Disc Injuries-Types, Symptoms and Treatment

In Dr. Koshes’ LMT continuing education course, “Clinical Neurology and Orthopedics for the Massage Therapist,” he reviews commonly diagnosed musculoskeletal conditions with protocols for treatment. In his accredited massage therapy class he reviews three types of disc injury; disc protusion (bulge), disc herniation and disc degeneration.

In a disc protrusion, the disc material will extend slightly past its normal boundaries irritate the adjacent nerve. The disc material will remained contained within the parent disc. The symptoms a patient experiences can be either localized to the spine and/or radiate down an extremity, but the greatest amount of pain is usually felt in the spine. There are muscle spasms, ROM limitations and occasionally sensory loss to an extremity following a particular dermatomal pattern. Muscle strength and reflexes are usually normal.

With disc herniations, the disc material extends well past its normal boundaries and will irritate the adjacent nerve root. The disc material is not contained within the parent disc. The symptoms patient experiences can be either localized to the spine and/or radiate down an extremity, but the greatest amount of pain is usually felt in the extremity. There are more severe muscle spasms and ROM limitations than compared to a disc protrusion. Sensation, reflexes and muscle strength may be effected within an extremity corresponding to a particular nerve root level.

The Massage Therapy continuing education class also covers Disc degeneration, which develops as a result of the loss of water (dessication). This causes the disc space to decrease in height compared to the adjacent vertebral levels producing nerve and joint pressure. The pain can be localized or refer down an extremity. The patient’s pain is generally worse in the morning hours and eases as the day progress. The pain can also be made worse if the patient over-does-it. Symptoms can include a moderate reduction in ROM’s but sensation, reflexes and muscle strength is usually preserved.

Treatment initially for all types of disc injuries should include “PRICES” which stands for; protection of the injury, rest of the injury, ice, compression, elevation and support for the injury. In-office care protocol could include massage treatment, acupuncture, physical therapy, chiropractic, mild support bracing and/or exercise therapy. With disc herniations that do not respond to conservative care a referral for medical evaluation is appropriate.

Dr. Koshes' online CEU massage therapy training is accredited by the Florida State Massage Therapy Association. Should you wish additional information on common musculoskeletal conditions and continuing education units for Florida Massage Therapists, including including Post Graduation CEU classes and Advanced Training For LMT's contact Dr. Koshes at his website www.koshes.com

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