What is a disc herniation?
Between the vertebrae of the spine sit elastic discs that act as shock absorbers. A disc herniation occurs when the disc’s protective outer layer (annulus fibrosus) weakens or tears and the gel-like material inside it (nucleus pulposus) leaks outwards.
What actually causes the pain?
The leaked material touches or compresses the nerve roots running through the spinal canal. Three mechanisms then come into play:
- Mechanical pressure — because the nerve is compressed, strong pain signals are sent to the brain.
- Chemical inflammation — the material from inside the disc triggers an inflammatory reaction on contact with the surrounding tissue and increases the pain.
- Radiating pain — the pain does not stay in the lower back; it spreads along the nerve to the legs (the sciatic nerve — sciatica) or to the arms, causing numbness and a feeling of weakness.
Does a disc herniation always need surgery?
No. Many patients think surgery is the only way out, yet a large proportion of disc herniations can be treated successfully with physiotherapy and rehabilitation.
What does the physiotherapy approach involve?
- Reducing pain — reducing inflammation and pressure with physiotherapy methods.
- Spinal stability — strengthening the muscles around the spine with specific exercises and reducing the load on the discs.
- Lifestyle change — teaching correct posture and movement habits so that the herniation does not recur.
What is osteochondrosis?
Osteochondrosis refers to degenerative changes in the spinal discs and vertebrae. Over time it can lower everyday quality of life and cause restricted movement and persistent pain. With a timely examination and the right physiotherapy — exercise-based rehabilitation and electrotherapy — the pain can be prevented.
What is facet joint syndrome?
One cause of pain felt in the lower back, neck or upper back during movement can be facet joint syndrome. It is related to injury or inflammation of the small joints between the vertebrae.
What happens if you put off treating low back pain?
- Becoming chronic — untreated pain becomes chronic over time and limits everyday movement.
- Risk of disc herniation — constant pressure and incorrect movements can damage a spinal disc.
- Lower quality of life — poor sleep, tiring quickly and constant discomfort reduce productivity at work.
Treatment methods: Manual therapy, Neural therapy and dry needling. If the pain spreads to the leg: Sciatica and piriformis syndrome.