What is a herniated disc and how is it created?
The creation of a hernia in the waist is a multifactorial event and there is not a single cause that causes it. It is a dynamic process that is affected by age, body weight, work, hobbies, general health, the existence of other problems such as diabetes, vascularity of the area, smoking, genetic characteristics, but also unquantifiable and unpredictable factors .
In general, it is a product of a degenerative process with a cumulative mechanism, that is, it takes time along with the factors mentioned above to form a herniated disc.
How can we prevent a herniated disc?
There really isn’t a way anyone can prevent or prevent a herniated disc from developing. The reason is simple. On the one hand, it is a degenerative process, on the other hand, there are too many factors that play a role in the creation of a hernia in the waist that are impossible to control at all times in an ideal way throughout our lives.
Are all herniated discs symptomatic or asymptomatic?
We have many examples of patients with a lot of pain who had no hernia, as well as people without any pain or other symptoms, with a very large hernia or hernias in the lower back.
Research has shown the existence of findings such as disc prolapse and herniation even in 20-year-olds without any symptoms. The same has been seen in older people, where it is more likely to find a herniated disc at more than one level, again without these people having pain.
Something that needs to be emphasized is that modern neurophysiology—which is the science that helps us understand the mechanisms of pain—has shown that pain is an experience involving quite complex mechanisms.
Having a herniated disc is nothing more than a structural change, like gray hair, which is not a necessary condition to cause pain. Sometimes it can participate in the symptomatology and sometimes not.The key to pain management is clinical examination, not MRI or CT. The clinical examination will give us the necessary information which sometimes goes hand in hand with the findings of the tests I mention above, but very often they are not related at all.
Conservative treatment or surgery?
It is especially important to distinguish between treating a herniated disc per se and treating low back pain in patients diagnosed with a herniated disc.
Surgical treatment of herniated disc
Since a herniated disc is a structural change and diagnosis, if it has to be treated, the only treatment is surgery and it consists of removing part or all of the intervertebral disc.We refer to the cases where surgery is necessary (hippurid syndrome or cauda equina syndrome) and where it is very important that the patient is referred to the doctor as soon as possible as you will see here. As strange as it may seem, there is no conservative treatment for a herniated disc or any hernia because they are structural changes and as we said, whenever we talk about treating a structural damage, it is Medicine that speaks.
Conservative treatment of a herniated disc or more properly treatment of lower back pain
Physical therapy treats pain and dysfunction regardless of the presence or absence of a herniated disc.So we are talking about back pain, sciatica, neck pain also known as “cervical syndrome”.
The most important thing for the public to know is that even in patients with a herniated disc, most of the time the symptoms are treated conservatively and not surgically.Conservative treatment offers in most cases complete recovery and return to daily activities.
How physical therapy helps
Pain reduction
It is usually a combination of different media and techniques. It is possible to use electrotherapy, techniques with the hands (manual therapy), narrowed exercises that create the best conditions for returning to functionality through the reduction of pain.
A very important part of the physical therapy intervention is the correct information about the mechanisms of pain so that the patients do not develop a fear of movement, which is the most destructive thing there is.
Muscle strengthening
More and more research has shown that therapeutic exercise that is done under the supervision of a physical therapist initially, and can be continued in a gym with the right trainer, has huge medium and long-term benefits.
The endurance of the waist and the whole body increases and it can handle more and more loads, withstand daily stresses better and fear is reduced.
Consequently, exercise improves quality of life and reduces the chances of problems related to the jobs and obligations of everyday life of all of us.
Treatment of kinesiophobia
Unfortunately, in recent years there are more and more people who have developed phobias related to exercise or other simple movements combined with depressive symptoms after back pain.
Physiotherapy plays a very important role in avoiding the creation of kinesiophobia and chronic patients, not only because it helps to reduce pain and strengthen the muscles in the affected areas, but also because it offers correct information in relation to the mechanisms of pain and therefore the management and his breakthrough.
