Physical Therapy for Herniated Discs

Physical Therapy for Herniated Discs Blog
Herniated discs can cause debilitating pain. There are many techniques available for treating this painful medical condition. The appropriate treatment depends on the patient’s situation, responses and willingness to try new methods. There are two main categories of treatments that can supplement physical therapy in a comprehensive treatment plan for herniated discs. The first category provides passive therapies, which are administered by a trained professional. The second category involves active techniques that can be provided by a trained clinician or physical therapist.

Here are some examples of common passive therapies:

Soft-Tissue Massage Therapies: There are a wide range of modalities that address secondary inflammation in the muscles of spinal support. The herniated disc will cause these muscles to contract, which is an attempt of the body to guard against additional injuries. Some of these massage modalities use light pressure, and others address deep tissue problems. It is important to work with a therapist who understands how to relieve the pressure around the injured area without adding to the injury.

Inversion Therapies: Inversion relieves the pressure caused by gravity on the muscles of the spine. This is effective for patients who are able to lie in a supine position on an inversion table. Similar therapies utilize traction to gently decompress the spine, which provides additional space around the affected nerves.

Here are some examples of common active therapies:

Hydrotherapy: This is a therapeutic method that uses water temperature to improve the local circulation in an injured area. This can improve the healing response by causing the muscles in the blood vessels to expand and contract. This is also a good way to move lymph into a nearby node nexus, which is important for patients who become immobile.

Strengthening Exercises: Physical therapists are highly trained in techniques that strengthen the core muscles of support in the body. These exercises are closely monitored and guided by the therapist, and they are designed to be supplemented by exercises the patient performs at home.

Physical Therapy and Herniated Discs

The most successful physical therapy protocols will integrate many of other treatment options. This allows practitioners to prepare the soft tissues for the physical therapy treatment.

Because physical therapy focuses on strengthening specific muscle groups, it is often necessary to treat the muscles of reciprocal inhibition as well. This is an effective approach because it addresses the dynamic of every joint. Muscles on the opposite side of the injury can play a restrictive role, so releasing trigger points or holding patterns can indirectly assist in the physical therapy process on the main area.

Re-Patterning Techniques

Physical therapists often assist patients with maintenance protocols that can be practiced in the comfort and privacy of your home. These exercises are designed to increase the supportive capacity of the muscles that attach to the spine. This is essential for long-term success, and it addresses the underlying movement pattern that can aggravate the original injury. Failure to perform these exercises correctly may undermine your recovery, so you should ask questions if necessary.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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