Wednesday, June 23, 2010

Treating Disc Injuries With Manual Therapy and Exercise – Part 1

Resolving a disc injury is a combination of removing any type of mechanical restriction that is causing stress on the disc and avoiding all physical stresses that are perpetuating the disc problem.

Initially, disc injuries can be incredibly painful, it may seem that surgery will be the inevitable outcome. Fortunately the majority of disc injury patients do not require surgery, in fact less than 5% of patients do. This is a good thing to keep in mind as you are going through therapy. The length of time therapy takes too resolve a disc injury depends on several factors; the severity of the disc problem, the length of time you have had the problem, your age, and your physical condition to begin with.

For acute disc injuries, ice should be initially applied for the first 72 hours to reduce pain, inflammation, swelling, and muscle spasms. For the lumbar spine one of the most effective ways to ice the area is either ice massage or wet ice. Wet ice refers to putting crushed ice in a bag which is then covered by a wet towel. This will lower the temperature of the affected area very quickly to reduce pain and inflammation.
After 72 hours, heat can be applied to the affected area to increase blood flow and reduce muscle spasms; even the deeper structures such as facet joints can benefit from heat therapy.

In the acute stage of injury resting for a maximum of two days can be helpful. If you have ever had a disc injury, as I have had, just lying on the floor for a few days may be all you can do. On the other hand, the sooner the patient can return to normal activities the faster the recovery will be. Disc injuries are not a condition that you can wait for symptoms to resolve before returning to your activities.

When you have a disc injury all your daily activities should be performed in a way that will not aggravate your condition. Essentially you must do everything you can to avoid performing tasks in a way that causes you pain or irritates the disc injury. This may require you to reduce your range-of-motion when performing a task, move more through your hips than your back and brace your core before moving or lifting any object.
Another essential action you have to perform is listening to your body. If your body tells you the way you are performing this action really hurts, listen to it. Basically, if you try to work through the pain you are experiencing you will only do more damage to your body turning an acute problem into a chronic one.

Activities that are especially damaging to the discs in your back are actions that involve any repetitive motions performed in a flexed spinal position. This is particularly true if you are lifting heavy loads in this position. Even lifting minimal loads can lead to considerable disc damage if the task is performed repetitively in a flexed position.
Static flexed positions are also very damaging to the discs in your back, such as sitting behind a desk without taking a break for a long period of time. Therefore avoid sitting for long periods of time, take frequent breaks, change your position often, and make sure you get up and out of your chair frequently.

Another motion that should be limited if you have a disc injury are twisting motions, especially if you are carrying even minimal loads. Torquing stresses can easily damage an already injured disc.

In general terms, doing any activity for too long of a time period, even tasks performed with perfect ergonomic conditions, can cause problems. If your task requires you to perform active tasks then take a rest break. Slow down and rest, give your body a break from whatever active tasks you have been performing. If your work or daily tasks are relatively static, such as sitting at a desk, then take active breaks. Get up and go for a walk, get your whole body moving; don’t just move from one static task to a static break.

In part two of “Treating Disc injuries with Manual Therapy and Exercise” we will cover manual therapy.

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