Herniated Discs (Part 2): Symptoms and Treatment

This blog is the second part of a two-part blog on herniated discs. In the first post we covered the anatomy of your spinal discs and the common injuries to these discs. You can visit that post by clicking this link. Today we will discuss the symptoms and treatment of a herniated disc and what you should expect when you see a physical therapist.

SYMPTOMS OF A DISC

Just as no two people are the same, neither are our injuries. So this is a list of all possible symptoms but even just having one or two could indicate a disc injury, or you could even have a herniated disc without any symptoms. But on the flip side you could have two or more and actually not have a disc injury. (Are you thoroughly confused yet?) An evaluation from a physical therapist or medical doctor would be required to properly diagnose or rule out a herniated disc.  These are the most common symptoms of a disc injury:

  • Forward flexed posture
  • Increased pain in the morning or late at night
  • You don’t love sitting (standing might also not be that great due to more pressure on the disc)
  • Symptoms radiating down your leg or arm such as numbness, tingling, and/or pain
  • Weakness in arms or leg
  • Muscle cramping or tightness in your neck or back

HOW CAN PHYSICAL THERAPY HELP?

Physical therapists can design treatment programs that help the discs heal and address any other associated issues the back and lower body have from compensating. The back will try to protect itself as you still try to function and it can result in muscle tightness and guarding, sacroiliac joint dysfunction, tension in the nervous system, core weakness, and injury to other structures in the spine (ligaments, joints, nerves) as the disc fails to do its job. Treatment of these related issues can help your pain and provide good stimulus for the disc to heal.  Additionally we can design exercise programs so you don’t risk re-injury.  You don’t have to become completely immobile while waiting to heal. For example walking 15-30 min can help pump nutrients to the disc to allow itself to repair.

Therapy can also involve “passive modalities” like traction, ultrasound, electric stimulation, heat and ice. These can help you feel better and promote healing, but you aren’t the type of person who lives your life laying down on a table. You need to lift, reach upwards, pick things off the ground, hike up 14,000ft while carrying a 20 lbs backpack.

Therapy will also include exercises to re-activate the small stabilizers (called the multifidus) of the vertebrae that “shut off” with low back pain. When these don’t work, the large muscles of the back to take over which leads to fatigue and spasm (aka more back pain and tightness). There is a large variety of simple to advanced exercises to work the muscles you need to and these aren’t your weight lifter grandma’s intense sit ups.

You might also be put through exercises to restore motion of the spine, improve the hydration of the disc and to improve flexibility of the lower limbs.  These help combat the stiff and “stuck” feeling of your low back.

Finally, PTs can teach you positions to ease your pain. Remember how I said sitting tends to be a painful position? Try a rolled up towel placed in the low back to maintain the natural curve. Don’t rely on the “lumbar support” from your desk chair or automobile seat. Don’t rely on a “one size fits all” for your specific back anatomy.

Low back bothering you through the day or at home? Try lying on the floor on your back with your hips and knees flexed to 90 degrees such as when you lay on the floor with your legs up on the sofa or a chair.

CONCLUSION

If after reading this you have further questions or suspect you may be suffering from a herniated disc, feel free to call us or stop by one of our offices to schedule an appointment with me or another therapist. One of the keys to a quick recover is to not only beginning to receive treatment right away, but also knowing what to do and what not to do. This is where we take each patient as an individual and create a specific program that matches your symptoms and abilities. So don’t waste any more time, come by and see us to get your back in shape and allow us to help you recover quickly and effectively.

Kacie Rognlie, PT

Clinic Manager – South Office

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

Piriformis Syndrome: A real pain in the butt!

SciaticNerve It may be there when you first wake up, after a run, or it can even haunt you as you are sitting at your desk. And whether it is called sciatica or piriformis syndrome, it can literally be a pain in the butt. Piriformis syndrome is a condition in which a small muscle (piriformis) in your posterior hip irritates the long sciatic nerve that runs down your posterior leg. The sciatic nerve commonly runs under your piriformis, but if you’re one of the lucky few (approx 17% of the population) it can also run directly through it which has thought to increased your odds of developing this condition. It can cause a variety of symptoms ranging from a simple annoyance or pain in the butt or posterior hip, to pain, numbness, or tingling down the back of your leg.

What causes it?

There can be a variety of reasons that the piriformis muscle can decide to tighten up on you. Commonly in non-athletic populations it occurs as a direct injury to the lower back or tailbone, causing the piriformis to tighten up in response to the injury as it tries to brace and protect your back from further damage. In athletes or those that workout regularly it can be from weakness in their gluteus muscles of the posterior hip, or from faulty mechanics while lifting, running, or working out. Externally rotated hips for extended periods of time can also lead to piriformis syndrome and allow for a shortening of this muscle to occur. If you tend to walk or run with your toes turned outward, this can indicate a possible source of the problem. Misalignment of the bones of the pelvis may also be involved.

To properly diagnosis piriformis syndrome is not the difficult part, but finding out the cause behind it can be. And to treat it without knowing the cause is likely to assure that this pain in your butt is not going anywhere anytime soon. This is why it is important to see your physical therapist so we can evaluate you and find the culprit as soon as possible.

What to do about it?

Fixing piriformis syndrome on your own can be challenging if you do not know the exact cause. I can tell you how to “plug the leak” for now, but if you don’t know why the piriformis muscle is squeezing the life out of the sciatic nerve, then it will come back. The most basic way to decrease the tension of a tight muscle is to stretch it. You can do this piriformisstretchby laying on your back with your feet flat on the ground, place one ankle on the opposite knee, and pull the thigh with the foot still on the floor to your chest (see picture). A deep pressure to the muscle can also help to release the tension in it. We sometimes will do this manually, almost like a deep tissue massage directly to the piriformis, or we advise our patients to sit on a tennis ball to perform a self massage. However, to do this effectively you will need some guidance on exactly where the piriformis is, or you could actually inflame it. Our clinics also use trigger point dry needling to help decrease the tension on the piriformis and other muscles that may be contributing to your symptoms. But when you come to Synergy Manual Physical Therapy we will likely find the cause and address the specific issues that are causing this in the first place. Sometimes it can be as simple as doing some simple stretching and exercises to improve glute activation which will decrease the need for the piriformis to fire during your runs or workouts.

As you read, there can be a ton of reasons for this pain in your butt and even more ways of how to correct it. This is why a little guidance from a musculoskeletal expert such as a physical therapist can help you get to the cause quickly and set you on the right track to making a full recovery without all the guess work you may be doing on your own. If you have any questions or want to know more, stop by one of our 2 physical therapy clinics in the Colorado Springs area today!

– Synergy Physical Therapy Team

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112