Disc Herniation and Physiotherapy as a New Path Towards Health Improvement!

What is Disc Herniation?

We all have a car that we drive, and we even have some knowledge about some of its parts. Thus, you may have heard about the shock absorbers (such as springs and metal) that are placed in the tire part and have the function of ensuring that the car's weight does not fall entirely on the tire, but this weight is cushioned, i.e., alleviated. Similarly, in the human body, between the spine bones (vertebrae) there is a cushion called the intervertebral disc, which consists of the tough part (anulus fibrosus) and the spring (nucleus pulposis).

When the tough part (anulus fibrosus) is damaged, as a result, the spring (nucleus pulposis) comes out, which exerts compression on other structures. But it's ironic that when someone's car breaks down, they quickly take it to the mechanic, whereas when parts of their own body break down, they react so slowly that they go to the doctor in the final stage of pain.

Why does it happen and what causes it?

Disc herniation is a pathology that begins after the age of 30. The profession has a very big impact, this is related to the body's position during work hours. Jobs that are accompanied by bending of the body, abnormal rotations (without moving the legs), lifting weights from abnormal positions, staying seated for a long time (drivers), weakening of the back muscles, but often impacts and microtraumas such as falls from heights, can present a clinical appearance after several years. Also, DH can be caused by tumors, inflammations, degenerative diseases, etc.

Who are the most at risk?

Often disc herniation is also called an occupational disease, because it is often found in drivers. HD becomes more present with increasing age as a result of the aging of the intervertebral disc (cushion), obese individuals, tall people (M>180 cm, F>170 cm), pregnant women, individuals who work in construction, who do heavy physical work.

Risk factors?

These are all causes of disc herniation, those which increase the risk for the development of disc herniation such as: bending, rotating movements of the body, smoking, weakening of the back muscles and many factors mentioned above.

How does disc herniation present itself, its symptoms?

The clinic of disc herniation depends on the damage, its degree, the direction of the nucleus pulposis protrusion. It can occur at several levels but is more common in the Cervical (neck) and Lumbar (lower back) part. People suffer more from lumbar disc herniation.

In milder grades, it presents with pain in the lower back region, not spreading to other regions, at the moment when the disc herniation is somewhat aggravated, we have involvement and irritation of the nerve root, the pains have a higher intensity. The pain is based on the level of damage, it spreads to several areas, starting from the lower back part, to the buttocks, thighs, whether in the front, as well as the back.

The most common, includes the back part of the thigh, in the front/back of the knee reaching to the foot, up to the big or little toe. This pain has a penetrating character (as if a needle is being stuck), worsens during coughing, sneezing, in a sitting position. The patient feels tingling in the legs, does not feel the legs well, the strength of the leg/s is decreased.

It may involve only one or both legs. Patients find relief when walking or when lying on a hard surface. It happens that these patients also have spinal deformities such as Scoliosis, which comes from the antalgic positions that the patient maintains to reduce pain.

How can we prevent it?

All the success of prevention depends on our education and care towards our posture, its form. This means that we should be careful during our daily activities, during our work, so as not to strain our back, nor to lead a sedentary life, to engage in walking, swimming (back), thus eliminating risk factors. It is important that smoking is also eliminated, which is a predisposing factor. It is easier to prevent it than to treat it.

Treatment of Disc Herniation

There are several treatment methods: conservative and surgical.

When is surgical treatment indicated?

The latter is indicated when we have sphincter disorders (with urination) or when there is no improvement within 4 weeks with conservative treatment. This can lead to loss of spinal stability.

What are the benefits from Physiotherapeutic Treatment?

Physiotherapy is the science of physical rehabilitation that consists of restoring lost functions. In Physiotherapy, various techniques and methods are used which give a very good result. This consists of strengthening, stretching of muscles, therapeutic modalities, and many other techniques. I had a case with disc herniation which was diagnosed in Greece, whom they had recommended for surgical intervention. After returning to Albania, we conducted several physiotherapeutic sessions and within the first week, he improved. Today he continues life normally, without pain.

During pains, it is advisable for the patient to sleep on a hard bed (wood) so that the right shape of the spine is maintained. The use of belts is recommended but not throughout the day only when performing actions/activities, whereas at rest it is not recommended.

Often a distinction must be made between doing Physiotherapy and doing Massage, they are two different things. A masseur is not a Physiotherapist, and anyone who claims or lies to you that doing massage, heals disc herniation, is seriously deceiving you. You should trust a Physiotherapist to treat disc herniation, he/she knows which techniques are indicated for the pathology and also adapts to you.