A herniated disc is when the cushion-like cartilage between the bones of your spine (the disc), is torn and the gelatin-like inner core of the disc leaks. A herniated disc is often mistakenly called “a slipped disc”. It can be caused by trauma to the spine or long-term pressure. Most people with this condition are between 30 and 50 years old. Men are twice as likely as women to get it.
A herniated disc can be caused by repeated lifting, weight-bearing activities, poor posture, smoking, and obesity. Most herniated discs don’t require surgery and can be treated with physical therapy. To help herniated disc patients regain normal movement, decrease pain and return to their daily activities, physical therapists create customized treatment plans. Movement experts are physical therapists. Physical therapists improve the quality of your life by providing hands-on care, education and prescribed movement. For a free evaluation, you can call a physical therapist.
How to Assess a Herniated Disc
A disc herniation found on a magnetic resonance imaging scan (MRI) does not necessarily mean you will feel pain. This issue can cause a number of symptoms. Low back pain can be caused by a herniation of the lumbar spine. It all depends on where it is located. If the disc material comes in contact with any of the spinal nerves, it can cause pain in your legs, buttocks, and feet. Nerve compression or pinching can cause weakness, tingling or numbness in the legs.
A herniated cervical disc can cause spasm or pain in the neck or shoulder blade (scapula). The pain can become so severe that the herniation pinches the nerves in the area, and may cause weakness, numbness, or tingling in your arm, hand or fingers.
Thoracic (mid back) disc herniations tend to be less common and have more complicated symptoms. A herniation of this type can cause abdominal, upper back or lower back pain. You may also feel weakness in your extremities and the symptoms could spread to one or both legs.
A thorough assessment is necessary because of the many places where symptoms may occur. A PT will ask you questions about your condition and examine your spine to determine your mobility. To determine if your strength has been compromised, they will check your leg and arm muscles. They will also need to assess your sensations and reflexes in order to determine if there is a herniation. They can help you improve your pain by getting a better understanding of the problem.
Physical Therapy for a Herniated Disc
Once you have been diagnosed by your doctor with a herniated disc and that therapy has been deemed necessary, it is important that you find a PT who is experienced in this type of treatment. A neurologic or orthopedic physical therapist is likely to be familiar with helping patients with this diagnosis. You can find an orthopedic clinical specialist (OCS), or a neurologic clinical specialty (NCS) in your local area on the American Physical Therapy Association’s site.
Your sessions in physical therapy will have specific goals once you’re enrolled. You will first be taught exercises to alleviate pressure on nerves that may have become compressed due to your preferences for direction. Core stabilization exercises are next to be prescribed to stabilize the spine. Aerobic conditioning can be added to increase your endurance. Stretching and manual therapy by a therapist can help improve your flexibility. A combination of physical therapy and pain medication is more effective than surgery after three months for treating lumbar disc herniation.
Herniated Discs: Passive Physical Treatments
- Deep Tissue Massage: Although there are many types of massage available, a deep tissue massage is the best option for a herniated disc. It uses high pressure to release muscle tension and spasms. This prevents muscle movement at the affected area.
- Hot and Cold Therapy: Each therapy has its own benefits and your physical therapist might alternate them to achieve the best results.
- The heat may be used by your physical therapist to increase blood flow to the area. The blood helps to heal the area by providing extra oxygen and nutrients. Also, blood removes muscle spasm-related waste products.
- Cold therapy, also known as cryotherapy, slows down circulation. This can reduce inflammation, pain, muscle spasms and pain. To cool inflamed tissue, your physical therapist might place an icepack on the area.
- Hydrotherapy: Like its name implies, hydrotherapy is water. Hydrotherapy can be passively done by simply taking a warm bath or sitting in a whirlpool. Hydrotherapy is gentle and relaxing.
- Transcutaneous electrical nerve stimulation machines use an electric current to stimulate your muscles. Although it sounds intense, it’s not painful. An electrode taped to your skin sends a small electrical current to specific points along the nerve pathway. TENS is believed to reduce muscle spasms. It also triggers the release of endorphins which are your body’s natural painkillers.
- Traction: This is a technique that reduces the gravity’s effects on the spine. The goal of traction is to reduce disc herniation by gently pulling apart bones. This analogy works in the same way as a flat tire “disappearing”, when you place a jack underneath the car and release the pressure. You can do it in your cervical or lumbar spine.
Physical Therapy May Offer Active Treatments
Active therapies address flexibility, strength, flexibility, core stability, joint movement, and posture. To achieve the best results, an exercise program might be recommended. This will help you not only reduce recurring pain, but also improve your overall health. Your physical therapist will collaborate with you to create a program that is based on your particular diagnosis and history.
Core stability: Many people don’t realize the importance of a strong core for their spinal health. Your spine is supported by your core (or abdominal) muscles. Your back muscles feel extra pressure if your core muscles are weak. To strengthen your back, your physical therapist might suggest core stabilizing exercises.
Flexibility: Learn proper stretching and flexibility techniques to prepare for strength and aerobic exercises. Flexibility makes it easier for your body to move by eliminating stiffness.
Hydrotherapy: This is not the same as passive hydrotherapy, which involves a bath or hot tub. Active hydrotherapy can include water aerobics that will condition your body and help you avoid unnecessary stress.
Muscle strengthening: Strong muscles can be a great support system to your spine and help you manage pain better.
Your physical therapist can teach you how to strengthen and condition your back to prevent future pain. To help you manage your pain, you may be taught self-care techniques. Your ultimate goal is to be able to live a pain-free life.
After the formal physical therapy is over, you must learn how to condition and exercise your back. You won’t be able to benefit from the long-term benefits of physical therapy if you don’t apply the lessons learned. You can prevent more disc pain by taking good care of your spine.
What kind of physical therapist do I need?
Physical therapists have the education and experience necessary to treat low back pain caused by a herniated disc. This is something you might want to think about:
- A physical therapist that is skilled in treating patients with orthopedic or musculoskeletal problems.
- A board-certified physical therapist or a fellowship or residency in orthopedic physical therapy. The therapist may have advanced knowledge, skills, and experience that could be applicable to your situation.
Find a PT is an online tool developed by the American Physical Therapy Association that allows you to search for physical therapists in your area who hold these credentials.
These are some general tips for those who are looking for a physical therapist.
- Ask for recommendations from friends and family.
- Ask about the experience of the physical therapist in treating people with herniated discs when you call a clinic to make an appointment.
- Prepare to describe your symptoms as fully as you can. Also, be prepared to tell us what is causing your symptoms to worsen.
Most Frequently Asked Questions
What can physical therapy do for a herniated disc?
Physical therapy can be used to treat symptoms of a herniated disc by reducing pressure on the spinal nerves. Physical therapy can help you build strength and flexibility in the muscles supporting your spine.
What is the average time it takes to get physical therapy for a herniated disc?
Although the initial treatment of a PT in acute disc herniation stages may offer some relief, it is possible that physical therapy will take some time to bring about significant and lasting improvements.
One study showed that physical therapy for lumbar disc herniation was effective in reducing pain and improving overall function. However, these improvements were not comparable to surgical intervention after the 12-week mark.
What is the cost of physical therapy for a herniated neck disc?
It can be difficult to calculate the cost of physical therapy. The location of the service and insurance coverage will determine the amount of reimbursement. Many policies have specific co-pays, deductibles and out-of-pocket amounts which can greatly impact the amount that is billed.
Your insurance company can help you find the right therapy care, which is both affordable and in-network. To help you estimate the cost, many hospitals and clinics have their billing resources available on their websites. Individuals in financial need, or those who are not insured may be eligible for self-pay or discount plans.