Physical Therapy for Herniated Discs
Physical therapy is the first-line treatment for herniated discs. A herniated disc occurs when the outer ring of the intervertebral disc of the spine is torn, allowing the gelatin-like core to leak which irritates and compresses nearby nerves. This can cause radiating pain, weakness, numbness, and loss of sensation in the back, leg, neck, and shoulder. A herniated disc is more common in the neck or back and is a common cause of low back pain. Physical therapists help those with a herniated disc relieve pain and restore function through strengthening exercises, manual therapy, and posture training.
What is a Herniated Disc?
The spine is composed of 33 bones called vertebrae that are stacked on top of one another, connecting to create a canal that protects the spinal cord. In between each vertebra are intervertebral discs, cushion-like pieces of cartilage that act as shock absorbers in the spine. Each disc is made up of a tough flexible outer ring (annulus fibrosus) with a soft gelatin-like center (nucleus pulposus).
As you age, the water content in your discs decreases, causing the disc to become less flexible; this shrinks the space between vertebrae and causes the space between vertebrae to get narrower. A herniated disc occurs when the outer ring of the disc is torn, allowing the gelatin-like core to leak. This can irritate or compress nearby nerves, leading to radiating pain, weakness, or numbness and loss of sensation.
A herniated disc most commonly occurs in the low back and is one of the most common causes of back pain and sciatica. While a herniated disc can result from a traumatic injury, like a car accident or fall or improper lifting mechanics, it is often the result of age-related wear and tear on the spine and intervertebral discs. A herniated disc can cause sciatica, radiating pain down the buttock through the leg from the low back.
Symptoms of a herniated disc include:
Pain in the neck, low back, arms, or legs
Inability to bend or rotate the neck or back
Numbness or tingling in the neck, shoulders, arms, hands, hips, legs, or feet
Limping when walking and difficulty getting up from a seated position
Unable to stand up straight; being stuck in a position e.g. stooped forward or leaning to one side
Inability to remain in one position for a long period of time due to pain
Physical Therapy for Herniated Discs
Physical therapy is the first line of treatment for herniated discs. Physical therapists help those with a herniated disc relieve pain and restore function through strengthening exercises, manual therapy, and posture training. The physical therapist initially performs an evaluation to assess symptoms, quality of movement, weakness or tightness in muscles, loss of sensation or reflexes, joint stiffness, posture, and walking ability. If testing reveals severe issues with the herniated disc, the physical therapist may refer you to and collaborate with a physician or surgeon for an MRI or surgery. However, research has shown that physical therapy provides effective treatment for the majority of herniated disc cases. Studies reveal that exercise is one of the most beneficial treatments for those with lumbar disc herniation to improve strength, endurance, and coordination of the muscles that support your spine.
Physical therapy treatment for herniated discs can include:
Pain management to relieve inflammation and tension through heat and cold therapy. Heat therapy helps to loosen muscle tightness that can cause spasms, increases blood flow, and improves the elasticity of tissues. Cold therapy decreases the temperature of the tissues, producing an anti-inflammatory effect and reducing pain.
Posture and body mechanic retraining to reduce pressure on the spine as poor posture contributes to herniated discs.
Manual therapy joint mobilization techniques to improve mobility and range of motion of stiff joints and the spine.
Strengthening exercises of weak or injured muscles, focusing particularly on the back, hips, pelvis, and trunk.
Core strengthening to provide greater stability and strength to the spine.
Low-impact aerobic conditioning to restore endurance and improve overall fitness.
Aquatic therapy exercises in a warm water therapy pool to reduce pressure on the spine and joints.
Functional retraining to reduce stress on the spine and back during daily, work, and sport activities.
If surgery is required, rehabilitation with a physical therapist following surgery is essential to regain function and mobility safely
