When the discs between the vertebra degenerate, herniation can result. The most common sites for a lumbar herniated disc are L4-5 and L5-S1. The degeneration causes a weakening in the fibers, leaving the disc susceptible to fissuring and tearing. The onset of symptoms is characterized by a sharp, burning, stabbing pain that radiates down the posterior and lateral leg to below the knee. There is often numbness and tingling, and motor deficit or reflex weakness may be present.
Back pain caused by a herniated lumbar disc is heightened by sitting and bending; however, the pain of lumbar muscular strain is aggravated by standing and twisting movements. Your physician will determine which is the cause of your pain.
Physical Therapy Treatment Plan: After careful evaluation by the physical therapist, the first step in treating this condition is to reduce pain and inflammation. Treatments may include ice, electric stimulation, iontophoresis, phonophoresis, and massage. The physical therapist will educate the patient on methods that will relieve symptoms in daily routines. Rest and exercise are recommended.
Extension and isometric exercises are used first, and after pain is relieved and some strength is achieved, flexion exercises are begun. The McKenzie exercise program is believed to be one of the most beneficial.
After your initial prescription for physical therapy is complete, the physician and physical therapist will decide if you need to continue physical therapy or if you will be discharged to a home exercise program.
This information is provided as a learning resource for the benefit of our patients. It is NOT INTENDED to replace personal consultation with your medical professionals.
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