A herniated or ruptured disc is an injury to the cushion-like cartilage (the disc) between the bones. The disc’s gelatin-like core leaks. A herniated disc is sometimes mistakenly called a “slipped disc”. This can occur due to sudden trauma or prolonged pressure on the spine. The majority of people affected by this condition are aged between 30 and 50. This is twice the likelihood for men to be diagnosed.
Herniated discs can also be caused by repetitive lifting, overweight, obesity, smoking, poor posture, and weight-bearing sport participation. Physical therapy is the best treatment for most herniated discs. They don’t usually require surgery. The personalized treatment programs that physical therapists develop for herniated discs are designed to allow people to regain normal mobility, reduce pain, get back to their usual activities.
Physical therapists are movement specialists. They can improve your quality of life by providing care and education to patients, as well as prescribing movement. To schedule an evaluation, contact a physical therapy professional directly.
Assessment of a Herniated Disc
However, a disc herniation detected on a magnetic-resonance imaging (MRI)scan does not mean you will experience pain. You may experience a range of symptoms from this condition. Low back pain may be caused by a herniation in your lumbar spine. This depends on the location. The disc material can also cause pain in the legs, feet, and buttocks if it comes into contact with one the spinal nerves. You may feel weakness, tingling, and numbness when you have nerve compression or pinching.
A herniated disc within the cervical spine may cause pain or spasms in the neck and shoulder blades (scapula). If the condition becomes severe, the herniation can pinch a nerve and cause pain in one arm. A herniation of the thoracic (mid-back disc) is less common, and the symptoms are more diffuse. Most often, pain in the abdomen, upper back, and lower back are caused by a herniation. These symptoms can spread down to your legs, causing weakness and pain in the extremities.
Due to the variety of places symptoms can appear, a physical therapist (PT), must begin with an extensive assessment. A PT will not only ask about the cause of your condition but also examine your spine and assess the location of the pain. They may also check the strength of your arm and leg muscles to determine if they have been affected. Your sensation and reflexes will be assessed as well to help determine whether there has been a herniation.
Once they have a better understanding, they can offer beneficial treatments to improve your pain.
Physical Therapy to Treat a Herniated Disc
After your doctor has diagnosed you with a herniated spine and recommended therapy, it is important to find a PT that is skilled in treating this condition. This diagnosis can usually be handled by either an orthopedic or neurologic physical therapist. The American Physical Therapy Association’s website will help you locate an orthopedic clinical specialist (OCS), and a neurologic clinic specialist (NCS).
You will be given a number of goals when you enroll in physical therapy. Based on your direction preferences, you will be shown exercises that can relieve any pressure on your nerves. To stabilize the spine, core stabilization exercises will be recommended. Aerobic conditioning is also available to improve your endurance. The therapist will also help you improve your flexibility by stretching and manual work. The combination of physical therapy, pain medication and education is generally more effective for treating a lumbar disc herniation than having surgery done after three months.
Herniated Discs – Passive Physical Treatments
- Deep Tissue Massage: There are over 100 types of massage. However, a deep-tissue massage is the best choice if you have a herniated disc. It uses great pressure to relieve muscle tension and spasms that can develop and prevent any muscle movement in the affected area.
- Hot and cold therapy: Both hot and cool therapies have their benefits. Your physical therapist may choose to alternate between the two in order to achieve the best results.
- Your physical therapist might use heat to increase blood circulation to the targeted area. By delivering more oxygen and nutrients, blood can help heal the area. The blood also helps to eliminate muscle spasm waste byproducts.
- Cryotherapy (also known as cold therapy) slows down circulation. This helps to reduce inflammation, muscle spasms, pain, and muscle spasms. The physical therapist can place an ice pack on the targeted area or give you an ice massage to reduce inflammation.
- Hydrotherapy: The name of hydrotherapy refers to water. Hydrotherapy is a passive treatment that involves sitting in a warm shower or whirlpool tub. Hydrotherapy can be used to ease pain and relax muscles.
- A transcutaneous electric nerve stimulation machine uses electrical current to stimulate the muscles. It sounds very intense but is not painful. The tiny electrical current is sent to the nerve pathways by small electrodes that are taped to your body. TENS is thought to reduce muscle spasms.
- Traction: The goal is to decrease the impact of gravity on the spine. To reduce disc herniation, traction gently pulls apart the bones. It is similar to a flat tire “disappearing” if you put a jack under it and relieve the tire of its pressure. This can be done in the cervical spine or lumbar.
You may also try active treatment in physical therapy
Active treatments address flexibility and strength as well as core stability and joint movement. A program of exercise may be prescribed for optimal results. This will not only help with recurrent pain but it will also help your overall health. Your physical therapist can work with you to design a program that suits your needs and will take into account your health history.
Core stability is vital for spinal health. Many people don’t know this. Your back muscles support your spine by supporting your core (abdominal). If your core muscles weaken, it can put extra pressure on your back muscles. Your physical therapist may recommend core stabilizing exercises for strengthening your back.
Flexibility: You can prepare yourself for aerobic and strength training by learning proper stretching techniques and flexibility. Flexibility allows your body to move more easily by preventing stiffness
Hydrotherapy: Hydrotherapy is different from passively sitting in a hot bath or tub, but active hydrotherapy could involve water aerobics to condition your body with minimal stress.
Muscle Strengthening: Strong muscles provide support for your spine, and can help with pain.
Your physical therapist will show you how to condition and strengthen the back to help prevent future problems. So you can better manage your symptoms, you might also learn self-care tips. You want to have the knowledge and skills to maintain pain-free living.
You need to learn how you can exercise and condition your spine after physical therapy. The long-term effects of physical therapy will not be enjoyed if you don’t follow the lessons learned. Your back can be taken care of on your own to prevent any further disc problems.
What type of physical therapist am I looking for?
All physical therapists have the experience and education to treat patients with low back pain due to a herniated or bulging disc. Consider these options:
- A physical therapist who has experience in treating orthopedic and musculoskeletal issues.
- A board-certified clinical specialist, or someone who has completed a fellowship or residency for orthopedic physical therapy. This therapist is able to apply their knowledge and skills to your particular condition.
Find a PT allows you to find physical therapists that have these credentials. It is an online tool created by the American Physical Therapy Association. This online tool will allow you to search for physical therapists within your local area.
Here are some tips to help you find a physical therapist.
- Refer to family members, friends, and other health care professionals for advice.
- For an appointment with a physical therapy clinic, inquire about the history of the physical therapist helping patients with a herniated or bulging disc.
- You should be able to describe your symptoms clearly and what makes them worse.
Frequently Asked Question
How can physical therapy be of help for a herniated disc
Physical therapy can reduce the pressure placed on your spinal nerves by alleviating symptoms caused by a herniated disc. It can also strengthen and improve flexibility in the muscles surrounding the affected area.
How long does physical therapy take to treat a herniated spine?
While the initial treatments that a PT uses in the acute stages are likely to provide relief for some symptoms, physical therapy can take a while before you see significant and lasting improvement. One study found that physical therapy for a lumbar disc herniation caused pain relief and improved function. The improvements, however, were not as dramatic as those seen with surgical intervention before the 12-week mark.
How much does physical therapy cost to treat a herniated disc in the neck?
It can be challenging to estimate the cost for physical therapy. Insurance reimbursements vary depending on the insurance coverage and where the service was delivered. Insurance policies often have unique copays, deductibles and out of pocket amounts. These can impact the total amount you are charged. Contact your insurance company to help you find therapy care that is in-network but cost-effective. Many hospitals and clinics offer billing tools that can be used to estimate the cost. For those in financial hardship or uninsured, self-pay plans and discounts might be available.