The tissue between the individual vertebrae of the spine is called intervertebral disc. In simple terms, intervertebral discs are round plate-like structures with a gel-like core and a harder outer shell. The intervertebral discs form a kind of joint between the individual vertebrae and thus enable movement and at the same time act as dampers.
When the outer shell of the intervertebral discs ruptures, the gel-like interior is pressed outwards. Seen in this way, the prolapse is not to be seen as an event but as a protrusion of the intervertebral disc, hence the term herniated disc. A herniated disc can occur at any point of the spine.
In this article, a herniated disc in the cervical spine will be discussed in more detail. The causes of a herniated disc can be very different. Age often plays a major role, since the intervertebral discs lose elasticity with age and tear more easily. Accidents or too fast movements can also be triggers for a herniated disc.
Treatment/Physiotherapy
In most cases, physiotherapy plays a major role in the healing process after a slipped disc in the cervical spine. Whether as a rehabilitation measure after an operation or as a conservative treatment method, physiotherapeutic treatment helps patients to get a grip on the pain and to strengthen and re-mobilize the damaged structures. First of all, the therapist carries out a new assessment.
During this so-called anamnesis, the therapist tries to find out as much as possible about the causes and connections that are connected to the herniated disc. Also the pain symptoms as well as movement restrictions are an important factor for the therapist when creating a patient-specific training plan. The article Physiotherapy for Spinal Canal Stenosis might also be of interest to you in this regard.
To treat a slipped disc in the cervical spine, there are a number of special physiotherapeutic techniques. In general, these can be differentiated into 2 fields: 1. passive therapy The passive therapy forms serve to relax and relieve the body. These include: 2. active therapy Active therapy forms serve to improve flexibility, posture, muscles and mobility.
This includes: The overall aim of physiotherapeutic treatment is therefore to restore the patient’s good general condition as far as possible and to provide the patient with the necessary knowledge to continue working actively on the rehabilitation process at home after the end of the therapy and to prevent or avoid later injuries.
- Massage, especially the Deep Tissue Massage, which is performed with a lot of pressure to release tension and cramps in the deep muscles
- Hot/cold applications, whereby the heat promotes blood circulation and relaxes and the cold has an anti-inflammatory and analgesic effect
- Hydrotherapy, a form of therapy in water that gently relieves pain and relaxes muscles
- TENS, an electrical therapy form, whereby the muscles are stimulated by electrical impulses and thus pain and cramps are released
- Active forms of therapy
- Abdominal muscle training. Many people do not know how important the abdominal muscles are also for the back.
If the abdominal muscles are too weak, this increases the strain on the back muscles and thus exerts additional pressure on the spine.
- Flexibility exercises. These help to keep the body flexible, so that movements fall more easily and stiffness is prevented
- Muscle training. Muscles are important to give the cervical spine additional stability and thus strengthen it.
Exercises for the cervical spine are a standard part of the physiotherapeutic treatment after a slipped disc.
The patient first learns the exercises and then performs them under the supervision of an experienced therapist. Some of the possible exercises are described in more detail below. 1.)
Strengthening of the musculature This exercise serves to strengthen the muscles of the cervical spine, so that they then provide more stability. In addition, the stretching of the cervical spine creates more space in the spinal canal. During the exercise, the patient is in a supine position with feet on the floor.Now try to push the back of the head into the ground while simultaneously pushing the chin backwards (as if you wanted to make a double chin).
Hold this position for 10 seconds. Repeat 3 times with small pauses. 2.)
Laser pointer: The laser pointer exercise aims to improve the coordination of the cervical spine. A headband with an attached laser pointer is put on the patient. The therapist then gives various instructions, such as shapes or letters, which the patient should follow on a wall with the help of the laser pointer.
3.) Strengthening the rear muscles of the cervical spine The patient lies on his stomach during this exercise. The forehead is supported on the back of the right hand.
The spinal column forms a straight line as far as possible. Now the head is lifted minimally by the hand. The eyes remain on the floor.
Hold this position for 5-10 seconds, then slowly lower it again. 5 repetitions. 4.)
Control of the cervical spine This exercise serves to give the patient better control over movements at the cervical spine. The patient sits straight and upright on a chair. The shoulders are relaxed.
Now the head is moved forward slowly and in a controlled manner, as if nodding. Then return to the starting position. 5 repetitions.
5.) Isometric strengthening of the cervical spine In this exercise the muscles are strengthened isometrically, i.e. without length extension. The patient sits straight and upright on a chair.
Now, with the help of the hand, give a resistance to the head from the front, back and sides. The head exerts a counter-pressure which is held. Breathing continues to be fluid and rhythmic.
Hold the position for 10 seconds each, 3 passes. More exercises can be found in the articles:
- Cervical spine mobilization exercises
- Physiotherapy exercises HWS
- Spinal canal stenosis HWS exercises
- Disc protrusion in the HWS – Physiotherapy
The successful physiotherapeutic treatment can and should also be supplemented by exercises which the patient can do at home. These exercises are also suitable for people who live without complaints, as they protect and stabilize the cervical spine preventively.
Many of the exercises that patients learn while under the care of a physiotherapist can also be easily performed at home once the therapist is sure that they are performed correctly. The following are some more examples of stretching and strengthening exercises that patients can perform at home after a slipped disc in the cervical spine: 1) Stretching the lateral cervical musclesStand with your back against a wall or door frame. The feet should be about 5-10cm away from the wall.
Tilt your chin slightly towards your chest and then move/rotate your head towards the wall/door until you feel a stretch at the side of your neck. Hold your head against the wall/door for 10 seconds, then change sides. Repeat the exercise 5 times per side.
2.) Strengthen the muscles in the area of the cervical spineSit up or sit up straight and upright. Take a dumbbell or other weight (e.g. a small water bottle filled with sand) in each hand.
The shoulders and arms hang down low and relaxed. The back and head are straight. From this position, slowly pull your shoulders upwards.
Hold this position for 2-3 seconds and then slowly lower the shoulders again. Repeat the exercise 10 times. 3.)
Stretching the cervical spine musclesSit up straight and upright on the front edge of the chair. If possible, tense the abdomen and buttock muscles slightly for support. Now stretch your arms straight forward.
Your elbows should point outwards. From this position, bend your arms so that your fingertips rest slightly on your shoulders (do not cross your arms!). Breathe out and pull your elbows together in front of your chest until they touch slightly.
When breathing out, return to the starting position with your arms. Repeat the exercise 5 times. For all exercises that you do after a slipped disc in the cervical spine, the general rule is: Listen to your body, what feels good is usually also good. If you feel strong pain during an exercise, do not perform it any longer and ask your doctor or physiotherapist for advice.For a successful rehabilitation it is important that you stay on the ball with consistent training to achieve good progress.
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