Physiotherapy for a slipped disc

Synonyms

  • Discus prolapse
  • Protrusio
  • NPP
  • Disc prolapse
  • Lumbar disc prolapse
  • Intervertebral Disc Protrusion

This page provides self-help assistance for patients with a lumbar disc herniation in the lumbar spine. An overview is given of what patients themselves can contribute to their improvement and long-term recurrence prophylaxis (prevention of recurrence of symptoms) in addition to medical conservative (non-surgical) therapy. The herniated disc is a common disease of the spine.

It can occur in all sections of the spine. It leads to leakage of disc material and possibly to irritation of surrounding tissue. A herniated disc can cause muscle weakness, pain and paralysis. In most cases, the herniated disc can be treated conservatively, by physiotherapy, physical therapy, pain therapy, etc. Surgery may be necessary in case of resistance to therapy or serious incidents.

What is a slipped disc?

The herniated disc is a degenerative disease, i.e. it is a sign of wear and tear. It can be caused by one-sided long-term incorrect load (heavy work e.g. in a bent position) but also by genetic preload or previous traumas. Poor posture and congenital axial malalignment (e.g. scoliosis) can promote this incorrect loading.

This leads to wear and tear of the intervertebral disc, which acts as a shock absorber between the vertebral bodies. In the case of a herniated disc, disc material (a distinction is made between the fibrous, solid outer part, the annulus fibrosus, and the gelatinous inner nucleus pulposus) has shifted out of the disc. A distinction is made between three stages, all of which are often summarized in everyday use under the term herniated disc.

The first stage is the protrusion of the intervertebral disc, no tissue has been released yet, only a displacement has occurred. The second stage is the herniated disc (prolapse), the outer annulus fibrosus is torn, and disc material has shifted. In the third stage (sequestration), the exuded material is no longer in contact with the intervertebral disc.

Depending on the location of the displacement, different symptoms may occur. The herniated disc can also be completely asymptomatic. A herniated disc can occur in any section of the spine.

In the thoracic spine (BWS), however, it occurs only very rarely. The most common location of the herniated disc is in the lumbar spine (lumbar spine), but it also occurs frequently in the cervical spine (cervical spine), depending on the previous incorrect loading. If the disc material irritates surrounding structures, pain or functional failure of muscles and nerves may occur.

One speaks of a segmental disorder when intervertebral disc material presses on the nerves exiting the spinal canal and as a result the structures supplied by these nerves can no longer be properly supplied. This can lead to sensations of discomfort, muscle weakness and paralysis or pain in the area supplied, and reflexes (e.g. patellar tendon reflex) can also fail. In severe cases, functional disorders of the bladder and bowel may also occur, these should be clarified immediately by an (emergency) doctor! In most cases, the herniated disc can be treated conservatively, i.e. without surgery.