Back Pain-Herniated Disc

Question:

A recent MRI revealed that I have moderate disc protrusion at the C6-C7 level and minimal central herniation at the C5-C6 level. Can you explain what this means? Are there any exercises I can do to decrease the pain?

Answer: By Jill Boissonnault, PT, PhD

First, it is important to note that the results of your medical imaging should be discussed with the physician who ordered the study. The physician and your physical therapist will correlate these results with findings from your physical examination to determine which of these structures are contributing to your symptoms and the most appropriate treatment plan.

The cervical spine has seven cervical vertebrae, numbered 1 through 7 so that medical professionals can locate the exact location of pathology. The vertebrae are separated by intervertebral discs, which are rings of cartilage with a softer, jelly-like center called the nucleus. The rings of cartilage can tear, allowing the nuclear material to ooze into the cartilage, most commonly in the posterior or posterior-lateral part of the disc. The resulting bulge in the disc may be identified on MRI as a protrusion or herniation, depending on the size of the bulge. Some disc protrusions and herniations cause symptoms and others do not. If the disc material is pushing on a nerve, symptoms of pain and numbness may be present in the area of the disc herniation and/or anywhere along the nerve route. In other words, symptoms may be felt a distance away from the actual source of the problem.  

Physical therapy can be effective in relieving pain from disc material pressing on nerves. It’s important to consult a physical therapist for an examination and individualized exercise program to ensure that all contributing factors are considered and addressed, including posture, mobility, biomechanics, and strength. Finally, as your symptoms improve the physical therapist will provide the necessary education and exercise program geared to prevent the return of the problems.

Biographical Information

Physical therapist and American Physical Therapy Association (APTA) member Jill S. Boissonnault, PT, PhD, is an assistant professor at the University of Wisconsin, Madison, Physical Therapy Program where she teaches seminars in professional issues, service learning, and palpatory anatomy, and coordinates a research practicum. She offers seminars in ethics to meet licensure requirements on behalf of the program, consults in the area of women’s health physical therapy, and teaches CE seminars on musculoskeletal management of the OB client. Dr Boissonnault is immediate past president and founder of the International Organization of Physical Therapists in Women’s Health, a sub-group of the World Confederation for Physical Therapy. She received her Bachelor of Science in Physical Therapy from the University of Illinois, her master’s in orthopedic physical therapy from Northwestern University, and her PhD from the University of Wisconsin, Madison, in curriculum and instruction with a minor in women’s studies. She’s held various leadership positions within APTA, including treasurer of the OB/GYN Section (now the Section on Women’s Health) from 1983-1989, vice president 1995-1999, and education director 2005-2006. In 2000, Dr Boissonnault was awarded the Elizabeth Noble Award, and in 2006, the Wisconsin Physical Therapy Association Mentor of the Year Award and APTA’s Lucy Blair Service Award. She has authored numerous professional articles and textbook chapters and practices in the area of women’s health.