Bulging / Herniated Lumbar Discs
For most people disc herniation’s and bulges are an inevitable and painless result of living a long healthy and active life. Much like the greying of hair as we age, over time the discs in our spines change. If you learn that you have a bulging or herniated disc but you do not experience pain, understand that this is normal and that you do not need to seek treatment.
However, not everyone is so lucky. Discs that bulge or herniate more rapidly as a result of trauma or abnormal forces on the spinal joints can be very painful. They may include acute low back pain and the pain may extend into one or both legs. Some patients will experience any combination of numbness, tingling, or weakness. These patients will benefit from working with a Physiotherapist.
What to expect form Physiotherapy for a Bulging / Herniated disc
Each patient’s physiotherapy program is designed based on their clinical presentation including the history of their problem, the factors that contributed to development of the problem, the behaviour of their symptoms and the functional deficits that have occurred. For this reason, it is not possible to outline a ‘typical physiotherapy program for bulging/herniated discs’. However, most programs will include some combination of the following elements;
- Pain relieving techniques
- Manual therapy to restore normal spinal joint range of motion
- Strengthening the core muscles that support the spine
- Strengthening the hips
- Neural mobility techniques
- Stretching of shortened structures
- Postural re-education and ergonomic advice/assessment
- Activity modification
- Directional exercises to restore lost range of motion and control symptoms
There are a great many options on how to treat the pain and symptoms of a bulging or herniated disc. It is important to ensure that you have a comprehensive assessment performed by and experienced Physiotherapist who can design a treatment plan that will meet your specific needs and goals. It is worth noting that passive electrical modalities should only be used very sparingly with the goal of pain reduction (if at all). The evidence for these sorts of treatments is very poor.
Important Considerations for Patients with Bulging / Herniated Discs
Serious complications from disc herniation’s or bulges are rare but it is important to know the signs of a problem that requires urgent evaluation. If a patient is experiencing any of the following symptoms they should seek medical evaluation urgently;
- Difficulty initiating urination
- Urinary incontinence
- Fecal incontinence
- Numbness in the perineal region
- Rapidly progressing leg weakness or dysfunction
- Loss of coordination of the lower extremity
- Symptoms developing in the upper and lower extremities.
Once again, the vast majority of patients never develop any of the symptoms above. They are very effectively treated with a physiotherapy program and are able to manage their problem with some ongoing home exercises to keep their spine healthy.