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Can I Recover From a Disc Injury?

You Can Recover From a Disc Injury

In short, you can recover from a disc injury without surgery.  Let’s take a look at Jesse’s story:

 

Jesse is a hardworking landscaper, who is limited in his ability to work due to low back pain that is radiating down his leg. His MRI revealed he had a L4/L5 posterolateral disc herniation that was contacting the corresponding nerve root. Faced with the challenge of managing his symptoms and continuing his occupation, Jesse was referred to physical therapy for assistance.

 

Picture the intervertebral disc as a cushion with two main parts: the gel-like nucleus pulposus at the center and the tough annulus fibrosus surrounding it. When there’s a weakness or tear in the annulus fibrosus, the nucleus pulposus can bulge out, putting pressure on nearby nerves and causing pain, numbness, or weakness down the leg.

You Can Recover From a Disc Injury

Some risk factors that may contribute to Jesse’s disc herniation are his physically demanding job as a landscaper (lots of bending/twisting and heavy lifting day in and day out), genetics (some people are just predisposed to it, even if your mother wasn’t a hamster), smoking (you will inhale carbon monoxide, reducing oxygen to the disc which already has a very poor blood supply), a sedentary lifestyle (discs need movement to distribute nutrients throughout due to the poor blood supply), and driving (sitting in a flexed position with a lot of vibration).

Did you know that around 80-95% of people with symptoms from a herniated disc get better within 6-12 weeks without needing surgery? In fact, surgery is only recommended if you have progressive weakness, loss of bowel/bladder control, saddle anesthesia or a change in reflexes, all of which indicate a severe compression of the spinal cord. Depending on the type of herniated disc you have, there’s even a chance for the disc to heal on its own through a natural healing process called disc resorption.

 

You Can Recover From a Disc Injury

A Bulging Disc is where the annulus fibrosis remains intact, but stretches out where the bulge is; Protruded Disc has some tearing in the layers of the annulus, and the nucleus enters into spinal canal, but does not extend past the height of the disc; an Extruded Disc’s nucleus extends above and/or below the height of the disc; and. A Sequestered Disc is when the nucleus disconnects from the rest of the disc and floats around in the spinal canal, without being connected to the rest of the disc.  As you can see, the “worse” the disc is, the more likely your body will take care of it on its own.

 

Here at Alta, we offer a variety of treatment options to help you manage your disc herniation symptoms:

Educating our clients on the importance of staying active, strong, and mobile to help overcome the fear of movement, is vital when recovering from a herniated disc. Many people develop anxiety about moving due to the pain they experience. Pain acts as a signal from your body, alerting you that something might be wrong. However, the intensity of pain doesn’t correlate with the severity of damage. For instance, a small disc bulge can cause significant pain, while a larger one might not hurt. This discrepancy occurs because pain is influenced by various factors, including emotions, thoughts, and past experiences.

You Can Recover From a Disc Injury

Visual Representation of All the Things Contributing to Pain (Click to Zoom in)

In addition to understanding pain, somatic tracking is a technique used to overcome this fear. It involves paying close attention to bodily sensations during movement. Sometimes the brain sets up the pain, and by focusing on where the pain is, or what it feels like, will cause the pain to move, change intensity, or quality. Have you ever noticed that the first time you might do something it hurts? But you keep doing the thing that hurts and notice it doesn’t hurt anymore?  That response is your brain realizing you weren’t putting your body in danger, and it was overreacting a bit to begin with.  Another form of somatic tracking is tuning into pleasant sensations (e.g. breathing) and sending positive messages to your brain, and then reassuring yourself that the movement is safe. Somatic tracking helps in regaining trust in your body, allowing you to gradually increase activity levels without fear of exacerbating pain.  And you better believe that this is happening during your PT appointment without you ever realizing it.

You Can Recover From a Disc Injury

You Can Recover From a Disc Injury

Here is Ross’ Extruded Disc (the nuclear material extends above and below the disc space).  He largely only experiences hip symptoms and leg tightness between 4-6am, stiffness that is worst in the morning, no weakness, and most importantly no pain with activities. As demonstrated by  standing up in a double undercling.

 

Manual therapy, which includes gentle movements and adjustments to help your joints and tissues move better. Manual therapy techniques can target specific areas of tension or stiffness, helping to reduce pain and improve flexibility.  Dry needling is another option that can work wonders when combined with exercises tailored to your needs.

 

Speaking of exercises, we’ll work with you to find your directional preference and your load tolerance that doesn’t aggravate your symptoms. Take Jesse, for instance. His therapist noticed that his pain got worse when he bent forward in standing, so they focused on exercises that involved leaning backward while laying down. These exercises are thought to help take pressure off his sore disc and promote healing. As Jesse’s symptoms improved, his therapist gradually added in exercises that involved bending forward again, in gravity dependent positions, with progressively more multi-directional load, making sure he knew how to do them safely especially when lifting heavy objects. However, if his back remained load sensitive, unloading with movement, would have been another option that helps to create temporary space between vertebrae, relieving pressure on the affected disc and reducing pain.

 

You Can Recover From a Disc Injury

Generally, lifting as demonstrated by the green checkmark will reduce back pain from a disc.  But, believe it or not, there are also some back pains that will find relief by lifting as demonstrated by the red X.

 

If initial physical therapy treatment is not sufficiently reducing acute symptoms, a doctor might recommend an epidural injection. This procedure can provide short-term relief by reducing inflammation and pain, allowing the patient to better tolerate physical therapy. By alleviating discomfort temporarily, epidural injections create a window of opportunity for the patient to engage more effectively in therapeutic exercises and other treatments aimed at long-term recovery.

 

Throughout his time in physical therapy Jesse learned the importance of proper body mechanics, understanding which movements could worsen his condition and how to mitigate risk, especially during his demanding tasks involving bending and lifting. Through education, targeted exercises, and continuous support from his therapist, Jesse achieved a notable reduction in pain, enhanced mobility, and a newfound confidence in performing his occupational tasks.

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