Where does physiotherapy fit in the treatment of a slipped disc?

Doctor's Answers 1

Photo of Dr Shee Yan Fong
Dr Shee Yan Fong

Orthopaedic Surgeon

Physical therapy (including physiotherapy) comprises up to 90% of treatment for pain from degenerative disc conditions (most commonly called "slipped disc" in layman's term).

Degenerative discs result from natural ageing "wear and tear" of the disc materials in between our spinal bones (vertebral bodies) as we load our spine with physical activities and/or prolonged postures day after day. And as we age, all these combine to gradually wear out our disc material resulting in "collapsing" and "bulging" of the disc, seen as a degenerated disc (or "slipped disc") in your MRI scan (but not X-ray) in 90% of patients.

Normal loading on a degenerated "tightened" disc may generate abnormally high pressure, irritating your spinal nerve next to the disc, leading to either discogenic pain in your back and/or neurogenic sciatica pain in your leg or arm (may include numbness and weakness).

All forms of physical therapy (including physiotherapy) use gradual repeated mechanical stretching to your neck or back to slowly "loosen" and reduce the high-pressure build-up of the disc usually over 6 weeks, leading to pain improvement with time. Further, later sessions of posture correcting and core strengthening exercises help to slow down the "wear and tear" in the long term.

Unfortunately, if the degenerated disc has further worsened in your MRI, compressing spinal cord or nerve (about 10% of patients necessitating surgery), physiotherapy will not help and may even worsen your condition further, hence the importance of seeking medical advice from your doctor before commencing any treatment on your own.

Similar Questions

How can I get rid of persistent back pain that is not responding to physiotherapy?

Thank you for your email and I am sorry to hear about your ongoing pain symptoms. This can be an issue after surgery even if it does resolve the disc issue/symptoms that you were experiencing. The only way to resolve pain is to assess you and consider the pain generators in the back - unfortunately there can be many. It could be residual pain from degenerative discs, facet joints, nerve irritation, muscular tightness, scar tissue formation and so on.

Photo of Dr Dinesh Sirisena

Answered By

Dr Dinesh Sirisena

Sport Medicine

What should I do next for lower back pain that occured on running?

Thank you for your questions. I agreed with both Dr. Sean and Dr. Dinesh that your pain is likely "discogenic", meaning that it is coming from the disc, which is the cushion in between the bones. There are also a spectrum of a "slipped disc", only when the slipped disc is very severe and compressing onto the nerve then you will develop tingling sensation or sciatica. Of course we don't want to wait until then before we do a thorough checkup on you, I'd recommend a MRI scan for you to investigate the actual cause of the pain and the severity of the condition.

Photo of Dr Henry Chan

Answered By

Dr Henry Chan

Orthopaedic Surgeon

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