29/01/2026
L5-S1 disc bulging
⭕ Aims of treatment:
1. To relief pain and muscle spasm
2. To improve muscle power / Strength
3. To minimise radiating pain
4. To maintain functional activities
5. To reduce tightness of muscles and ligament
6. To maintain spinal alignment / curvature
7. To maintain good posture / ergonomic
8. To rehabilitate the patient.
⭕ Physiotherapy Intervention (Plan 1 set-up)
➡️ Mobilization & manipulative
➡️ Core stability exercises
➡️Hip & knee bending exercise
➡️ Back muscles strengthening exercise
➡️ Stretching exercises - Erector spinae, Hamstring muscles, Piriformis, Gluteus muscles.
➡️Neurodynamic stretching
➡️Isometric back muscle exercise
➡️Myofacial release
➡️Buttocks contraction
➡️Bridging exercise
➡️Hydrotherapy - pool therapy
➡️DTFM
➡️Posture re-education exercise
➡️Aquatic vertical traction (decompression)
➡️Dry needling
➡️Electrotherapy -
🔸Shortwave diathermy - pulsed SWD in acute condition and continuous SWD in chronic condition.
🔸Ultrasound - As phonophoresis, it increases extensibility of connective tissues.
🔸Transcutaneous Electrical Nerve Stimulation (TENS) - TENS therapy contribute to pain relief and improvement of function and mobility of the lumbosacral spine
🟥 Home Remedies
✅ Hot and Cold Therapy
▪️Cold Compress (First 48 hours of sharp pain):
》Apply a cold pack or ice wrapped in a cloth on the lower back or buttock area for 15-20 minutes, 3-4 times a day.
》Reduces inflammation and nerve irritation.
■ Heat Therapy (After 48 hours):
》Use a heating pad or warm compress.
》Apply for 20 minutes at a time to help relax tight muscles and improve blood flow.
✅ Stay Active (But Rest When Needed)
☆Avoid long hours of sitting or lying down.
☆Take short walks every 1-2 hours.
☆Use a firm mattress for sleeping.
☆Don’t lift heavy items or twist suddenly.
✅ Turmeric Milk (Golden Milk)
✔️Anti-inflammatory natural remedy.
✔️Mix ½ tsp of turmeric powder in warm milk.
✔️Add a pinch of black pepper (to help absorb curcumin).
✔️Drink before bedtime daily.
✅ Epsom Salt Bath
● Soak in a warm bath with Epsom salt for 15-20 minutes.
● Helps relax muscles and reduce nerve irritation.
✅ Natural Anti-Inflammatory Foods
🔹Add to diet:
☑️Ginger
☑️Omega-3 rich foods (like flaxseeds, walnuts)
☑️Leafy greens
☑️Berries
☑️Garlic
❌ Avoid These:
➡️Soft sofas and poor sitting posture
➡️Lifting heavy objects improperly
➡️Long bed rest
➡️High heels or unsupportive shoes.
🔶️ Prevention:
☑️Keep a healthy weight by following a Mediterranean-type diet
☑️Don’t smoke or use other to***co products
☑️Stay active - continue or start exercising
☑️Improve strength with resistance exercises and flexibility with stretches
☑️Maintain good body alignment by keeping your head up, your ears over your shoulders, and your back straight
☑️Avoid twisting, keep your back straight, and use your legs when lifting.
☑️Exercise regularly
ADL
★ Use lumber corset during travels
★Positioning and postural correction ( Ergonomics)
★Avoid prolong sitting & bending position
★ Position change after 30 min ( must)
★ Sunrise ☀ 45 min everyday if needed
★ Avoid weight bearing
☆Regular home exercises
☆Lifestyle Modifications
☆ Proper sleep and tension free
🔻Exercises should be done 3 times per day.
☑️Holding 10 seconds
☑️Repetitions 10 times
👉If you are unable to perform any of these exercises due to excessive pain or anything else, please inform a physicaltherapist.
SRprakritik Chikitsalaya Singhana
Dr.sandeep Choudhary
Sandeep Choudhary
