Herniated Disc Treatment.

1. The signs and symptoms present: Your herniated disc symptoms will dictate the treatment required for your disc herniation. As a physiotherapist working daily with herniated disc clients, I can tell you that there are many conservative treatment options for your herniated disc. I commonly use mobilisation techniques in a directional manner.
   
   That means easing your disc back into place using specific techniques in the direction in which it needs to go. Once we have your disc back in its correct position, I then teach you herniated disc exercises to strengthen the muscles around the weakened area of your spine, so that your disc does not tear again in the future.




2. Duration of your symptoms and the affect your symptoms are having on your daily life: If your herniated disc symptoms have been with you for days, I will attempt mobilisation therapy to correct your disc alignment.
   
   If, however, your symptoms are very severe and you cannot tolerate treatment or mobility due to pain, I will ask your doctor to prescribe medication to reduce your pain so that I can do my work.
   
   If you have neurological signs such as numbness or lack of toileting control I will refer you immediately for surgical treatment, as the risks of manual treatment are too great. I will typically see you again during your herniated disc surgery recovery.




3. Response to initial treatments: Rest and avoidance of aggravating movements is the initial treatment of choice in disc herniations. Most disc herniations, if addressed at the early stages, will resolve with rest and good positioning.
   
   However, if your disc pain is worsening with rest, or if you develop severe signs such as problems with your waterworks or numbness in your saddle area, you should seek immediate medical attention as surgery is typically required.




4. The size and direction of your disc herniation: If you have a typically common posterior or posteriolateral disc herniation of moderate size, then my manual treatment usually resolves you of your pain and disc herniation.
   
   However, if you have a large protrusion causing neurological signs, or you have an anterior herniation I will send you for surgical review as this type of disc herniation generally responds poorly to physiotherapy management in my experience.

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