Physical Therapy for Herniated Disk: Treatment and Exercises
A herniated disk affects up to 2% of people each year. They can occur anywhere along the spine, but the most common locations are the lower back and the neck. A herniated disk in the middle of the back is relatively uncommon.
However, despite the prevalence, not many people know that majority of such issues as neck, arm, or back pain are caused by herniated disks making it vital to always consult with a professional when experiencing potential symptoms.
The good news is that in about 90% of cases, the herniated disk doesn't require surgery and can heal with physical therapy for a herniated disk.
In this article, we explore what a herniated disk is, how physical therapy can help, and which physical therapy exercises for a herniated disk to incorporate into your routine.
What Is a Herniated Disk?
The spine is made up of vertebrae that run from the base of the skull to the tailbone, and there are gel-like disks between each of them. The main purpose of a spinal disk is to absorb the stresses of the spine and make movement smooth and easy.
However, when the gel-like part of the disk tears, leaks, or protrudes through the outer disk layer, the person experiences what it's called a herniated disk.
Credits: MayoClinic
Although it's most common in the lower lumbar spine, this problem can occur in any of the three sections of the spine, including the neck.
Physical therapy for herniated disks is one of the best ways to approach herniated disk treatment and manage its symptoms.
What Are the Symptoms of Herniated Disk?
Usually, people don't feel where the herniated disk is because it doesn't necessarily have any symptoms.
What people notice is the new challenges, such as difficulty in bending over and picking something up, feeling discomfort or pain when carrying heavier things, or starting to feel uncomfortable with specific movements.
Credits: OrthoInfo
Some start changing their sitting positions, shift while sitting, or prefer standing or walking to sitting out of a sudden.
The lack of symptoms is one of the reasons why patients don't get diagnosed for a long time or get diagnosed accidentally.
However, this doesn't change the fact that discomfort will most likely continue and worsen, so it's critical to visit the doctor as soon as possible when noticing changes and start herniated disk therapy.
Common herniated disk symptoms include:
Pain. Depending on the person and the area of disk herniation, people can experience dull, sharp, shooting, or aching pain in their back, neck, hands, or legs. This includes sciatic nerve pain.
Tingling & pins and needles. Tingling can occur together with pain or separately due to pressure on the nerves. People may experience it in their low back, legs, hips, or arms. A similar symptom is pins and needles that last longer than usual when the arm or leg starts waking up after falling asleep.
Credits: University of Maryland
Muscle weakness & spasms.
Because the spine nerves are pressured, patients may experience muscle spasms and muscle weakness in the long term.
Numbness & stiffness. Numbness from herniated disks may affect the legs, arms, shoulders, and hands. If the herniated disk is in the cervical spine, it can also cause neck stiffness.
Loss of bowel control. This is one of the most dangerous symptoms, and people who experience it should not wait and go to the emergency room immediately.
What are the Main Causes of Herniated Disk?
It's important to note that herniated disks can happen through both an injury and degeneration over time.
The risk factors are extra weight, incorrect posture, repetitive lifting, genes, and aging.
A herniated disk is common in the older population because of its wear and tear throughout the years. As we age, disks become stiffer and are more susceptible to tears.
When it comes to injury, sometimes it can be a sudden blow to the back or a sudden fall; however, often, it's something as simple as lifting something heavy or twisting when doing that.
Herniated disk physical therapy is needed to manage pain and heal.
Risk factors and causes for a herniated disk include:
Excess weight as it puts pressure on the disks in the lower back.
Repetitive lifting, pulling, pushing, twisting, and bending sideways.
Sitting for long periods at work or in the car can put pressure on the spine.
Genetic predisposition to developing a herniated disk (if possible, check with your family members)
Smoking as it hinders the oxygen supply to disks and leads to a faster breakdown.
Injuries such as a blow to the spine, fall, or automobile accident can cause an intervertebral disk to rupture and a herniated disk.
Age is a common factor as the disk starts losing the cushiony fluid leading to disk thinning and rupture over time.
How is a Herniated Disk Diagnosed?
It is essential to visit your doctor or physical therapist as soon as you feel any symptoms that may potentially be a sign of a herniated disk.
When you visit your doctor or physical therapist, they will assess your pain, muscle strength, sensations, and reflexes. They may also order some tests.
Hearing out the patient's symptoms is the first step, as it is the first sign for the health provider to look further.
A physical exam follows, during which the doctor or therapist checks the back for tenderness and other signs of a herniated disk. The exam may include moving your legs to various positions and lying on your back to determine the pain's possible cause.
Magnetic resonance imaging (MRI) is the most common and accurate imaging test. It can help determine if the patient has one or more herniated disks.
X-rays help rule out other potential causes of back or neck pain.
How Can Physical Therapy Help?
The answer to the question can physical therapy help herniated disks is a resounding yes.
Physical therapy for a lower back herniated disk and other herniated disks can reduce pain, increase mobility, and decrease inflammation, speeding up the healing process.
There are many modalities of physical therapy for the herniated disk in the lower back, including manual therapy techniques like joint mobilization, soft tissue mobilization, and trigger point dry needling. These can be used on the lumbar and thoracic spine.
These combined modalities and physical therapy exercises can help improve muscle strength and flexibility, core stability, endurance, etc. The exercises include strength training, stretching, and resistance exercises.
How Long Does a Herniated Disk Take to Heal?
Depending on the individual condition, the answer to the question of how long does herniated disk take to heal varies from 6 to 12 weeks.
It mainly depends on the extent of the herniation and what structures are impacted, as well as on the treatment, physical therapy modalities, and exercises.
The key to promoting speedy healing and reducing potential complications is doing the work and not ignoring the problem.
The treatment process usually encompasses a holistic approach, and your therapist will work both on the spine and adjacent areas such as your knees, hips, and feet.
You can expect 4-8 therapy visits if the treatment progresses properly.
How Long Does Physical Therapy Take for a Herniated Disk?
The number of visits for your herniated disk therapy will depend on your individual condition too.
The physical therapist will evaluate you and prepare an individual treatment plan.
Usually, the first few appointments focus on relieving the most annoying symptoms, such as pain. Later, patients work on bringing back flexibility, building muscle strength, and working on long-term improvement.
If the physical therapy progresses well, it is reasonable to expect that no surgery will be necessary.
Herniated Disk Exercises
Physical therapy exercises for herniated disk can help speed up healing and provide relief. However, it's important to discuss them with your health provider before incorporating them into your daily routine.
Neck stretches
Do these easy, light neck stretches for herniated disks in the neck.
Sit straight in a chair, slowly move your chin toward the chest and back against the headrest feeling a stretch.
Gently move your left ear toward the left shoulder and your right ear toward the right shoulder. Repeat a few times.
Dead Bug
Despite the strange name, this exercise is essential in your recovery program as it strengthens your core and back muscles.
Lie on the back. Place your feet on the floor with your knees bent.
Make sure your back is flat on the ground by contracting your abdominal muscles.
Keep your core engaged. Slowly reach your left arm back over your head and toward the floor while at the same time extending your right knee and hip, reaching your right heel toward the floor. Maintain a steady core and stop before your limbs touch the ground. Repeat on the other side and a few times again.
Bird Dog
This exercise helps stabilize your back muscles and develop core strength. It helps strengthen your hips and back muscles, promote proper posture and increase your range of motion.
Step onto your mat on hands and knees, squeeze in the abdominal muscles and place your back in a flat tabletop position.
Keep your body and pelvis straight, and slowly straighten your right arm in front of you and the left leg behind you. Hold for 5-10 seconds, release, and repeat on the other side. Repeat a few times.
Back flexion stretch
Incorporating back flexion exercises to stretch your spine and back muscles is essential. They help improve lumbar mobility and decrease low back pain.
Lie on your back and pull your knees toward the chest.
While doing so, move the head forward until you feel a stretch across the mid and low back. It should not be too gentle nor too strong. Repeat the stretch a few more times.
Piriformis muscle stretch
The piriformis is a small muscle deep in your buttocks. Tightness in this muscle can cause pain radiating into other body parts.
Lie on your back with your knees bent and your feet on the floor.
Cross your left leg over the right one and rest the ankle on the right knee.
Slowly and gently pull the crossed knee toward your chest until you feel a stretch in your buttock. Repeat on the other side.
Is Herniated Disk Preventable?
While there are no guarantees for avoiding herniated disks, everyone can do a few things to minimize the risks.
Exercise is always important, especially focusing on the spine and strengthening the core muscles, as it helps keep the spine stabilized and flexible.
Maintaining a healthy body weight is also recommended, so there's no excess stress and strain on the spinal disks.
Other things you can do:
Maintain good posture. Poor posture contributes to the condition, so always keep your back straight. That's especially important when sitting for a long time (e.g., in the office or driving).
Lift heavy objects carefully. Avoid potential injury by lifting heavy objects properly or avoiding lifting them altogether. If you can't avoid it, have the legs do most of the work (not the back).
Quit smoking. Smoking contributes to the degeneration of the disks, so quit smoking.
Avoid high-heeled shoes as they may lead to injury.
Focus on proper body mechanics when walking, sitting, and working out. Your physical therapist can help you identify your errors and fix them.
Final Thoughts
A herniated disk occurs when a part of the disk tears or leaks, leading to pain, inflammation, reduced range of motion, and discomfort.
This can be caused by various factors, from aging to injury to degenerative diseases.
Surgery is unnecessary in most cases, and herniated disks can be treated with physical therapy.
Because many people don't know that herniated disks are one of the most common causes of neck and lower back pain, it's essential to visit a health provider to get a diagnosis. Untreated herniated disks can get worse.
After diagnosis, the physical therapist will develop a comprehensive treatment plan that includes manual therapy techniques like joint mobilization, soft tissue mobilization, dry needling, and, most importantly - exercises.
Physical therapy exercises can help improve muscle strength and flexibility, core stability, endurance, etc. Contact Miracle Rehab Clinic and book your appointment now. Do not neglect your pain.