Ask a PT Response: "When treating patients which have these conditions, a therapist should remember the anatomy and pathology for these conditions. For treating a patient which has a lumbar discogenic syndrome a PT would usually work on teaching proper posture to minimize further injury (ie. sitting, bending, squatting, lifting, carrying). Activities which requires flexion are usally avoided. Based on the evaluation and findings, a PT could issue McKenzie based exercises which could include extension based and core training exercises (ie. prone on elbows/prone trunk extension, prone arm & leg lift/4 point arm & leg lift, 1/4 wall slides, partial fwd lunges, etc.) Bridging is a possible exercise to prescribe to a patient who is suffering from an acute herniated disc if the patient's condition is not exacerbated. Like most exercises, should a patient experience increase symptoms from performing the exercise, the exercise should be either modified or not performed.

 

A patient that has a facet dysfunction will require a somewhat similiar yet different approach as far as treatment goes. Postural training and core training are again very important. Maximizing core strength will help mimimize stresses placed on the facet joints. Flexibility training is also important as well. Lumbar extension based exercises are usually NOT prescribed to a patient with this condition as these exercises may increase irritation to the facet joints. Typical exercises a PT could prescribe to a patient with a facet dysfunction can include and isn't limited to pelvic tilts, single knee to chest stretch, 4 point arm/leg lift, partial forward lunges, etc.

 

Should you have any questions about treating your patients, I would not hesitate to consult with other therpaists who you are working with. It may also be a good idea for you to look into taking some continuing education courses which focus on treating injuries of the spine as well. Good luck with everything and thanks for using CyberPT."