herniated disc therapy
Does physical therapy help heal an L3-L4 herniated disc? I have had 3 epidural blocks.?
Most times it can…it depends how you respond to mechanical movements. I would highly recommend you see a physical therapist who is trained in mechanical diagnosis and therapy (go to http://www.mckenziemdt.org for a list of credentialed providers). The MDT approach doesn’t just take a bunch of random stabilization exercises (which are not shown to be effective for a herniated disc) for you to do at home (this is probably how most PTs practice). Rather, therapists trained in MDT curtail your exercises specifically to YOUR responses to MOVEMENT rather than giving you exercises based on your “diagnosis.” Only once we see your responses to movement and/or positioning can we give you a prognosis.
Your chances for a good recovery include:
1. Intermittent symptoms
2. Pain no further than the knee
3. An internal locus of control
4. Your symptoms demonstrate “centralization” on the first visit (meaning they move from the leg to the back).
5. You don’t smoke
6. You adhere to the program
Signs of a poor outcome include:
1. Constant symptoms that always radiate to the foot…they are there at rest and with activity 24 hours a day
2. No centralization can be achieved in the first 3 visits
3. You have an external locus of control (meaning you believe “bad” things “happen to you” rather than being able to control your own destiny)
4. You smoke
5. You are dissatisfied with your job
6. You present with a significant shift in your spine towards the side of your symptoms.
…interestingly, a recent study demonstrated that those who attended a PT program for this same problem and their program included massage therapy and passive modalities (like ultrasound), they were deemed to be less likely to recover. (Not that these things cause the problem to be worse, just they are not effective for this type of problem). Therefore, you should seek a treatment problem that requires your ACTIVE participation.
Finally, it not that people who have these things CANNOT get better, it’s just that their chances are lessened.
There ARE some cases which are deemed “irreducible,” but this will be made apparant in a very short time. (first 3-6 visits)
Good luck to you
Bulging Disc FAQ Video 5: How Effective Is Physical Therapy?
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