What is a Herniated Disc?

As a disc degenerates, it can herniate (the inner core leaks out), which is known as a disc herniation or a herniated disc. The weak spot in the outer core of the disc is directly under the spinal nerve root, so a herniation in this area puts direct pressure on the nerve.

Symptoms of a Lumbar Herniated Disc

Approximately 90% of disc herniations will occur toward the bottom of the spine at L4- L5 (lumbar segments 4 and 5) or L5- S1 (lumbar segment 5 and sacral segment1), which causes pain in the L5 nerve or S1 nerve, respectively.

• L5 nerve impingement from a herniated disc can cause weakness in extending the big toe and potentially in the ankle (foot drop). Numbness and pain can be felt on top of the foot, and the pain may also radiate into the buttock.
• S1 nerve impingement from a herniated disc may cause loss of the ankle reflex and/or weakness in ankle push off (patients cannot do toe rises). Numbness and pain can radiate down to the sole or outside of the foot.

Common Cause of Lumbar Herniated Disc

A herniated disc usually is caused by wear and tear of the disc (also called disc degeneration). A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc.

Injury to the disc can occur from:

• A sudden heavy strain or increased pressure to the lower back. Sometimes a sudden twisting movement or even a sneeze will force some of the nucleus (the material inside the disc) out through the disc's outer layer (annulus or capsule).
• Activities that are done over and over again that may stress the lower back, including poor lifting habits, prolonged exposure to vibration, or sports-related injuries.

Prevention / Treatment of Lumbar Herniated Disc

The following guidelines are for information purposes only. Seeking professional advice before beginning rehabilitation is recommended.

It is unclear if herniated disks cause pain themselves, or if they must press on a nerve root to cause pain. Pain may also occur with herniated disks as a result of mechanical or neurological irritation of surrounding structures such as muscles, tendons, ligaments, or joint capsules. Therefore, many treatment strategies will be primarily focused on managing symptoms that occur in conjunction with a herniated disk.

Massage Therapy

The skilled Medical Massage Therapists at Advanced Alternatives Massage Therapy will focus on muscular reactions to the herniated disk. Neurological irritation that comes with a herniated disk will often cause excessive muscle spasms in the lower back muscles. These spasms will perpetuate dysfunctional movements in the joints of the spine and may exaggerate compressive forces on the intervertebral disk.

By relaxing the muscles, massage therapists will attempt to manage the symptoms of disk herniation until proper movement can be restored. Proper movement and avoidance of aggravating postures, like sitting for long periods, will often be a great help in completely resolving the symptoms.

Sources:

1. http://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc
2. Hammer, W. Functional Soft Tissue Examination and Treatment by Manual Methods, 2nd ed. Gaithersburg, MD: Aspen, 1999.
3. Kessler, R.M. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. Philadelphia: J.B. Lippincott Co., 1990.
4. Liebenson, C. Rehabilitation of the Spine. Baltimore: Williams & Wilkins., 1996.