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I Have a Herniated Disk: Physio 101

September 14 | 2023
Posted by Sharon Tierney

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Herniated discs may also be referred to as slipped discs, or disc bulges. They can be a source of pain and fear for many people.  To understand a herniated disc, a quick anatomy lesson is needed, we have included a picture below to help.

What is a Herniated Disc?

Between each of our vertebrae in our spine, there is a disc with a soft inner core (nucleus pulposus, and tougher outside (annulus fibrosus). The herniation refers to the soft layer protruding out, and may vary in size. In larger protrusions, it may put pressure against other structures in the area like the nerves, causing a variety of symptoms in the areas the nerve root gives sensation and motor function to. Herniated discs can occur anywhere along the spine but are are most common in the lower back (lumbar) region.

What are the causes of a herniated disc?

  1. Firstly, age-related degeneration. With age, the intervertebral discs get stiffer which makes them more susceptible to injury when exposed to even minor strains.
  2. Secondly, trauma or injury. For example, a fall or heavy lifting with a twist are strong external forces which can cause a herniation.
  3. Additionally, repetitive strain. Jobs or activities with repetitive bending, twisting and lifting expose the disc to lots of pressure, increasing the risk of herniation

Do I need an x-ray/MRI?

Notably, many people have no symptoms from herniated discs, and are usually unaware they even have one. Oftentimes, many people will receive imaging reports that show varying level of degeneration and even disc herniations in the back, which may seem alarming.  It is important to note that this is actually a normal part of life, many people will have “positive” findings. In other words, even though these things appear on imaging tests, they are not necessarily a problem or correlated with pain. Therefore, it is crucial not to put too much stock in imaging and let the symptoms guide your back pain management instead.   Choosing Wisely Canada has a great article about why imaging may not always be included in the treatment plan.

What are the symptoms?

  1. Firstly, back or neck pain is usually the first sign. It can be mild or severe, stay in one spot or travel down the legs. Usually, the pain is more on one side.
  2. Secondly, numbness and tingling down the arms or legs is a sure sign of nerve involvement. In a disc herniation, the bulge may be putting pressure on the spinal nerves.
  3. Next, muscle weakness may be present due to nerve compression as above.
  4. Additionally, changes in reflexes where they are either exaggerated or reduced. For example, the common example of the reflex is when your doctor hits the reflex hammer beneath the knee on the patellar tendon and your knee automatically kicks out straight.
  5. Finally, pain is dependent on activities and is commonly worsened by certain positions. Usually prolonged sitting, bending, lifting, coughing, and sneezing.

The symptoms of a herniated disc will vary depending on location and severity. Not everyone will experience every symptom, many disc herniations occur with nerve involvement as they do without nerve involvement.

Can a herniated disc be treated?

Physiotherapy Treatment for Low back pain

Back pain from a herniated disc can be treated safely through physiotherapy treatment. Common treatments may include education about how to avoid aggravating your condition, movements or positions that may give you relief, electrotherapy, heat or cold therapy, manual therapy, stretch and strengthening exercises. The specific treatment plan is unique to the individual and the direction of the herniation and will be modified appropriately by your physiotherapist as you get better. Eventually, once your pain has been managed, your physiotherapist will work with you to get you back to normal function and doing the activities you love while remaining pain free. In some cases, they may not respond to physiotherapy in which case further medical management may be required.

If you are experiencing low back pain PhysioNow has many experienced physiotherapists to help you find relief. Book with PhysioNow today for your first assessment and treatment!




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