Unless your condition is causing significant problems or is rapidly getting worse, treatment for lumbar disc herniation usually begins with nonsurgical treatment. Most people with a herniated lumbar disc get better without surgery. As a result, it is usually recommended that patients try nonoperative treatments for at least six weeks before considering surgery.
At first, your Physical Therapist at Advanced Sports Therapy may want your low back immobilized. Keeping the back still for a short time can calm inflammation and pain. This might include a period of bed rest. Lying on your back can take pressure off sore discs and nerves. However, our Physical Therapists usually advise against strict bed rest and prefer their patients to do ordinary activities using pain to gauge how much is too much. In rare cases in which bed rest is prescribed, it is usually used for a maximum of two days.
A back support belt is sometimes used for patients with lumbar disc herniation. The belt can help lower pressure inside the problem disc. Our patients are encouraged to gradually discontinue wearing the support belt over a period of two to four days. Otherwise, their trunk muscles begin to rely on the belt and start to weaken and atrophy (shrink).
Our Physical Therapy treatments focus on relieving pain, improving back movement, and fostering healthy posture. The first goal of our treatment is to control symptoms. Your Physical Therapist will help you find positions and movements that ease pain. Treatments of heat, cold, ultrasound, and electrical stimulation may be used in the first few sessions. Lumbar traction may also be used at first to ease symptoms of lumbar disc herniation. In addition, our Physical Therapist may use hands-on treatments such as massage or spinal manipulation. These forms of treatment are mainly used to help reduce pain and inflammation so you can resume normal activity as soon as possible.
Your Physical Therapist will show you how to keep your spine safe during routine activities. You'll learn about healthy posture and how posture relates to the future health of your spine. We will teach you about body mechanics, how the body moves and functions during activity. Our Physical Therapists teach safe body mechanics to help you protect the low back as you go about your day. This includes the use of safe positions and movements while lifting and carrying, standing and walking, and performing work duties.
The next part of our program will include a series of strengthening exercises for the abdominal and low back muscles. Working these core muscles helps our patients begin moving easier and lessens the chances of future pain and problems. Aerobic exercises such as walking or swimming are used for easing pain and improving endurance.
We will work closely with your doctor and employer to help you get back on the job as quickly as reasonably possible. You may be required to do lighter duties at first, but as soon as you are able, you'll begin doing your normal work activities. Our therapist can do a work assessment to make sure you'll be safe to do your job. We may suggest changes that could help you work safely, with less chance of re-injuring your back.
A primary purpose of your Physical Therapy is to help you learn how to take care of your symptoms yourself and prevent future problems. We'll provide you with a home program of exercises to continue improving flexibility, posture, endurance, and low back and abdominal strength. Our Physical Therapist will also discuss strategies you can use if your symptoms flare up.
When patients simply aren't getting better during their therapy program, or if the problem is becoming more severe, surgery may be suggested.
Rehabilitation after surgery is more complex. Some patients leave the hospital shortly after surgery. However, some surgeries require patients to stay in the hospital for a few days.
During recovery from surgery, patients should follow their surgeon's instructions about wearing a back brace or support belt, and should be cautious about overdoing activities in the first few weeks after surgery.
Although recovery time varies for each patient, as a guideline you may expect to see our therapist for one to three months, depending on the type of surgery. At first, your Physical Therapists may use treatments such as heat or ice, electrical stimulation, massage, and ultrasound to help calm pain and muscle spasm. We provide reassurance to help you deal with fear and apprehension about pain. Then our therapist will teach you how to move safely while putting the least strain on your healing back. Exercises are used to improve flexibility, strength, and endurance.
When your recovery is well under way, your regular visits to Advanced Sports Therapy will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.
Advanced Sports Therapy provides services for Physical Therapy in Wellesley.