Disc Pain? Surgery’s Not the Only Option

People with all sorts of injuries or conditions have reaped the benefits of physical therapy. From car accidents to amputations or rheumatoid arthritis to surgery, PT can help the body re-learn, improve and exceed expectations. In fact, PT is sometimes the treatment of choice over surgery, and this is true of some back injuries. Let's focus on one such injury: herniated discs. The term alone sounds awful, excruciating, and like it needs surgical care. But before anyone picks up a scalpel, it may be wise to seek the benefits of physical therapy.

WHAT IS A HERNIATED DISC?

The spine is an amazing part of your body. It provides strength, control and movement. The bones, or vertebrae, that make up the spine are cushioned by small, spongy discs. When the discs are healthy, they act like little shock absorbers for the spine, keeping it flexible. But if a disc is damaged, it can bulge out or break open, also referred to as a herniated disc. (You may also hear the terms "slipped disc" or "ruptured disc.")

CAUSES AND SYMPTOMS

A herniated disc may be caused by:

  • Wear and tear of the disc 

  • Aging: As you get older, the discs dry out and 
aren't as flexible 

  • Injury to the spine

WHAT ARE THE SYMPTOMS?


A herniated disc presses on nerve roots, which can send pain all over the body. Here are the most 
common symptoms:

  • Pain 

  • Numbness and weakness in areas of the body 
where the nerve travels 

  • Sciatica (pain/numbness down the buttock 
and leg) 

  • Backache 

  • Loss of bladder/bowel control
    It is important to note, if the herniated disc isn't pressing on a nerve, you may actually not have any pain at all.

HOW CAN PHYSICAL THERAPY HELP?

Depending on the severity of the injury, there are a variety of physical therapy techniques that may be used for treatment. To better understand them, they can be split up into two main categories: passive treatment and active treatment. Passive treatments sound exactly like what they are—these treatments aim at the relaxation of the body. Active treatments are used to address joint movement, strength, flexibility and posture. 
It is common to begin a routine of passive treatments, then switch to active treatments. This gives the body a chance to heal and then work at improvements. But just as each patient is different, each physical therapy routine also varies. Only a licensed PT can develop a plan that is best for you. 
Let's explore each branch of treatments and how they can help you.

PASSIVE TREATMENTS

  • Deep Tissue Massage: This type of massage uses a lot of pressure to relieve deep muscle tension and spasms.
  • Hot and Cold Therapy: Heat can be used to increase blood flow to the target area. Blood delivers necessary oxygen and nutrients, which not only help heal, but also get rid of waste caused by muscle spasms. 
Cold therapy is just the opposite. It slows circulation, which reduces inflammation, muscle spasms and pain.
  • Hydrotherapy: Typically involves sitting in a whirlpool or tub and allowing the water to relieve pain and relax muscles.
  • TENS (transcutaneous electrical nerve stimulation): Electrical currents are used to stimulate your muscles. But don't be alarmed. It may sound intense, but it actually reduces muscle spasms and releases endorphins.

ACTIVE TREATMENTS

  • Core Stability: Your core (abdominal) muscles help your back muscles support your spine. If they are weak, extra pressure is put on your back. Exercises can help strengthen your core and alleviate back pain.
  • Flexibility: Stretches and flexibility techniques are important to eliminate stiffness.
  • Hydrotherapy: Remember this is active treatment, so this type of hydrotherapy involves water aerobics.
  • Muscle strengthening: Building muscle around troubled areas in the body can help in mobility and strength.

DISCUSS IT WITH YOUR PT

If you have back pain and suspect that you may have a herniated disc, it is important to see a physician right away. You will undergo an exam, X-ray and may be referred to a physical therapist. Here is what you need to know when seeing a PT:

  • Make sure the cause of the condition is identified.
  • Develop a targeted program specific to your condition.

If those two things didn't happen, here's what you need to ask for:

  • Can you figure out what caused my condition?
  • Did you identify any muscle imbalances? If so, ask specifically what they are and how they can affect you.
  • Did you identify any postural dysfunctions?

  • Explain the exercises you are prescribing and how each one will affect my injury.
  • Will my program work to bring my body back into balance, or strengthen? (Remember, you want both!)


If PT doesn't work, surgery may be recommended. But just remember you have options. Be sure to discuss all of them with your physician/ PT before any procedure is scheduled.

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