Disc Herniation
What is a Disc Herniation?
A disc herniation occurs when the soft internal material of an intervertebral disc protrudes through the outer layer. This protrusion can exert pressure onto nearby nerves, resulting in pain, weakness, and/or numbness. Disc herniations commonly occur in the lower back or neck.
What causes A herniated Disc?
1. Age
The older the body becomes, the less water content is retained within the disc therefore decreasing flexibility and resiliency. This makes the discs more susceptible to herniation even with minor stressors on the spine.
2. Improper Lifting Technique
Lifting heavy loads with improper technique, such as excessive twisting, rounding, or arching of the back can exert pressure on the discs and in extreme cases, cause a herniation.
3. Repetitive Strain
Repetitive movements that stress the disc, such as labour-intensive jobs that require repetitive twisting, bending, and lifting, can lead to disc degeneration which weakens the disc and makes them more susceptible to herniation.
4. Trauma
Trauma that exerts force to the spine can cause a disc herniation. Examples include car accidents, sports injuries, and falls. The compressive forces, sheering forces, and twisting of the spine can cause the disc to herniate.
5. Posture
Slouching forward or sitting with or without crossed legs for long periods of time can strain the disc and make it more susceptible to herniation.
How does physiotherapy Treat Disc Herniations?
Focus on functional improvement
During the assessment, your therapist will determine the extent of how the disc herniation has affected your function. Your therapist will then provide treatments, prescribe exercises, and educate you on how to reverse your symptoms.
management Strategies
1. Manual Therapy
Myofascial release: to reduce pain, tightness, and inflammation of the muscles, joints, nerves, and fascia of the affected areas.
Joint mobilization: to promote smooth joint movement and mobility of the neck, back, pelvis, hip, and other affected areas.
2. Biomechanical Optimization
Improves alignment and stability of the neck, spine, pelvis, and legs to reduce pressure on the affected nerves via:
Postural conditioning: corrects poor posture and improves alignment of the neck, spine, and pelvis during sitting and standing.
Movement pattern conditioning: optimizing lifting and walking mechanics by recruiting the appropriate back, core, hip, knee, and foot muscles.
Core strength conditioning: improves the stability of the trunk by properly training and recruiting the core muscles.
3. Exercise Therapy
Stretching: to improve flexibility and reduce muscle tension in the back and legs.
Strengthening: to improve the activation and stability of the muscles in the lower back, core, and lower extremities which can restore optimal nerve function and reduce the risk of future injuries.
Low-impact aerobic exercise: low-impact endurance activities such as walking, cycling, or swimming can improve blood flow and reduce muscle tension.
Home exercise program: individualized exercise prescription to restore optimal and balanced movement.
4. Modalities
Acupuncture: use of thin needles to improve local and systemic function, regulate the nervous system, and promote the body’s natural healing processes.
Heat and cold therapy: to manage reduce pain and tension or control inflammation.
Electrostimulation: use of electrical currents to stimulate muscles and reduce pain.
Ultrasound: use of high-frequency sound waves to produce deep tissue heating to reduce muscle tension, fascial tension, and inflammation.
Laser therapy: to improve blood flow, reduce pain and inflammation, and promote tissue healing.
5. Education
Recommendations regarding lifestyle and activity modifications, ergonomics, posture, and sleeping position to help reduce load, risk of recurrence, and further injury.