Physical therapy: exercises for a herniated disc

Physical therapy can be used as treatment for a herniated disc during its early stages, as well as being a very useful recovery tool. It can use in combination with other therapies such as adapted exercise, postural education, and taking pain relievers and muscle relaxants.

Disc herniation is one of the most common degenerative diseases of the spine. This pathology occurs when a spinal disc, or part of the disc, ruptures, and the interior content is displaced, which can put pressure on the adjacent nerve structures, causing pain as a result. 

There are various types of disc herniation, and they can occur in different parts of the spine, although they occur most frequently in the cervical and lumbar discs. Each type has its own symptoms. In many cases, physical therapy can be the best way to treat the pain and inflammation, as well as leading to better posture habits which will help reduce wear and stress on the vertebral discs.

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Physical therapy: exercises recommended for a herniated disc 

Physical therapy is part of the range of conservative, or non-surgical, treatments for both cervical and lumbar disc hernias. This category also includes analgesics, anti-inflammatories, muscle relaxants and neuroleptic medications that, as you can imagine, are most effective when combined with appropriate physical therapy and exercise. As Iria Rabell, physiotherapist and Director of Instituto Clavel Rehabilitation, explains, "You have to understand that recovery from a herniated disc means recovering the natural capacity for movement and proper functioning of the body, and this cannot be achieved by taking medication alone." 

These types of conservative treatment are used for the early stages of the pathology. If symptoms do not improve after one or two months of using physical therapy to treat a herniated disc, it would be necessary to explore other alternatives. In this case, it is usually the physical therapist who will refer the patient to a doctor for further treatment. 

The following are some of the exercises we recommend for the treatment of herniated discs and the relief of low back pain (always to be performed under the supervision of a professional): 

1. Lying face up on a mat and with your arms at your sides, with your knees bent, gently roll your hips, dropping your knees to one side and then the other.  
2. On your hands and knees on a mat or flat surface, extend one arm and the opposite leg, and hold the position for a few seconds. Repeat the procedure several times alternating sides. Iria Rabell recommends, "Remember to keep the spine aligned from the head to the tailbone." 
3. Strengthening your hamstrings is also good for your spine, and it can be done easily by practicing a few simple stretches. You can start by sitting on a chair with one foot on the floor and the other leg stretched in front of you and resting on its heel. Then, try to stand up and lean forward until you notice the pull on the back of your thigh. Repeat this exercise with both legs, holding the position for 15 to 30 seconds. 
4. If your pain is in your lower back, knee-to-chest stretches can also help. Lying on your back, bend one knee up and, holding it with your hands, gently pull it toward your chest. Repeat several times, alternating legs. 
5. When using physical therapy to treat neck pain from a cervical disc hernia, try sitting in a chair and first lower your chin to your chest and then slowly lean your head back towards the headrest. Making circles with your shoulders is another good exercise for neck pain, as it mobilizes all of the cervical and thoracic spine, helping relieve the accumulation of stress in your muscles. 
6. Do not hesitate to go for walks. It will help your body’s overall mobility.  "Of course, walking should not be painful, you should wear comfortable shoes, and especially, walk on smooth, flat, stable ground," adds our physiotherapist.

At Instituto Clavel Rehabilitation we have a team of physiotherapists who are experts in the spine who can devise a personalized therapy plan for each patient and their needs.

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Other treatment alternatives for herniated discs 

While it is true that physical therapy is one of the most common treatments for herniated discs during their initial stage, there are other treatments that can be used depending on the patient's condition and stage of the disease. So, in addition to the so-called conservative treatments, there are also other options: 

• Outpatient treatments. The goal is to reduce pain without resorting to surgery. These treatments may include epidural infiltrations or radiofrequency of the nerve root, for example. 
• Surgery. In those cases in which treating the herniated disc with physical therapy or outpatient treatments is not sufficient, there is the possibility of surgery. With respect to surgery, there are different alternatives, and the decision as to which is the most appropriate will depend both on the pathology itself, and also the criteria of the doctor and the patient’s decision.

In the case of surgery for a cervical disc herniation, the anterolateral approach is the most frequently used. When treating a lumbar disc herniation, the most commonly used surgery is a microdiscectomy, although sometimes the case may require disc replacement surgery (ADR). The latter of these consists of replacement of the degenerated lumbar or cervical disc with an artificial prosthesis that mimics a healthy natural disc.

How to prevent disc herniations  

Before considering physical therapy as an aid in treating a herniated disc, it is important to consider how they may be prevented. Leading a healthy life is the key. To this end, we suggest some basic recommendations from health professionals for taking good care of your spine: 

• Proper nutrition.  Maintaining a healthy weight is the first step. And of course, in addition to eating a healthy and balanced diet to ensure your discs and bones get the nutrients they need, it is important to avoid a sedentary lifestyle. 
• Regular exercise and good posture habits. It is no secret that regular exercise is a plays a major role in staying healthy. However, in addition to the benefits provided by activities like sports, when it comes to preventing back problems, it is essential to do exercises that strengthen the back muscles, do stretches, take breaks if you spend many hours in the same position, and use correct posture when sitting or lifting heavy loads. Physical therapists with expertise in herniated discs can design a therapy plan specifically for this condition, including ways to integrate postural strategies, preventive measures, and pain-relieving positions in your daily life, and help you to better understand your body mechanics, which will help you prevent back injuries.

We hope we have helped you learn more about what a herniated disc is and what exercises can be helpful for alleviating pain. If you have any questions about the treatment for herniated discs, we invite you to contact Instituto Clavel.

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