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Your physical therapist may give you passive treatments such as:
Deep Tissue Massage: This technique targets spasms and chronic muscle tension that perhaps builds up through daily life stress. You could also have spasms or muscle tension because of strains or sprains. The therapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).
Hot and Cold Therapies: Your physical therapist will alternate between hot and cold therapies. By using heat, the physical therapist seeks to get more blood to the target area because an increased blood flow brings more oxygen and nutrients to that area. Blood is also needed to remove waste byproducts created by muscle spasms, and it also helps healing.
Cold therapy, also called cryotherapy, slows circulation, helping to reduce inflammation, muscle spasms, and pain. You may have a cold pack placed upon the target area, or even be given an ice massage. Another cryotherapy option is a spray called fluoromethane that cools the tissues. After cold therapy, your therapist may work with you to stretch the affected muscles.
Spinal Traction: By stretching the back, spinal traction works to alleviate pain caused by muscle tightness or compressed nerves. The therapist can do that manually (by using his or her own body) or mechanically (with special machines). Especially if your nerve is being pinched by the foramen—the area where the nerve exits the spinal canal—your therapist may try traction. It's thought to widen the foramen by stretching the spine to readjust the vertebrae.
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Active Treatments
In the active part of physical therapy, your therapist will teach you various exercises to improve your flexibility, strength, core stability, and range of motion (how easily your joints move). Your physical therapy program is individualized, taking into consideration your health and history. Your exercises may not be suitable for another person with DDD.
DDD won't ever entirely "go away"—once your discs start to degenerate, you can't reverse that process—and because of that, your physical therapist will help you learn how to work around it and how to limit the pain. You'll learn about body mechanics and how to avoid positions that cause pain.
If needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily activities. This is all part of the "self-care" or "self-treatment" aspect of physical therapy: through physical therapy, you learn good habits and principles that enable you to take better care of your body.
Your physical therapist may also suggest a personalized exercise program for you. The goals may include: strengthening abdominal and back muscles, increasing muscle endurance (so that your stronger muscles can work harder longer), and getting your body to carry your weight more efficiently. An exercise program comes with another bonus—it may help you lose weight. Extra weight can exacerbate pain from DDD, so if you need to lose weight, your physical therapist can work with you to set goals and then follow through.
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