Herniated/Bulging disc

The spine is made up of vertebrae, and the disc is what holds one vertebrae to the next, acting as a cushion between the bones. The disc is made up of a tough outer layer called the annulus fibrosus and a gel-like center called the nucleus pulposus. As you get older the nucleus can lose water content, making it less effective as a cushion. This degeneration can cause a displacement of the disc’s center causing a herniation, or bulge into the spinal canal, which can put direct pressure on a nerve. This pressure can cause pain to radiate from your back all the way to your leg. Approximately 90% of disc herniations occur at L4-L5 or L5-S1 segments of the spine.

Symptoms:

Diagnosis:

An evaluation by your physical therapist. X-rays and MRI may be needed to get a more detailed picture of your spine.

Treatment:

While a disc herniation may sound serious, most people recover and return to their normal lifestyle within several weeks or months without having surgery.  Non-surgical treatment may include physical therapy, anti-inflammatory medications to reduce swelling, analgesic drugs to control pain, and epidural steroid injections if needed.   

The goals of physical therapy include reducing the irritation of the nerve and disc, improving physical condition, protecting the spine and increasing overall function. Physical therapy could include hot/cold modalities, mobilizations, manual therapy, soft tissue massage, exercises for flexibility, strengthening for the back, leg and abdominals. Research has shown that having stronger abdominals and back muscles will take the pressure off your discs which can decrease pain.  By performing repetitive stretching exercises the pressure on the nerve can be relieved thus decreasing your pain. In addition a physical therapist will educate you on back care, ergonomics for work and home, and advise you on an exercise program to continue with in order to prevent recurrence of the pain.