Struggling with Herniated Disc Pain? How to Tell When It’s Time to See a Physical Therapist

Herniated Disc Pain

By:  Chuck Schulte, PT  Diamond Physical Therapy – Algonquin, IL

Did You Know You Could Relieve Your Herniated Disc Pains with Physical Therapy?

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.

Strange neck pains, back pains, or extremity symptoms can indicate a variety of potential problems – including one or more herniated discs.

How can you tell for sure whether you have this specific problem? If you do have a herniated disc, what can you do about it? These questions don’t have to add confusion and frustration to your physical woes.

If you believe your pain and dysfunction is caused by a herniated disc, we encourage you to contact us 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.

Herniated discs, defined

“Herniated disc,” “slipped disc,” and “ruptured disc” are all just different ways of describing the same physical problem. Your spinal discs are squat discs of tissue that lie between the vertebrae.

A disc consists of a fluid-filled center called the nucleus pulposus encased in an outer structure called the annulus fibrosus. This arrangement makes the disc both tough enough and spongy enough to absorb shocks.

Unfortunately, that toughness has its limits. Sometimes a disc will lose hydration over time, causing the nucleus pulposus to shrink. The disc loses its height, which stresses the spinal joints and may cause the disc to bulge outward.

Eventually these changes can cause part of the annulus fibrosus to balloon and tear open; this is herniated disc. Herniated discs can also occur suddenly due to an auto accident, workplace accident, or sports injury that traumatizes the spine.

Physical therapy for herniated discs

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.

What can happen with a 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:

  • Acute trauma, e.g., auto accident or fall
  • Smoking
  • Obesity
  • Male gender
  • Age between 30 and 50
  • Frequent bending, heavy lifting, or twisting
  • Physically demanding occupation

How can I tell if I have 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 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:

  • Pain that improves or “centralizes” (moves toward the spine) with spinal extension, such as when lying down or lying prone
  • 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
  • Arm or leg pain, numbness, tingling, and weakness (if the herniated disc compresses on an adjacent nerve root that innervates the affected limb)
  • Neck or back pain, stiffness, and muscle spasms at the level of the injured disc

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.

Still struggling with the pains of a herniated disc? Consult with a physical therapist today to get started on the path toward pain relief!