Physical Therapy for Herniated Discs

PT may include deep tissue massage, hot/cold therapies, hydrotherapy, and exercise
Reviewed by Jason M. Highsmith, MD
Peer Reviewed

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Physical therapy often plays a major role in herniated discrecovery. Its methods not only offer immediate pain relief, but
they also teach you how to condition your body to prevent further injury.

There are a variety of physical therapy techniques. Passive treatments relax your body and include deep tissue massage,
hot and cold therapy, electrical stimulation (eg, TENS), and hydrotherapy.

Passive
treatments relax your body and include deep tissue massage and electrical stimulation (eg, TENS). Your
physical therapy program will usually begin with
passive treatments. But once your body heals, you will start active treatments that strengthen your body and prevent
further pain. Your physical therapist will work with you to develop a plan that best suits you.
Passive Physical Treatments for Herniated Discs

 Deep Tissue Massage: There are more than 100 types of massage, but deep tissue massage is an ideal option if
you have a herniated disc because it uses a great deal of pressure to relieve deep muscle tension and spasms,
which develop to prevent muscle motion at the affected area.

 Hot and Cold Therapy: Both hot and cold therapies offer their own set of benefits, and your physical therapist
may alternate between them to get the best results.

Your physical therapist may use heat to increase blood flow to the target area. Blood helps heal the area by
delivering extra oxygen and nutrients. Blood also removes waste byproducts from muscle spasms.

Conversely, cold therapy (also called cryotherapy) slows circulation. This reduces inflammation, muscle spasms
 and pain. Your physical therapist may place an ice pack on the target area, give you an ice massage, or even use
a spray known as fluoromethane to cool inflamed tissues.

 Hydrotherapy: As the name suggests, hydrotherapy involves water. As a passive treatment, hydrotherapy may
involve simply sitting in a whirlpool bath or warm shower. Hydrotherapy gently relieves pain and relaxes
muscles.

 Transcutaneous electrical nerve stimulation (TENS): A TENS machine uses an electrical current to stimulate
your muscles. It sounds intense, but it really isn't painful. Electrodes taped to your skin send a tiny electrical
current to key points on the nerve pathway. TENS reduces muscle spasms and is generally believed to trigger
the release of endorphins, which are your body's natural pain killers.

 Traction: The goal of traction is to reduce the effects of gravity on the spine. By gently pulling apart the bones,
the intent is to reduce the disc herniation. The analogy is much like a flat tire "disappearing" when you put a
jack under the car and take pressure off the tire. It can be performed in the cervical or lumbar spine.
Active Treatments You May Try in Physical Therapy
Active treatments help address flexibility, posture, strength, core stability, and joint movement. An exercise program
may also be prescribed to achieve optimal results. This will not only curb recurrent pain but will also benefit your overall
health. Your physical therapist will work with you to develop a program based on your specific diagnosis and health
history.

 Core stability: Many people don't realize how important a strong core is to their spinal health. Your core
(abdominal) muscles help your back muscles support your spine. When your core muscles are weak, it puts
extra pressure on your back muscles. Your physical therapist may teach you core stabilizing exercises to
strengthen your back.

 Flexibility: Learning proper stretching and flexibility techniques will prepare you for aerobic and strength
exercises. Flexibility helps your body move easier by warding off stiffness.

 Hydrotherapy: In contrast to simply sitting in a hot tub or bath like its passive counterpart, active hydrotherapy
may involve water aerobics to help condition your body without unnecessary stress.

 Muscle strengthening: Strong muscles are a great support system for your spine and better handle pain.
Your physical therapist will teach you ways to condition and strengthen your back to help prevent future pain. You may
learn self-care principles so you understand how to best treat your symptoms. The ultimate goal is for you to develop the
knowledge to maintain a pain-free lifestyle.

It's essential that you learn how to exercise and condition your back after the formal physical therapy ends. If you don't
implement the lessons you learned during physical therapy, you won't enjoy its long-term results. By taking care of your
back on your own, you may prevent further herniated disc pain.