Herniated Disc: Non-Surgical Solutions and Physical Therapy

Eight out of every 10 people will have back pain at some point in their life. This suggest you are probably one of them. Back pain with or without leg pain is commonly due to a herniated disc in the low back. Discs are the cushions between each individual bone, or vertebrae, of the spine. They are strong structures that allow your spines to move and handle loads during your everyday lives. The outer part of your disc is durable with multiple layers. The inner aspect of your  disc resembles a thick fluid. A herniated disc occurs when a small tear in the outer part of your disc results in the inner material leaking out.  Thankfully, your herniated disc is best managed with exercise and other physical therapy treatments.

Low back disc injuries

Herniated Disc, Sciatica, and Pain

Disc herniation is the most common cause of of sciatica. Put simply, sciatica is pain that originates in your low back and travels down your leg. However, not all herniations cause pain in your back or down your leg. Many people older than 30 have a disc herniation on MRI but never experience pain. I am one of them. You might be too.  One study showed 30% of people in their 30’s and 60% of people in their 60’s have a disc injury but experience no pain. There are many factors that determine whether or not a person will experience pain. Possible contributors include the location of the herniation, the person’s physical health, and psychological factors.  Download our free report to learn more about pain here.


Recovery from Disc Herniation without Treatment

A disc herniation can spontaneously heal without treatment. In these instances, resorption of the displaced inner material occurs over time. This occurs within a few weeks of injury or it may not be seen for several years. One recent study showed spontaneous recovery occurs in approximately 2 out of every 3 lumbar disc herniations.  Because many disc herniations spontaneously resolve, conservative treatments are recommended before considering surgery. Conservative treatments include those offered by your acupuncturist, massage therapist, and physical therapist.

Evidence for Conservative Treatments

Half of the people who access the services of a physical therapist do so for low back pain. More than half of these people have conditions related to the disc. Your physical therapist will first conduct a comprehensive examination to rule out the presence of any serious problems such as an injury to the nerves or spinal cord. Whenever pain is present in your legs, the first objective of treatment is to decrease these symptoms. Disc problems are easier to manage once your pain is localized to only your low back.  This is called centralization.

McKenzie exercises

Exercise for Disc Herniations

Research shows that exercise is one of the most beneficial treatments for people with lumbar disc herniations. Exercises are designed to improve the strength, endurance, and coordination of the muscles that support your spine. Also, exercises can be extremely effective at reducing pain in your legs. Very often, exercises that promote extension of the spine, also known as “McKenzie exercises” are effective at resolving pain in your legs. However, an individualized examination must always be performed in order to determine the exercise approach which is best for you.

Manual Physical Therapy for Your Herniated Disc

Manual therapy performed by your physical therapist is also an evidence-based and effective treatment for people with a disc herniation. Joint mobilization techniques are useful to improve mobility, promote extension of your spine, and resolve symptoms in your legs. Joint manipulation alleviates stubborn pain and stiffness from a herniated disc. Doctors of Physical Therapy with advanced residency and fellowship training have expertise and skill with these techniques.

What Steps Can You Take

I recently rehabilitated a 40-year old landscaper with an L4-L5 disc herniation and pain radiating from his low back to his calf.  His doctors were considering injections and even surgery. However, after 5 weeks of physical therapy he was back to work and nearly pain free. Today he feels like a new person! Physical therapy takes patience and a commitment. There is no magic pill for resolving your back pain.  However, excellent results often occur. Your physical therapist will guide you through the recovery process. Contact us today if you are suffering or simply have questions about which treatments are right for you.

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