Herniated disc symptoms are often the reason that you may experience neck or back pain, an ailment that plagues as many as 75% of people over their lifetimes. Fortunately, neck and back pain is often better dealt with through physical therapy than surgery, which saves those who suffer from the pain both the cost of surgery, and the lengthy recovery time.
What is a Herniated Disc?
Much like the shock absorbers in your car, the bones (vertebrae) in your spine are cushioned by spongey pieces of cartilage called “intervertebral discs.” These discs have two primary components: an outer “annulus,” which is made of strong fibers that distribute pressure evenly throughout the disc, and an inner “nucleus,” which is a gelatin-like substance that does most of the shock absorption. Before we reach 30, our spinal discs are mostly made of that gelatin material, but as we age it starts to deteriorate. Our spinal discs become less flexible as we get older, and that makes them more susceptible to injury. Damaged discs run the risk of bulging or breaking open, which is then called a herniated disc. Herniated discs are most likely to occur in the neck and lower back, due to the nature of these areas being used most frequently.
Some risk factors for herniated disc injuries include:
- Age: Most herniated disc patients are in the 30 – 50 year old range, due to wear and tear on their spinal discs and age-related degeneration. Adults over 50 are less likely to suffer from herniated discs, because as their bodies age, there is less fluid to dislocate their spinal discs.
- Obesity: More weight equals more pressure on the discs, which increases the risk of injury.
- Occupation: Any job that is labor intensive and requires repetitive motion, such as lifting, pushing, pulling, or twisting, will be more stressful on your spinal discs than a less active job.
- Insufficient physical activity: If you don’t take care of your body, your body won’t take care of you. If you don’t keep yourself active, your body is less equipped to handle physical demands, leaving you vulnerable to injury.
Signs and Symptoms
Some people who have herniated discs are completely unaware, as they can sometimes show no symptoms. When the disc herniates (ruptures), the part of the disc that is coming out can put pressure on the nerves in your spine, or on your spinal cord (this is often referred to as a “pinched” nerve). The technical term for this is “radiculopathy,” and usually results in back pain, or pain, numbness, or weakness in the legs.
Wherever your nerve pressure is determines the location of your pain:
- Cervical spine: pain, tingling, numbness, and/or weakness in the arms, shoulder, or neck is a result of cervical spine injury.
- Lumbar spine: pain, tingling, numbness, and/or weakness in the back, buttocks, or legs is a result of lumbar spine injury.
These injuries usually only affect one side of your body. Additionally, certain activities or sitting/standing in certain positions can worsen herniated disc pain. If your herniated disc is in your lumbar spine, pain may increase when you sit, bend, or reach; could be worse first thing in the morning or if you stay in the same position for too long; you may need to switch positions often; and you may find yourself wanting to stand instead of sit. If your herniated disc is in your neck, you’ll usually experience worse pain when you sit for long periods of time, or when you lie down.
How Are Herniated Disc Injuries Diagnosed?
After reviewing your medial history, and evaluating your current condition, a physical therapist can determine if your symptoms are likely due to a herniated disc.
Some means by which your physical therapist will evaluate you are:
- Asking you to specify where your symptoms affect you, and to describe how your pain feels.
- Asking you to identify where your pain/numbness/tingling is on a body diagram.
- Testing your muscle strength and sensitivity to determine how severely your nerves are being pressured.
- Examining your posture while walking or doing other things.
- Measuring your range of motion in your spine, arms, and legs.
- Performing tests such as the straight leg raise test or the crossover straight leg raise test.
- Using manual therapy to evaluate how mobile your spinal joints and muscles are.
- Testing the strength of important muscle groups.
Sometimes your physical therapist may need to refer you for special tests, such as magnetic resonance imaging (MRI), electromyography, or nerve condition studies, if your muscle weakness, loss of sensation, or pain levels are severe.
How Can a Physical Therapist Help?
Your physical therapist is there to help you get back to all the things you do in your day-to-day, and work with you to alleviate the pain you experience from your injuries. Your therapist will design a treatment program that will fit your needs, based on the results of the therapist’s evaluation, and the goals you set for yourself.
Your program will combine a number of different exercises, some of which include:
- Exercises involving specific movements that alleviate pressure on problem nerves, and decrease pain and other herniated disc symptoms.
- Stretching and flexibility exercises to improve joint and muscle mobility, because improving motion is critical to pain relief.
- Strengthening exercises for major muscle groups in order to support your joints that cause your pain.
- Aerobic exercises to promote overall health—body weight, strength, and mobility—which will alleviate current pain and prevent future injuries. In addition to exercises, your physical therapist may also utilize:
- Manual therapy to increase the mobility of stiff joints and tight muscles.
- Posture and movement education to show you the best ways to sit, stand, bend, lift, and sleep.
- Special pain treatments, such as ice, traction, and electrical stimulation, to reduce severe pain that other treatments haven’t alleviated.
Don’t forget that once you’ve remedied your pain through physical therapy, it’s important to continue positive practices to maintain your health and avoid injuries!