Herniated disks are a common problem resulting from poor posture, being overweight, lifting incorrectly and other factors. This can be a very painful condition, prompting clients to come to us with high hopes for major pain relief.
A herniated disk is a malfunction in the soft, cushioning, jelly-like disks between the vertebrae. These disks absorb the impact between the vertebrae as we move through life, protecting the bones and nerves that run throughout the body from the spinal cord. When they are damaged, they often bulge and burst, and this is often referred to as a herniated or slipped disk.
Signs and Symptoms of Herniated Disks
Signs of a herniated disk can include unexplained arm and leg pain, numbness or tingling, and/or weakness in the arms and legs. Reduced muscle strength, loss of reflexes and ability to walk or the ability to feel light touch, and changes in frequency of elimination of bowel and bladder are also symptoms. Most herniated disks occur in the lumbar region, or low back.
Sometimes there is no pain when one of these disks is damaged and we do not know unless we have an MRI scan (magnetic resonance imaging), CT scan (computerized tomography) or myelogram test done (when a dye is injected into the spinal fluid so that X-rays can map out the structures). In other instances, there can be a great deal of pain associated with a herniated disk as the nerves and bones are compressed with no cushioning.
Causes of Herniated Disks
There are many contributing causes of herniated disks: wear and tear that occurs with aging, excessive body weight, injury to the spine, poor posture or bad habits in exercise or lifting. These disks are designed to protect the spine and spinal column from damage and they themselves can be damaged when the spine is overly compressed or compromised. Often surgery is required to repair the damage, but these disks can sometimes recover by themselves in a few weeks to a few months.
Managing Pain from Herniated Disks
Pain from damaged or herniated disks can range from mild to severe. Managing the pain is similar to managing other soft tissue pain:
- Do not overdo it. If you have a herniated disk, go easy on your body. Do not lift anything heavy and be sure to use proper body mechanics when lifting – bend the knees, lift with your legs – not your back.
- Run hot or cold. Try heat or ice packs for 15-20 minutes at a time.
- Rehabilitation. Consistently do the exercises your doctor or physical therapist gives you to strengthen back and core muscles.
- Stand up straight. Bad posture can lead to a herniated disk and can aggravate an existing one.
- Exercise. Light, regular exercise such as walking will help maintain healthy muscles and circulation to the area.
- Lighten up. Maintaining a healthy body weight takes the load off of these disks, reducing the chances of damage and allowing damaged disks to heal.
- Ask your doctor about medications. There are medications that can help with the pain associated with herniated disks. These can range from over-the-counter analgesics, narcotics, muscle relaxers or cortisone injections. Your doctor will be able to assess an appropriate medication based on your level of pain.
- Massage Therapy! Massage can assist in maintaining healthy muscle tissue in the surrounding area, taking the strain off of the spinal column.
Massage Therapy and Herniated Disks
Massage therapy will not “heal” or “cure” a herniated disk, but when done on the surrounding tissue it can help through increased circulation, muscle flexibility and range of motion. Massaging directly on a herniated disk is contraindicated, as is pressure directly on a damaged disk because it may aggravate the condition and increase pain levels. If the client indicates that his or her doctor is recommending surgery or they are having any severe symptoms such as loss of bladder or bowel control, it may be a good idea to refer them to a physician and get their approval as a precaution before doing massage therapy.
When clients come in with herniated disks, work the muscles on either side of the spine and throughout the area in order to restore range of motion, lengthen muscle tissue, and increase circulation to these areas. This will provide the disk(s) with the best possible chance of healing on their own as the body tends to tighten up around pain or weakness in order to protect itself. Releasing the muscle tissue that is engaged in holding tension throughout the area will allow the client to relax, restoring circulation and movement.
When working around a damaged disk, use most of the same techniques otherwise used during a massage – only with more caution! The specific techniques will be determined by the specific disk that is damaged. This means you would also use the same precautions – working within the pain tolerance of the client, checking in often and warming up the area as you slowly work deeper.
Begin by using effleurage to warm up the tissue and assess the muscles. Then deepen the work moderately, introducing some petrissage to the muscle tissue and using friction as appropriate. Remain aware of the herniated disk(s), moving slower than normal during the approach to any adjacent muscle tissue. It is vital to check in with clients as they are our best indicators of the path this work should take. If they are experiencing increased pain, lighten up or back off of the area completely.
Massage therapists have tools for relieving tight muscle tissue surrounding an injury such as herniated disks. As always, we must exercise caution in using them. Basic massage techniques such as effleurage, petrissage and friction can be used to release the tissues and bring relief, but the client may experience an increase in pain if we overdo it. Working on a client with a herniated disk is the perfect exercise in tuning in to the client’s needs and feedback.