Part Two, How A Physical Therapist Treats Disc Herniation
As explained in Part One of our Herniated Disc Series, a disc herniation occurs when the soft, jelly-like center of a spinal disc pushes out through a tear in the tougher exterior layer; basically, your spine has a bunch of little bones in it, and each bone has a cushion above/below it. Disc herniation occurs when this cushion is pushed out of place. This can cause pain, numbness, or weakness in the limbs, depending on where the herniation occurs in the spine. The most common areas for a disc herniation are the lower back (lumbar spine) and the neck (cervical spine). When a disc herniates, it can press on nearby nerves, leading to the symptoms many people experience.
Initial Assessment
When you visit a Texas physical therapist for a herniated disc, the first step is a thorough assessment. The therapist will ask about your symptoms, when they started, and what activities make them better or worse. They’ll also review your medical history and perform a physical examination. This examination often includes checking your posture, range of motion, and the strength of your muscles. The therapist may also perform specific tests to determine which nerves are affected and how severe the herniation might be.
This initial assessment is crucial because it helps the therapist understand the extent of your injury and develop a treatment plan tailored to your specific needs.
Education And Understanding Your Condition
A big part of the treatment process involves educating you about your condition. Your therapist will explain what a herniated disc is, how it’s affecting your body, and what you can do to manage your symptoms. Understanding your condition is important because it empowers you to take an active role in your recovery. The therapist will also address any concerns or misconceptions you may have. For example, some people might think they need to avoid all physical activity, but in reality, certain exercises can be very beneficial.
Pain Management
Managing pain is often the first priority in treating a herniated disc. Physical therapists have various techniques to help reduce your pain. One common method is manual therapy. This involves the therapist using their hands to apply pressure and manipulate your muscles and joints. This can help relieve tension and improve blood flow to the affected area, which can reduce pain and inflammation.
Another technique is the use of modalities like heat, ice, or electrical stimulation. Heat therapy can help relax tight muscles, while ice can reduce swelling and numb painful areas. Electrical stimulation, such as Interferential Current (IFC), uses low-voltage electrical currents to provide pain relief by disrupting the pain signals sent to your brain.
Exercises To Strengthen And Stabilize
Once the pain is manageable, the focus shifts to exercises that can help strengthen the muscles supporting your spine and improve your flexibility and posture. Strengthening exercises target the muscles in your back, abdomen, and hips, which play a crucial role in supporting your spine and maintaining good posture.
For example, your therapist might guide you through exercises like:
- Abdominal Bracing: These help strengthen the deep, corset-like stability muscles of your trunk.
- Bridging: This exercise targets the gluteal muscles and lower back, which are important for supporting the spine.
- McKenzie Exercises: These are specific exercises designed to help reduce the pain associated with disc herniation by encouraging the disc material to move away from the nerves. In the video below, founder Eric Finger demonstrates some exercises that are part of the McKenzie protocol.
Flexibility exercises, on the other hand, focus on improving the range of motion in your spine and other related areas. Stretching the hamstrings, hip flexors, and other muscles around the spine can help reduce the strain on your back. Your therapist will create a custom set of exercises for you that target your problem areas so that you can support your body as it recovers from a herniated disc.
Posture And Body Mechanics
A significant part of managing and treating a herniated disc is learning how to move your body in ways that reduce stress on your spine. Your physical therapist will teach you proper posture and body mechanics. This includes how to sit, stand, and lift objects correctly.
For example, if you have a desk job, your therapist might show you how to set up your workspace to reduce strain on your back and neck. This might involve adjusting your chair height, using a footrest, or positioning your computer screen at eye level. Your therapist can also teach you exercises that counter the pressure you put on your body from sitting all day. If you frequently lift heavy objects, your therapist will teach you to lift with your legs rather than your back to avoid putting unnecessary pressure on your spine. They can also teach you some warm-up type stretches to do before lifting heavy objects to loosen up your body beforehand.
Learning and consistently practicing good posture and body mechanics can significantly reduce your risk of future injuries and help you manage your current condition.
Core Strengthening
Strengthening your core muscles is a key component in treating a herniated disc. The core muscles include not just your abdominal muscles, but also the muscles in your back, sides, and pelvis. These muscles work together to support your spine and keep it stable during movement.
Your physical therapist will guide you through exercises that target these muscles. Some common core strengthening exercises include:
- Planks: These involve holding a push-up position to engage the abdominal and back muscles. There are several variations that can be done to either protect your lower back, your knees, or even your shoulders.
- Bird-Dog: This exercise involves balancing on your hands and knees while extending one arm and the opposite leg, which helps improve stability and strengthen the core.
Building a strong core can alleviate some of the pressure on your spine, reducing pain and preventing further injury.
Stretching And Flexibility
Tight muscles can put extra stress on your spine, which can worsen the symptoms of a herniated disc. Stretching exercises are an essential part of physical therapy because they help to keep your muscles flexible and reduce this stress.
Your physical therapist will teach you how to stretch key muscle groups like your hamstrings, hip flexors, and lower back. For example, hamstring stretches can help relieve tension in the lower back, while stretching the hip flexors can improve posture and reduce strain on the spine; many people carry their stress in the neck or hips, which can lead to a disc herniation.
It’s important to perform these stretches regularly, as maintaining flexibility can help manage pain and prevent further injury.
Aerobic Conditioning
Aerobic exercises, or activities that get your heart rate up, are also an important part of treating a herniated disc. These exercises help improve blood flow, which can promote healing and reduce pain. They also help you maintain a healthy weight, which can reduce the strain on your spine.
Your therapist might recommend low-impact aerobic exercises like walking, swimming, or cycling. These activities are easier on your joints and spine compared to high-impact activities like running or jumping. As mentioned earlier, your first thought might be that all exercise is bad after a herniated disc. However, with approval from a professionally trained physical therapist, there are certain exercises that will be beneficial to your healing journey as well as building strength to avoid more herniated discs in the future.
Starting with short, easy sessions and gradually increasing the duration and intensity as your condition improves is often the best approach. This way, you can build your endurance without overloading your spine.
Manual Therapy
Manual therapy is a hands-on technique that physical therapists use to mobilize joints, stretch muscles, and reduce pain. For someone with a herniated disc, manual therapy can be particularly effective in relieving muscle tension and improving mobility.
Your therapist might use techniques like:
- Joint Mobilization: This involves gently moving the joints in your spine to increase range of motion and reduce stiffness.
- Soft Tissue Mobilization: This focuses on the muscles and connective tissues around your spine. The therapist may use their hands to apply pressure and stretch these tissues, which can help reduce pain and improve flexibility.
Manual therapy is often combined with exercises and other treatments to provide comprehensive care for disc herniation. Again, your therapist will tailor your exercises to your specific injuries as someone who has injured their lower back should not do the same exercises as someone that has injured their neck.
Patient Education And Lifestyle Modifications
Education is a critical part of physical therapy. Your therapist will work with you to understand how lifestyle factors might be contributing to your disc herniation and what changes can be made to support your recovery.
For instance, they might discuss:
- Weight Management: Carrying extra weight, especially around the abdomen, can put additional pressure on your spine. Your therapist may provide guidance on weight management strategies to reduce this burden.
- Quitting Smoking: Smoking can decrease blood flow to the spinal discs, which can impair healing. If you smoke, your therapist might encourage you to quit and provide resources to help you do so.
- Stress Management: Stress can contribute to muscle tension and pain. Techniques like deep breathing, meditation, or yoga might be recommended to help manage stress.
Making these lifestyle changes can play a significant role in your recovery and help prevent future issues. Eating healthy is also a big key factor that can help protect your body from future injuries.
Progress Monitoring And Adjustments
Physical therapy is not a one-size-fits-all solution. Throughout your treatment, your therapist will monitor your progress and adjust your plan as needed. This might involve increasing the intensity of your exercises, adding new treatments, or modifying your activities based on how you’re responding to therapy.
Regular follow-up appointments allow your therapist to track your improvement and ensure that you’re on the right path. If certain exercises or techniques aren’t working as expected, your therapist will make the necessary adjustments to keep your recovery on track.
Be open and honest with how you feel and how often you are keeping up with your exercises. All of this plays into your health, and it helps your therapist best treat your injuries. Always feel free to ask any questions you may have whether you want to know what group of muscles an exercise targets or maybe why one exercise is better than another.
Long-Term Management And Prevention
Once your symptoms have improved, your therapist will help you develop a long-term management plan. This plan will include exercises and strategies to prevent future disc herniations and maintain your spine health.
For example, you might be given a home exercise program to continue building strength and flexibility. Your therapist will also review the importance of maintaining good posture and body mechanics in your daily activities. It is important to stick to this regimen to see results, or else you might return later with the same injuries.
Staying active, maintaining a healthy weight, and practicing good body mechanics are key components of long-term spine health. Your therapist will provide you with the tools and knowledge you need to manage your condition and prevent future injuries.
Treating a herniated disc with physical therapy involves a comprehensive approach that includes pain management, strengthening exercises, posture correction, and education. By working closely with a physical therapist, you can reduce your symptoms, improve your spine health, and get back to your normal activities. Remember, every person is different, and the key to successful treatment is a personalized plan that addresses your unique needs. With the right guidance and commitment to your therapy, you can manage your herniated disc effectively and prevent future problems.
Work with a therapist from Move Empower Concierge Physical Therapy to get back on the road to being pain free. Schedule a FREE discovery session today with one of our specialist physical therapists who have experience treating herniated discs and the related pain they cause.