Herniated disc muscle imbalances are two very different diagnostic conclusions often theorized to be related together by a variety of care providers, including some physical therapists, chiropractors and osteopaths.
While it is possible for a patient to suffer from separate herniated disc pain or anatomical muscle imbalances, some patients seem to have both expressions. In cases where the herniation is suspected of causing nerve compression, the muscular imbalances might be caused or contributed to by the problematic disc pathology.
This essay will provide some evidence of the relationship between intervertebral herniations and muscular imbalances in some patients. We will also help to debunk other cases where a definitive association between the conditions is never established.
Muscle imbalances are defined as a lack of equal functional ability between opposing sets of muscles. To move a body part in different directions, it takes two sets of muscles. One is used for extension, while the opposite set is used for contraction. If one set of muscles is stronger than the other, there is said to be an imbalance in the muscular grouping.
This soft tissue diagnosis has become incredibly popular in complementary medicine and even in mainstream physical therapy, as it is virtually impossible to disprove and allows for continuing and highly profitable hands-on treatment.
In many patients, herniated discs might be implicated as the source of symptoms. In others, muscle imbalances might take the exclusive blame. In a few cases, complete diagnostic evaluation might show a link between herniations in the spine and the muscular imbalances they create elsewhere in the anatomy. This last scenario is the focus of this particular article.
Muscles are innervated by the spinal nerves. These nerve roots are the same often theorized to be compressed by a herniated disc. Remember, if a nerve root is impinged upon, then the effects will possibly be produced locally, at the site of compression, as well as in the areas of the body served by the constricted nerve.
Therefore, when a herniated disc compresses a nerve, the innervated muscle might suffer a functional deficiency, thereby potentially enacting an imbalance.
Additionally, herniated discs compressing the spinal cord might also produce a variety of muscular issues, including imbalances, and these symptoms might be harder to accurately correlate due to the great diversity of possible central spinal stenosis expressions.
When muscle imbalances are blamed on a herniated disc, the theory may be right when the exact symptomatic expression matches the clinical expectation. This is easiest to witness in cases of foraminal stenosis in which one set of muscles is obviously suffering from definitive nerve innervation problems and demonstrates true objective numbness and weakness.
If the opposing muscle set is unaffected, an imbalance could develop if the condition is left untreated. This is certainly a scenario which is possible, but improbable, especially since muscular pain and weakness might be present, but this does not mean there is an imbalance, per se, just a reduction in functional capacity common to any innervation concern.
In rare instances, the explanation of imbalances being to blame for symptoms is plausible and in some extremely uncommon cases, the diagnosis may actually be right. In cases where the spinal cord, cauda equina or a particular nerve root is verified to be structurally compressed by the herniation, and the impingement location correlates to the affected muscles, then the diagnosis has the best chance of being accurate.
Personally, I believe that painful muscle imbalances are quite rare, although they can occur. In the vast majority of diagnosed patients, the criteria used to determine a muscular imbalance is anatomically illogical and often laughably ridiculous.
As a lifetime martial artist, student of the anatomy and certified fitness trainer, I find it hard to believe that some doctors and chiropractors can keep a straight face when explaining the nonsense I have heard used to justify the diagnosis of this condition.
My advice when dealing with any muscle imbalance diagnosis is to learn all you can about the supposed condition and question the diagnostician thoroughly for an explanation which can be proven, not theorized. I would also recommend talking to a neurologist for their thoughts on the symptomatic expression.