If you have a herniated lumbar disc then you may experience pain and restriction of motion. You may be wondering if physical therapy can help, or your doctor may be recommending it. Or you may be afraid you are going to need surgery.
What is a Herniated Lumbar Disc?
Your spine has cushions between the vertebrae to prevent them from grinding against each other. A herniated disc happens when the disc is torn or ruptured and bulges into the spinal canal. It is one of the more common causes of back pain. This can happen after a back injury, after a mild strain as you get older, or as a result of degenerative disc disease (DDD). Age is a major risk factor for a herniated lumbar disc, as is spinal stenosis, which happens when the space inside the backbone is too small.
Most herniated discs are in the lower back (lumbar) region, but they can happen higher up too.
What are the Symptoms of a Herniated Disc?
Symptoms can vary, but may include:
- Pain in the back.
- Pain in a limb. For lumbar discs, this often means pain in the buttocks, thigh, and calf on one side, possibly in part of the foot. If the disc is higher, you may experience pain in the shoulder or arm. This is caused by the disc pressing on the nerves that serve the affected area.
- Numbness or tingling in the affected limb.
- Weakness in the affected limb.
In some cases, a herniated disc may not present any symptoms at all. Symptoms tend to improve over time as inflammation reduces.
Can Therapy Help a Herniated Disc?
Physical therapy is, in fact, a go-to treatment for herniated discs. In some cases, a herniated disc can resolve itself with a period of reduced activity (but not bed rest) and nonsteroidal anti-inflammatory medication to reduce pain. If this does not work, however, therapy is the next step. Surgery is only for people with disc issues for whom therapy does not work.
How do Physical Therapists Treat Herniated Discs?
Treatment varies depending on the location and severity of your bulging disc. However, the focus is always on improving motion and reducing pain. Your physical therapist will work with you on a specific treatment plan. This typically involves a combination of passive movement (where the therapist physically moves you) and active movement (where you move yourself).
Therapy may or may not follow a specific approach. These are the two most common:
- The McKenzie Method. This is a specific series of exercises that you do every day until the pain from the exercise decreases, before moving on to the next one.
- Mulligan’s Technique. This uses something called SNAGs, which stands for Sustained Natural Apophyseal Glides. You perform the motion that induces pain and the therapist applies an appropriate glide, which should result in pain-free movement.
You might also see a combination of these. Other techniques commonly used include:
- Manual treatment.
- Core strengthening and stabilization exercises to take the strain off of your back. Core strengthening can also help prevent disc injuries from developing or recurring.
- Myofascial relief and deep tissue massage.
The goal is to restore movement, relieve pain, and reduce inflammation. Your therapist will also give you advice on preventing further damage, which might include core strengthening and posture training.
The short answer is that therapy is useful for herniated discs. In fact, it is typically the first treatment prescribed if rest does not resolve your symptoms. Physical therapy, not surgery, is the first line of treatment and in most cases can resolve your symptoms and help you return to a normal, pain-free life.
For more information, contact us at Cawley Physical Therapy and Rehab and find out how we can help you.
