorporate incidental movement throughout the day, such as walking, stretching, and light activity.
  • Engage in forms of exercise that you genuinely enjoy and find sustainable. If you never use it, there is no point in having the best gym routine mapped out for you.
  • Recognize the importance of the lymphatic system and how movement can support its function.  This means gentle rhythmical movements that help move this fluid around the body.

Mindset

  • Cultivate emotional awareness and learn to process difficult emotions healthily.
  • Reframe challenges as opportunities and cultivate a mindset of resilience and adaptability.
  • Explore practices like mindfulness, gratitude, and visualization to promote a parasympathetic state. Many apps can help with this. One I use is Calm.
By embracing this holistic, personalized approach to health and wellness, you and Dr. Lessler's patients can experience remarkable transformations, even in the face of complex, chronic conditions. Sometimes, you need a coach to help set you up on the right path. If you want to discuss your specific situation with me, please contact me via the Contact Us page. We'll see if we can make 'your lifestyle your medicine'.
5 Things Every Lazy Middle-Aged Man Should Try
Osteopath and Lifestyle Medicine Coach Ed Paget shares his expertise on how to avoid – or reverse – the midlife health slump and weight gain.  I'm now firmly in middle age. From the little hair I still have, I can see it's gray; there are a few wrinkles around my eyes, but I'm the same weight as I was when I was 21, maybe even a little lighter. The same is different for my friend group. The 'spare tire' seems to get bigger yearly, and the health complaints keep mounting. Most think it is an inevitable part of aging, but, as I'll explain below, it isn't inevitable; it isn't due to genes, falling testosterone levels or getting older. 

What happens as we get older? 

From a physiological point of view, our ability to gain muscle decreases as we age. If we don't actively seek to keep them, our muscles will tend to waste, and the scientific term for this is sarcopenia. Decreased muscle mass means we need less energy, which can also change our body's ability to handle sugar. Muscles are a great way to use sugar quickly; less of it means excess sugar will be converted to fat. We will gain weight if we don't match our caloric intake with our caloric needs. As we discover, extra fat can produce hormones, and the added stress of middle-aged responsibilities can dysregulate our normal hormonal rhythms. These are the confluence of factors that lead to the "dad bod."   Simply put: Decreased muscle from inactivity plus no change or increased calories consumed equals more fat storage.Add to this the stresses of middle age, and we have hormonal dysregulation, high blood pressure, decreased mental well-being, and a host of other physical and psychological problems that affect men in their 40s, 50s, and 60s. But there is good news—these five tips have been well-proven to reverse these physical and mental changes; we need to follow them.  

1. Get Moving and Stay Active

A sedentary lifestyle significantly contributes to weight gain even when we don't lose muscle. Put bluntly, the World Health Organization (WHO) estimates that physical inactivity is responsible for around two million deaths annually. It warns it could be among the top ten leading causes of death and disability worldwide. Regular physical activity reduces the risk of cardiovascular diseases, diabetes, obesity, and mental health disorders. Actionable Tip: Start with small, achievable goals to incorporate more movement into your daily routine. Simple actions like doing one press-up or squat a day or taking a five-minute run to build a habit of regular activity.  The 19th-century athlete Walter George spent long hours working as a pharmacist and, as a result, couldn't train. Instead, he started running on the spot between customers. He attributed this training method to his success. He held the world record for running the quickest mile, which wasn't beaten for 30 years!  

2. Embrace Strength Training

To counteract muscle loss, we need to do something involving resistance. That means moving something that isn't easily moved, like a weight or band. Not only does it help with weight management, but it also improves balance and coordination and keeps the hormones running just fine. Compared to men in their 20s, only a tiny percentage of middle-aged men meet the recommended guidelines for muscle-strengthening activities. This can be due to the busyness of work and family commitments. However, I always questioned people about how busy they were, and after 20 years of coaching, I usually found a time that people could exercise.   Actionable Tips:
  • Incorporate strength training into your daily routine without needing a gym.
  • Keep weights around your home and lift them during phone calls or whenever you pass by.
  • Lift your children or someone else's…ok, maybe not, but you get the idea.
Simple exercises like squats and lunges can also be done at home; make it a habit. Strength training just twice a week can significantly improve muscle mass and overall health.  

3. Moderate Your Alcohol Consumption

Many middle-aged men shift from binge drinking in their youth to more consistent, daily alcohol consumption. In a recent interview on my podcast, Your Lifestyle Is Your Medicine, I interviewed Kevin Smith (45), who was drinking five days a week and feeling the spread of middle age. He had an epiphany about two years ago when he realized his groggy mornings were why he was seeking out bad food and not going to the gym. Once he cut back and stopped drinking, he had the energy to change his diet and go to the gym. He joined a Cross Fit gym, and he's been there ever since. Now, he's the strongest he's ever been while rocking the body of a 20-year-old.   Actionable Tip: What Kevin did is not for everybody. Many people believe that giving up alcohol may seem like social suicide, but the group "One Year No Beer" advocates a more moderate approach, limiting your alcohol intake to special occasions and avoiding making it a daily habit. They are also an excellent resource for those wanting to re-examine their relationship with alcohol. Also, with the advent of decent-tasting non-alcoholic options, not drinking doesn't mean not socializing.  

4. Pay Attention to Food Labels

Like my old science teacher told me, this is boring but important. The modern food environment is filled with ultra-processed foods (UPFs) high in fat, sugar, and salt. These foods might lie at the core of our current obesity and heart disease epidemics. Our brain is wired to seek sugar, salt, and fat. When we were evolving, these foods were in short supply but provided essential calories and nutrients for survival. We still have the legacy of our more primitive brain coupled with our ingenious ability to satisfy it…and turn a profit at the same time. Unfortunately, these highly addictive foods are marketed aggressively and can contribute to weight gain and other health issues. Actionable Tip: Make a habit of reading food labels and choosing whole, minimally processed foods. Prepare meals at home using fresh ingredients, and be cautious of foods with long ingredient lists or those high in additives. Prioritizing nutrient-dense foods over convenience options can significantly improve your diet. It might sound a little preachy, but finding time to cook with fresh food is one of the best things you can do for your body. If you genuinely have no time, there are some great resources to become more efficient, with companies like 'Hello Fresh' in the UK, delivering fresh food to your house or 'Dashing Dishes' offering meal kits for pick up in Canada.  

5. Maintain Mental and Social Health

A study in the British Medical Journal found that cognitive decline can begin as early as 45, meaning that we have to keep our brains active as we age. Interestingly, the better we are at something, the less we use our brains. For example, a 2003 study in NeuroImage agreed with other studies when it showed that professional musicians used a smaller area of their brain than amateur musicians to play music. This means the mental effort it takes to learn music or even a language is more significant than playing or speaking when you are fluent. The act of leaning stimulates the brain.  Actionable Tip: Engaging in mentally stimulating activities like puzzles and board games will help but as Dr Tommy Wood, associate professor of Neurology at Washington University, recently said on my podcast, it doesn't compare to learning something new like a language or dance. Along with training the brain, we should maintain social connections by scheduling regular meetups with friends or joining clubs and community groups. Activities that combine physical and mental engagement, such as playing sports or attending classes, are particularly beneficial. I've noticed a massive uptake in a game called Pickleball in my community. I've seen people who had a myriad of health complaints, from high blood pressure and reflux to high cholesterol, get the medical all-clear by losing 10lbs and running around a bit.  Middle age doesn't have to mean inevitable weight gain and physical decline. By staying active, incorporating strength training, moderating alcohol consumption, making mindful food choices, and maintaining mental and social health, men can defy the myth of unavoidable middle age spread and enjoy a healthier, more vibrant life. Remember, the key is consistency and making sustainable lifestyle changes. References
  1. World Health Organization. "Physical Inactivity: A Global Public Health Problem." WHO.
  2. Britton, Annie, and Steven Bell. "Alcohol Consumption and Health Outcomes: Evidence from the UK." University College London, 2023.
  3. Singh-Manoux, Archana, et al. "Timing of Onset of Cognitive Decline: Results from Whitehall II Prospective Cohort Study." British Medical Journal, 2012.
  4. Kleber, B., Birbaumer, N., Veit, R., Trevorrow, T., & Lotze, M. (2003). The musician's brain: Functional imaging of amateurs and professionals during performance and imagery. NeuroImage, 20(3), 1817-1829
  5. Podcast: your Lifestyle Is Your Medicine