What is Lumbar Hernia? Physiotherapy for Lumbar Hernia

Is Lumbar Hernia Healed With Physical Therapy? The most common treatment method in the treatment of herniated disc is physical therapy. Physical therapy not only relieves pain but also creates body awareness. It prevents the recurrence of pain due to lumbar hernia by putting the body into shape with the right movement patterns and exercises.

What is Lumbar Hernia? Causes Lumbar Hernia?

Can a herniated disc be treated with physical therapy? Before starting our article, we need to understand what is a herniated disc. A lumbar hernia develops due to the deterioration of the discs that act as a pillow between our spine bones. The lumbar hernia can occur as a result of sudden trauma or prolonged stress on the spine.

When the spine is loaded, the ” annulus fibrosus “ fibers forming the outer part of the disc may be torn. In the central part of the disc, gel-like content called ” nucleus pulposus ” leaks through these tears. The leakage or overflow of this substance is called a herniated disc. The lumbar hernia can occur repeatedly due to reasons such as heavy lifting, obesity, poor posture, and smoking.

What is Lumbar Hernia? Physiotherapy for Lumbar Hernia

Top view of the spine. The disc located in the front of the spine is represented in blue. There are tight and regular annulus fibrosus fibers on the outer wall of the disc and a gel-like nucleus pulposus material in the central part. The circular space in the middle is the spinal canal.

In the figure, wear and tear in the annulus fibrosus fibers are represented in red. Yellow represents the nerve tissue.

Lumbar Hernia – What is Bulging?

Bulging is frequently mentioned in lumbar MRI reports. Statements such as “bulging in the L4-L5 disc” are a matter of curiosity for patients. As we mentioned above; the JeLSIM agent to protrude disc in playing back the normal position, the overflow line from the rear bulging is called.

It can be said that bulging is the first stage of lumbar hernia. Lumbar hernias in bulging situations generally do not require surgery. Because the effects of the surgery such as scar tissue formation and inflammatory process have the possibility of further disrupting the waist structure in the long term.

Complaints due to bulging lumbar hernias are greatly improved with physical therapy methods. Physical therapy methods work by reducing pain and muscle spasms, reducing inflammation, increasing blood circulation, strengthening waist and abdominal muscles.

What is Lumbar Hernia? Physiotherapy for Lumbar Hernia

Lumbar hernia – a bulging can cause pain because it compresses the nerve roots or disturbs the nerve endings in the disc.

At Which Levels Does Lumbar Hernia Occur Most Frequently?

Lumbar hernia most commonly occurs in the lower levels of the waist at the levels called L4-L5 and L5-S1.

Most lumbar hernias do not require surgery and benefit from physical therapy. A physical therapy and rehabilitation physician questions and examines the person’s complaints and creates an appropriate treatment program.

Who Has Lumbar Hernia?

In people under 30 years of age, the disc is soft and flexible, perfectly absorbing shocks to which the spine is exposed. However, as age progresses, the stretching ability of the disc decreases. After the age of 50, the gelatin-like substance (nucleus pulposus) in the center of the disc dries out and loses its ability to stretch and is, therefore, less prone to herniation.

Lumbar hernia is most common in individuals between the ages of 30-50. In older people, distortions in the disc structure can cause painful problems called “degenerative disc disease” or calcification (degenerative joint disease).

Men are twice as likely as women.

What are the Symptoms of Lumbar Hernia?

In lumbar disc herniation, signs and symptoms that vary according to the region of the herniated disc and the level of herniation can be seen. In addition to the pain and stiffness in the lumbar region, signs and symptoms related to a possible nerve compression can also be seen. These:

  • Decreased muscle strength
  • Sensory problems (numbness, numbness, tingling)
  • Symptoms such as a decrease in reflexes.

As represented in the image below, nerve roots from the waist are responsible for sensing a particular area in the leg. Therefore, complaints such as leg pain, numbness, and burning may occur in lumbar hernias.

What is Lumbar Hernia? Physiotherapy for Lumbar Hernia

Does Lumbar Hernia Correct On Its Own?

There is no improvement in the recovery of a worn and herniated disc. However, the body has its own mechanisms to reduce complaints.

When the hernia first occurs, the water in it disappears over time and passes to the surrounding tissues. This can reduce the size of the hernia. For example, it is possible for a dislocated disc to decrease in size as a result of an immune system response.

Although lumbar hernias do not fully recover over time, there may be a reduction in size. Thus, nerve root compression can be relieved and complaints can be reduced.

Is Lumbar Hernia Corrected With Physical Therapy?

Some of the patients attach great importance to the disappearance of the hernia. Obviously, physical therapy is not intended to return a herniated disc to its previous state, to a healthy brand new disc. The aim of physical therapy is to control the complaints and prevent the recurrence of back pain attacks.

In the MRI examinations performed in healthy people, abnormal images defined as lumbar hernia was found, although there was no pain in a large part. In other words, even if there is a herniated disc, most people continue their normal lives. Lumbar hernias that cause severe nerve compression and loss of strength in the foot can be operated on.

What is Lumbar Hernia? Physiotherapy for Lumbar Hernia

Physical therapy methods are applied primarily for the treatment of lumbar hernias, except for some well-defined emergencies. In physical therapy, deep tissue massage, hot or cold treatments, electrotherapy, hydrotherapy, traction, and exercise applications are performed.

Physical therapy methods applied in lumbar disc hernia are divided into passive and active treatments:

  • Passive Treatments: It consists of massage, electrotherapy applications, and warming therapies in which the patient does not actively participate.
  • Active Treatments: These are exercise treatments that require patient participation.
    In lumbar hernia, first of all, passive physical therapy is started and after pain control is achieved, active exercise treatments are started to prevent the recurrence of the disease.

Lumbar Hernia Physical Therapy – Passive Physical Therapy Applications

  • Electrotherapy: Nerves are stimulated by giving a light electrical current with electrodes placed on the skin. Especially TENS (transcutaneous electrical nerve stimulation) application is often preferred. TENS reduces muscle spasms and pain.
  • Massage: Superficial and deep tissue massages applied to waist and back muscles are effective in resolving muscle spasms in this area and reducing pain.
  • Hot Treatments: Increases tissue blood flow. Thus, more oxygen and nutrients go to the tissue, and the waste materials accumulated in the tissue are removed. It is especially effective in relieving muscle spasms in chronic back pain.
  • Cold Treatments: It reduces circulation and with this feature, it reduces the inflammatory response, muscle spasms, and pain.
  • Traction (Pulling): Pulling force is applied to the lumbar vertebrae with the straps and belts tied to the waist and legs. With this force applied in the opposite direction of gravity, the pressure on the bones and disc is reduced. A hernia can also shrink as the pressure on it decreases.
What is Lumbar Hernia? Physiotherapy for Lumbar Hernia

Lumbar Hernia Physical Therapy – Active Physical Therapy Applications

Lumbar hernia improves with active applications within the scope of physical therapy. With the exercises performed, improvements are seen in the person in terms of flexibility, core stability, strength, and range of motion. Exercises not only prevent the recurrence of pain but also contribute to a person’s overall health.

  • By strengthening the waist and abdominal muscles, the stability is increased, preventing the recurrence of low back pain and the spine is protected against strains.
  • With the correct stretching techniques, an increase in joint range of motion and a reduction in muscle spasms can be achieved.
  • In-water exercises accompanied by a physiotherapist also reduce back pain.

Participating in active treatments after passive physical therapy methods are essential for long-term benefit in lumbar hernia!

The page content is for informational purposes only. Items containing information about therapeutic health services are not included in the content of the page. Consult your physician for diagnosis and treatment.

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  3. American Physical Therapy Association. Find a PT.
  4. Gugliotta M, da Costa BR, Dabis E, et al. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort studyBMJ Open. 2016;6(12):e012938. doi:10.1136/bmjopen-2016-012938
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