25/11/2025
L4-L5 disc protrusion (Plan set-up 1)
Physiotherapy management of disc protrusion
of treatment:
▪︎To relieve pain and minimise caregiver burden
▪︎To prevent deformity and stiffness
▪︎To improve muscle strength and flexibility
▪︎To maintain functional activities
▪︎To maintain ROM
▪︎To reduce muscle spasms or tightness
▪︎To improve postural correction
▪︎To rehabilate the patient
▪︎To maintain normal alignment of spine
procedure: (Reps 10 × Hold 10 × 3 times)
1. Back Stretching exercises :
》Stretching exercises - Erector spinae, Hamstring muscles, Piriformis, Gluteus muscles and Hip flexor stretches and hip rotations can help improve hip mobility and reduce stiffness.
2. Strengthening Exercises:
●Back Strengthening:
》Exercises like superman stretch, plank, and back extensions can help strengthen back muscles and improve posture.
●Core Strengthening:
》Exercises like crunches, leg raises, and planks can help improve core strength and stability.
3. Aerobic Exercises:
●Swimming:
》Swimming is another low-impact activity that can improve cardiovascular health and range of motion.
☆ Swimming: three times a week for six weeks: 10 min warm-up + 5 min stretching
4. Breathing exercises - deep breathing
5. Mobilizing exercise
▪️Cat - Cow
▪️Knee to chest stretch
▪️Child's Pose
▪️Pelvic tilts
6. Electrotherapy-
》Deep heat- SWD
》TENS
》Moist heat compression
7. Ergonomic correction
8. Core stability exercises
》Bridging
》Plank
》Airplaning
9. Others (by physio)
➡️Isometric back muscle exercise
➡️Myofacial release
➡️Buttocks contraction
➡️Neurodynamic stretching
➡️Hydrotherapy - pool therapy
➡️DTFM
➡️Posture re-education exercise
➡️Aquatic vertical traction (decompression)
➡️Dry needling
ADL
》Regular home exercises
》Posture correction ( Ergonomics)
》To maintain spinal alignment
》Avoid Smoking
》Swimming
》Maintain good posture to prevent a hunched spine.
》Use ergonomic furniture and avoid prolonged sitting and forward bending position.
》 Position change after 30 min ( must)
》 Sunrise ☀ 45 min everyday
》 Avoid weight bearing
》Avoid soft sofas and poor sitting posture
》Avoid twisting, lifting heavy objects
》Use lumber corset
》Avoid prolong sitting & bending position
》Avoid high heels or unsupportive shoes
》Lifestyle Modifications
》Don’t smoke or use other to***co products
》Keep a healthy weight and reduce obesity
》Hot and Cold Therapy
■ Some promote inflammation:
》Avoid High-inflammatory Foods: Processed foods, sugary snacks, and refined carbs. Saturated and trans fats (e.g., fried foods, margarine).
》Excessive red meat or processed meat products. f. Limit Alcohol:
》Stay Hydrated: Drink plenty of water
》Avoid Smoking
■ To help reduce inflammation in your body, strive to eat a diet rich in:
□Normally, dietary recommendations for Spondyloarthritis include:
》Fruits: Berries (blueberries, strawberries), oranges, and cherries.
》Vegetables: Leafy greens (spinach, kale), broccoli, and bell peppers.
》Healthy Fats: Olive oil, avocados, and fatty fish (salmon, mackerel, tuna). Whole Grains: Brown rice, quinoa, and oats.
》Calcium and Vitamin D: As Calcium-rich foods: Dairy products, fortified plant-based milk, almonds, and leafy greens.
》Vitamin D sources: Fortified foods, fatty fish, and sunlight exposure. c. Omega-3 Fatty Acids: Found in fish like salmon, walnuts, flaxseeds, and chia seeds, omega-3s can help reduce inflammation.
》Fiber-rich Foods: Promote gut health, which may influence inflammation. Include fruits, vegetables, beans, and whole grains.
👉Talk to your doctor!
🔎 It is important to consult your doctor before starting any exercise. If any of the exercises below cause more or worse pain, please stop immediately.
▪️Exercises should be done 3 times per day.
●Holding 10 seconds
●Repetitions 10 times
Dr younas physiotherapist
