Problem: A disc herniation, commonly referred to, as a “bulged disc” is a condition that relates to the spinal column. It can be caused from a one-time specific over load to the spine or can by cumulative trauma or stress (for example, poor posture). Before we look at herniated disc treatment options for this condition, let’s take a closer look at the injury itself.

The “discs” of your spine are located between the vertebrae and have a soft centre. They allow the spine to move freely and also absorb shock. Trauma to the spine cause the outer layer of the disc, which is made of tissue that resembles the consistency of an onion layer, causing it to crack and break down – leading to a herniated disc.

When the outer layer of your spine is compromised, then the soft inner layer is vulnerable to “bulge” out and often pushes against the adjacent nerve root. This compression of the nerve root causes pain down your leg, depending on which vertebral level is injured will dictate where the pain or altered session follow.

If you are a young individual, your discs are soft and elastic, but like so many other structures in the body, the disc gradually looses its elasticity and is more vulnerable to injury.

Generally an individual with a herniated disc will experience intense pain, you may sometimes experience it as an electrical shock feeling, in the back and/or leg. Also people can experience a feeling of weakness in their leg, as if their leg will give way.

All of these symptoms are due to the irritation of the nerve from the herniated disc. By interfering with the pathway by which signals are sent from your brain out to your extremities and back to the brain, all of these symptoms can be caused by a herniated disc pressing against the nerves.

Action: So, what are considered to be the best herniated disc treatment options? Opinions vary, but a combination of light medication to assist with pain, inflammation around spinal structures and to reduce muscle spasm, and most importantly an individualized physiotherapy program, is known to be quite effective.

Physiotherapy will often include education regarding optimal postures and positions to reduce the compression of the nerve root and to facilitate the healing process of the injured herniated disc.

Modalities (therapy devices) to reduce pain are also used to facilitate the healing process as part of a herniated disc treatment option.

Acupuncture in particular, is a treatment that is supported by the scientific literature, which can greatly assist with pain and the other neurological symptoms associated with a disc herniation.

Traction of the lumbar spine has been proven to greatly assist recovery if there is leg involvement, as well as a specific program of exercises that encourage a lengthening of the spine (extension) and that promote improved motor control of the spine (core stabilization).

Response: Individuals who received a comprehensive physiotherapy program as part of a herniated disc treatment option, consistency have significantly better than those who don’t. If surgery is required for a disc herniation, those individuals who are involved in an intense individualized exercise program, supervised by a physiotherapist, have a great reduction of pain and improved function compared to those who do not have therapy after surgery.

The bottom line: for any back and leg pain, consider consulting a physiotherapist for an effective herniated disc treatment option! 

References:
Awad N, & Moskovick R. (2006). Lumbar disc hernations: surgical versus nonsurgical treatment. Clin Orthop Relat Res, 443, 183-97.

Filiz M, Cakmack A, & Ozcan E. (2005). The effectiveness of exercise programmes after lumbar disc surgery: a randomized controlled study. Clin Rehabil, 19, 4-11.

Skytte L, May S, & Petersen P. (2005). Centralization: its prognostic value in patients with referred symptoms and sciatica. Spine, 30, E293-9.