Lumbosacral Disc Injuries: A Physical Therapy–Centered Framework for Assessment and Rehabilitation
Abstract
Background: Lumbosacral disc injuries are a leading cause of low back pain and radiculopathy, primarily affecting the L4–L5 and L5–S1 levels due to high mechanical demands. These injuries result from complex interactions between biomechanical stress, genetic predisposition, and inflammatory processes rather than isolated mechanical overload.
Aim: To present a physical therapy–centered framework for assessment and rehabilitation of lumbosacral disc injuries, emphasizing evidence-based evaluation and conservative management strategies.
Methods: This review synthesizes current literature on anatomy, pathophysiology, epidemiology, and clinical assessment, integrating findings from imaging studies, genetic research, and rehabilitation trials. It outlines diagnostic principles, red-flag screening, and treatment pathways, including exercise-based interventions and adjunctive measures.
Results: Evidence indicates that most patients (>90%) improve with conservative care, including structured physical therapy emphasizing trunk control, graded strengthening, and patient education. Imaging findings often lack correlation with symptoms, underscoring the need for clinical reasoning over reliance on MRI. Genetic factors account for approximately 34% of disc degeneration variability, while mechanical loading contributes minimally. Surgical intervention offers faster relief for select cases with persistent radicular symptoms but does not guarantee superior long-term outcomes compared to rehabilitation.
Conclusion: Physical therapy plays a pivotal role in managing lumbosacral disc injuries through individualized, function-oriented programs. Emphasis on movement confidence, graded exposure, and interprofessional coordination enhances recovery and reduces chronicity.
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Authors
Copyright (c) 2025 Abdulrahman Sood Aliraqi, Entissar Shrar Almutairi, Bashaer Talal Abualkhayr, Ahmed Hussain Sharbatly, Ayman Ali Makki Alqubby, Rawan Mohammedali Alluqmani, Bashaer Talal Abualkhayr, Najah Falah Alazmi, Abdullah Ali Tayeb Ageeli, Halah Rashed Aldosari, Norah Saad Mohmed Alahmari, Hanadi Mobarak Alqhtani, Fahad Hajjaj Alharbi
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