One of the cartilage disks in your lower back has ruptured and it's painful to walk and sit. Your doctor has suggested surgery to remove part of the disc. As an alternative, they offer physical therapy to strengthen your back. If you're patient and follow your therapist's recommendations precisely, you may avoid surgery completely. Here is what you can expect from physical therapy for your injured back and how to make sure it is successful for your condition.
Muscles and Nerves are the Source of the Pain
The ruptured disc has no sensation but it puts pressure on the muscles that run along the side of your spine. The contents of the disc press against the nerves that run in and out of the spine. Together, the irritation of the muscles and nerves cause your pain. Physical therapy on your back will stretch and strengthen the muscles so they can better support your back while it's healing. It also reduces the painful irritation of these tissues. A course of physical therapy covers three areas: stretching, stabilizing and strengthening.
Stretching Tense Muscles
Constant irritation of the back muscles causes them to contract. These tense muscles may begin to have spasms. The muscle fibers shorten as they become exhausted from the stress. The contraction of the muscles prevents them from supporting your back properly. Your therapist will guide you through stretching exercises to slowly pull those muscles out to their normal length. As they stretch out, the spasms will go away and the muscles will be better able to support your spine securely.
Some of the stretching exercises you will do include:
- bending forward at the waist while sitting on the floor
- rounding your back up and down while on your hands and knees
- rotating your lower back while lying on the floor
- bending your lower back side-to-side while sitting in a chair
The therapist will also have you use an exercise ball or other equipment to stretch out those lower back muscles.
Stabilizing Lower Back Muscles
These exercises strengthen the muscles that run along and around the spine. Once the muscles have been stretched, strengthening them stabilizes your lower back to prevent bending and twisting injuries while the ruptured disc is healing. You'll regain full range of motion in your back so it won't feel stiff as you sit or walk.
These exercises will include:
- deep forward lunges with hand weights
- twisting at the waist and squatting with hand weights
- push ups while rolling the lower back off of the floor
These exercises slowly add resistance to your back muscles by increasing the weights or the amount that you roll your back. Strengthening must be done a little at a time so as not to stress the lower back muscles and cause pain.
Strengthening Core Muscles
The previous exercises strengthen the muscles next to the spine to give you more stability. The core strengthening routines work on the muscles in your abdomen and hips to give you more support. Some of these exercises include:
- leg lifts and sit-ups
- crunches and squats
- stationary bike and rowing machines
These exercises are started after the stretching and stabilizing routines have shown progress to make sure your spine is being supported while your core muscles are given a workout.
Making Sure Your Physical Therapy is Successful
If you want to avoid surgery on your lower back, here are some tips to get the most from your physical therapy:
- do the exercises exactly as demonstrated by your physical therapist
- set a pace with your therapist and stay within that
- never push your muscles beyond the point of pain
- if you skip a session, don't double up on exercises to "catch up"
You'll need to be patient and make slow and steady progress. Hurrying will result in pain and setbacks.
Talk to experts like Advance Physical Therapy & Sports Rehabilitation for more information.