What Is a Herniated Disc?
A herniated disc is one of the most common causes of lumbar pain among adults, though it can occur in the neck as well. When a disc in the spine herniates, most of a person's daily activities are affected. Signs and symptoms depend on where the disc is located and whether it is pressing on a nerve, patients often describe the pain as a radiating numbness or tingling in the body part served by the affected nerve. A herniated disc often occurs with movements such as lifting, pulling, bending, and twisting.
Risk factors that increase the chance of a herniated disc include excess weight, which puts extra stress on the discs in the lower back; occupations that involve repetitive lifting, pulling, pushing, bending sideways, and twisting; genetics, for those with an inherited predisposition; and smoking, which lessens the oxygen supply to the disc and causes it to break down more quickly.
How Physical Therapy Helps
Pain management and injury prevention are central goals of physical therapy, aimed at helping each patient reach an optimal level of performance. Physical therapy teaches gentle exercises and activities that strengthen the muscles supporting the spine and reduce pressure on the spinal column, exercises patients can also perform at home. It promotes flexibility in the spine and helps reduce the risk of a herniated disc recurring, guiding patients back to their normal lifestyle and activities.
Healing time varies, but results can often be achieved in two to eight weeks or less when a proper posture, pain-reduction, stretching, and strengthening program is implemented. A doctor may suggest starting slowly and building up activity level gradually, discussing which specific exercises a person should and should not perform during recovery. Gentle activities that can help include yoga, swimming, walking, and cycling.
What to Do Right After Diagnosis
In the first 24 to 48 hours following a herniated disc diagnosis, a physical therapist may advise resting the area by avoiding activity that worsens symptoms in the arms or legs, while still avoiding bed rest, staying active around the house and taking short walks several times a day, since movement decreases pain and stiffness. Applying ice packs to the affected area for 15 to 20 minutes every two hours and sitting in firm chairs rather than soft couches can also help, since soft seating may make symptoms worse. Patients should consult a physician for further services, such as medications or diagnostic tests.
What Your Physical Therapist Will Work On
Throughout treatment, a physical therapist will work with a patient to reduce pain and other symptoms, improve posture, improve motion, improve flexibility, improve strength, improve endurance, learn a home program, and return to normal activities. Once pain resolves, it remains important to continue the new posture and movement habits learned in therapy to keep the back healthy and pain-free.
Preventing a Herniated Disc From Recurring
To help prevent a herniated disc, exercise regularly to strengthen the trunk muscles that stabilize and support the spine, and maintain good posture to reduce pressure on the spine and discs, keeping the back straight and aligned, particularly when sitting for long periods. Lift heavy objects properly, letting the legs rather than the back do most of the work, maintain a healthy weight since excess weight puts more pressure on the spine and discs, and avoid tobacco products, since smoking reduces the oxygen supply that keeps discs healthy.
Most patients who choose physical therapy report it as a better option than surgery. Before considering surgery, it's worth consulting with a physician and physical therapist about other options available.