Prevention and Prognosis

1. Prevent new damage to the disc
2. Create conditions so that damaged tissue can heal as well as possible

Preventive recommendations

• A good understanding of the issue is necessary to recover and prevent new damage to the back. Therefore, read carefully both the section on 'hernia and lumbago' and'chronic back pain'.

• Take body signals seriously:

- Rest in time if the back becomes tired
- Stop an activity immediately if the back becomes painful or more painful

• Ensure the back is in a relaxed position at night. Sleep with a body pillow (more info: best sleeping position, less complaints);

• Ask someone to check if your back is straight when lying on your side on your mattress. If not, consider purchasing a custom mattress.

• If the back becomes stiffer later in the day (again), repeat the exercises;

• Take extra breaks during back-straining activities you are not used to;

• Increase load capacity through (medical) fitness, but do so very gradually. Do not force anything and do not do abdominal exercises without instructions from a therapist (more info: abdominal and back muscle exercises);

• Be very active: walking, cycling, swimming. Build up from three times 5 minutes of walking per day (end of acute phase) to as often and as long as possible and comfortable (more info: effect of active movement);

• Avoid bending as much as possible and avoid repetitive bending completely (more info: risk of bending);

• If bending is unavoidable, bend your knees and minimize bending your back (more info: risk of bending);

• Lift only as far as it does not cause fatigue or pain in the back.

• Avoid postures where the back is curved. Do not slouch on the couch and do not sit too long in one position;

• Stand up regularly and alternate sitting, walking (and if necessary also lying down) regularly.

• Be careful with loading and moving after a long car ride. The back is then more vulnerable (more info: effect of static load);

• Use the lumbar support of the car and office chair or, if not available, use an external lumbar cushion. Also use this at home on the couch or in a chair;

• If the back feels tired or extra painful, also lie down on your side with a body pillow between the knees and possibly on your back with legs bent and a thick pillow under the knees;
  
  

A) Prognosis of disc damage (lumbago, hernia and many chronic back complaints)

The prognosis for lumbago and hernia depends on the damage to the disc. It also strongly depends on the prevention measures taken. Without preventive measures, not only is recovery delayed, but there is also a high chance of recurring back problems.
The healing of the tissue in the annulus takes time. The fibers consist of collagen connective tissue and heal slowly. With sufficient preventive measures and exercises, improvement usually occurs quickly (after one to several months). The back then becomes reasonably load-bearing again. After about 3 years, the disc can be fully healed again. At every stage, it is advisable not to overload and to stop at the first body signals indicating the limit of load capacity has been reached (fatigue in the back).

B) Prognosis of joint pain and muscle disorders