March 10th, 2020
Did you know that a herniated disc can occur anywhere in your spine? At our physical therapy clinic, we see disc herniations frequently among our patients with back, arm, and/or leg pain.
If you believe your pain and dysfunction is caused by a herniated disc, we encourage you to ProMotion Rehab and Sports Medicine today to schedule an appointment with a physical therapist. Our experienced team can help you understand the source of your symptoms and heal the injured disc so your relief is longer-lasting.
How to Know if Your Back Pain is Caused by a Herniated Disc
Spinal discs are small soft structures found between vertebral bones. Their main jobs are to absorb shock and maximize mobility within the spine. On the outside, these discs are tough and fibrous, but on the inside they are soft and gel-like. A herniated disc occurs when the tough outer layer of the disc (called the annulus fibrosis) ruptures. This allows the inner gel substance (called the nucleus pulposus) to leak out. The ruptured this disc tissue can trigger an inflammatory response and compress nearby structures, including joint receptors and spinal nerve roots.
Interestingly enough, not all herniated discs will lead to pain (especially because the discs themselves are relatively low in innervation and vascularization). However, when a herniated disc does cause symptoms, these symptoms often include:
- Neck or back pain, stiffness, and muscle spasms at the level of the injured disc
- Arm or leg pain, numbness, tingling, and weakness (if the herniated disc compresses on an adjacent nerve root that innervates the affected limb)
- Pain that worsens with forward flexion or prolonged sitting—forward flexion may also cause the pain to "peripheralized" or move further away from the spine
- Pain that improves or "centralizes" (moves toward the spine) with spinal extension, such as when lying down or lying prone
A herniated disc is similar to a bulging disc; in the latter condition, the disc tissue may protrude out of place but will not rupture.
Risk Factors for Herniated Disc
In addition to analyzing your symptoms and performing various tests and measures, a physical therapist can help you determine if you have a herniated disc by assessing your medical history and lifestyle. We'll look for risk factors known to be linked to herniated discs, including:
- Physically demanding occupation
- Frequent bending, heavy lifting, or twisting
- Age between 30 and 50
- Male gender
- Obesity
- Smoking
- Acute trauma, e.g., auto accident or fall
When to See a Physical Therapist for Herniated Disc Treatment
Research shows that physical therapy is effective for treating herniated discs. If your symptoms are affecting your activities of daily life or work, or if your symptoms persist for longer than two weeks, we recommend consulting with a physical therapist. Physical therapy interventions like spinal traction, corrective exercises, and non-invasive modalities like electrical stimulation or diathermy can heal the injured disc, alleviate pain, and help you avoid recurring issues.
Physical therapy may also be indicated if you've been told by a surgeon that you could need spinal surgery to fix the herniation. In many cases, surgeons ask their patients to work with physical therapy before undergoing a spinal fusion or disc decompression procedure to preemptively improve core strength and spinal health. This can maximize surgical outcomes and reduce the risk of complications post-operatively.
Interestingly, research shows that even "idiopathic" cases of back pain (conditions with no known cause) respond positively to physical therapy. In other words, even if it's not entirely clear whether you have a herniated disc, our services can still help.
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