Back pain affects approximately 80% of people at some point in their lives, with lower back pain being the most common complaint. Although minor aches and pain or an acute injury may disappear on their own with rest and gentle stretching, some conditions require more attention and time, especially if the pain becomes chronic. One of these conditions is herniated disc. Knowing what to do for herniated disc often depends on when you begin your treatment. Here are 14 approaches that may help you.

What is a herniated disc?

A herniated disc occurs due to the spinal column’s unique combination of strength and weakness. The spine is made up of 33 vertebrae in five different sections:

1. Cervical (neck)
2. Thoracic (upper back)
3. Lumbar (lower back)
4. Sacrum (bottom of the spine)
5. Coccyx (largely immobile bottom tip of the spine)

These vertebrae are held in place with connective tissue and ligaments to protect the spinal cord and nerves that emerge from the spinal column. Facet joints help further stabilize this structure.

Between each vertebra is an intervertebral disc. These discs are small sacs of jelly-like fluid called nucleus pulposus. Intervertebral discs provide a cushion between vertebrae, a sort of shock absorber in the spine that allows for smooth, comfortable movement along the spine.

A herniated disc occurs when pressure or force exerted on the spine causes the intervertebral disc to push between the vertebrae and rupture, releasing some or all of the nucleus pulposus.

Herniated disc vs. bulging disc

Herniated disc differs from a bulging disc in that a bulging disc is still intact, just protruding from between the vertebrae.

A herniated disc has actually burst and no longer provides any cushion or shock absorption. Bone begins to rub painfully on bone, leading to symptoms that may be unrelieved by most comfort measures.

What causes a herniated disc?

Common herniated disc causes include:

• Disc degeneration: The natural process of aging causes wear on a disc, making it susceptible to herniation
• Spinal stenosis: This narrowing of the spinal cord is also most often seen in older people
• Injury: Trauma to the spine can cause disc herniation
• Repetitive motion: People who work jobs with repetitive motion and heavy lifting are more likely to suffer back problems (including herniated discs)

Genetics also play a part in the development of herniated discs, as does a person’s weight and occupation. More weight on the body tends to mean less activity and more stress on all of the body’s structures. Physically demanding occupations or those with repetitive motions also put workers at increased risk of a herniated disc.

Do I have a herniated disc?

Herniated disc symptoms are difficult to ignore. In addition to pain that can be regular or intermittent, other herniated disc symptoms can include:

• Leg pain: Herniated discs can lead to sciatic pain, a pain that radiates from the lower back, across the buttocks, and down the side of your hip and leg. This pain may be shooting with sudden movement (i.e., when you sneeze) or it may be a dull, constant ache that worsens with too much standing or sitting.
• Numbness and tingling: These symptoms are a sign that nerves are being impinged or compressed by the vertebrae.
• Weakness: Weakness develops as nerve involvement continues.

If the herniated disc is in your neck, you may experience pain across the shoulders and upper back. This may worsen as the nerves continue to compress.

In some instances, people with herniated discs have no symptoms. The only way to confirm a diagnosis is to visit your doctor. They will conduct a thorough physical exam that might include a CT scan, MRI, or X-ray (to rule out other conditions). Your doctor will also test your strength and reflexes, but imaging is the best way to get an accurate diagnosis.

It is important to get a proper diagnosis not only for the herniated disc but also the underlying cause. Your treatment approach may vary depending on what caused the disc to herniate. If the disc is herniated and treated but the underlying cause remains, re-herniation is possible.

What to do for herniated disc: 14 approaches

For some people, a herniated disc resolves itself without any intervention whatsoever. The symptoms may be minimal and simply disappear on their own.

For others, there are a variety of herniated disc approaches to ease symptoms and prevent further injury. Here are 14 approaches to treating herniated discs, from steps to take when you first notice pain to more interventional treatment options.

Note though that of the most serious herniated disc symptoms is a sudden loss of bowel or bladder control. This may be accompanied by suddenly worsening symptoms or something called saddle anesthesia (numbness in the areas that would touch a saddle – back of the legs and inner thighs). If this occurs, treat it as an emergency situation and head to the ER immediately.

First steps

When you first notice herniated disc pain, there are steps you can take to ease symptoms, even before a diagnosis.

1. Brief rest

Although rest is not indicated as a long-term strategy for the treatment of herniated disc, in the acute phase it can be necessary.

Most pain physicians do not recommend rest for longer than three days, but it can be very healing and helpful when the pain is at its peak.

2. Hot and cold therapy

Treating back pain with hot and cold therapy can work well when combined with rest.

Hot therapy (i.e., with a heating pad) can relax and loosen muscle spasms, while cold therapy (ice packs and frozen peas, most often) reduce inflammation and can ease pain.

3. Over-the-counter medications

Some pain and inflammation can be easily managed with over-the-counter pain medications like ibuprofen and naproxen sodium.

These should only be taken as directed by your doctor, as they can come with a host of gastrointestinal side effects when taken in large quantities over a long period of time.

4. Exercise

Disc degeneration may be a natural occurrence as we age, but you can support a strong, healthy back with regular exercise. In addition to whole-body exercise like walking, running, swimming, and biking, targeted exercises for a strong core and back help support the structures of the spine and reduce the chances of injury and pain as you age.

These approaches work best for mild pain in the beginning stages of disc herniation. It may be possible to slow, halt, or reverse the progression without further treatment, as discussed below.

Advanced care

If you find that your pain persists after non-interventional approaches, it’s time to talk to your doctor and explore other options.

1. Physical therapy

Physical therapists work with your pain specialist to design an exercise program for your herniated disc.

They will work with you on the proper form and technique to maximize your workout for best results. Most programs combine stretching routines with targeted strengthening exercises.

2. TENS unit therapy

Transcutaneous electrical nerve stimulation (TENS) replaces pain signals with a mild buzzing sensation.

A mild electrical pulse is delivered through the skin to the nerves as close to the area of pain as possible. The patient controls the signal with a small, cellphone-sized power pack. The electrical signal disrupts pain signals and can offer significant pain relief. Many patients find that a TENS unit relieves pain when other options do not.

3. Radiofrequency ablation

Radiofrequency ablation uses heat to destroy pain-sensing nerves and disrupt the pain signal caused by a herniated disc.

This procedure may offer long-lasting pain relief, but some patients may need more than one treatment.

4. Steroid injections

Steroid injections can help with herniated discs in both the lumbar and cervical spine.

Some patients find that the risks of these injections are worth the opportunity to avoid more invasive surgeries for their herniated disc.

5. Percutaneous discectomy

Herniated disc surgery is a treatment of last resort after other conservative approaches have failed.

A percutaneous discectomy removes the disc material to relieve pressure on the nerves. This procedure is considered less invasive than other types of surgery, some of which may fuse vertebrae together for support or insert pins to maintain space between the vertebrae.

How to heal a herniated disc naturally

As stated above, many people with herniated discs do not require any medical intervention beyond their diagnosis. There are steps you can take at home to start on the path towards herniated disc recovery.

1. At-home care

At-home care for herniated disc means using your body mindfully as you go about your daily tasks. Pay attention to the ways you reach for things on shelves or how you bend over to tie your shoes. Are you engaging your core as you move? Are you picking up objects the correct way? This can help support your healing back.

Likewise, at-home care means taking care of yourself with a proper diet. Look for anti-inflammatory foods that include plenty of fresh vegetables and fruit, lean proteins, and whole grains. Not only will this give your body the fuel it needs for healing, but it might also help you gain (or maintain) a healthy BMI.

2. Massage

Massage can help soothe tight muscles and areas around the herniated disc but don’t use it for the area of the disc itself, especially in the acute phases.

After the acute phase passes, massage can help you reduce stress and tension in the back. Work with a therapist who has extensive experience with sports massages or care for those with back conditions.

3. Herniated disc exercises (plus herniated disc exercises to avoid)

The best herniated disc exercises are those that help you stabilize your core, bringing length to your spine, and building muscles on the lower back, belly, and sides of the abdomen. Think side planks, bridge poses, and partial crunches.

Additionally, tight hamstrings can make your herniated disc pain worse. A simple L-shaped fold at the wall and hamstring stretches on the floor (use a belt or a scarf for support, see below) can help loosen tight hamstrings and give you more freedom in your spine.

There are also exercises to avoid when it comes to herniated discs. Although stretching out your lower back in a deep forward bend may feel good (and seem like it’s helping stretch your hamstrings), you may reach a point where the stretch gets painful. Too much stretch in that area, or too deeply stretching when your body isn’t ready, can make the pain worse.

4. Yoga for herniated discs

Yoga for herniated discs is one of the best things you can do for your body and mind. Find a therapeutic yoga class near you, and get there early to talk to the teacher so they know you are working with a healing back.

Focusing not only on a sequence of breath-supported, low-impact exercise but also on training your mind to remain in the moment without judgement can help you manage your pain as your back heals.

5. Back brace for herniated disc

One of the best treatments for lower back pain, including pain from a herniated disc, is to get a little support.

Back braces can help you go about your daily life with less pain, especially as you work with your doctor to coordinate other treatments. You can also use them while engaging in low-impact cardio or other exercises.

At Arizona Pain, we know what to do for herniated disc, and it starts with a proper diagnosis and a comprehensive treatment plan to help you get your life back. Get in touch today.

If you suffer from back pain, you already know what a negative impact it can have on your life. Activities you once enjoyed and performed with ease suddenly become difficult, and even just trying to sit and relax can be painful. One of the culprits behind many people’s back pain is a herniated disc. Read on to learn more about the common signs, symptoms, and treatments of a herniated disc.

What is a herniated disc?

People sometimes refer to herniated discs as ruptured discs, slipped discs, or disc prolapses. All of these names imply that something has gone wrong with part of your body. But what exactly is a disc, and what happens to it when it herniates?

The bones that make up your spine are called vertebrae. They are separated from one another by thin layers, or discs, filled with a jelly-like substance called the nucleus pulposus. In a healthy spine, these discs prevent your vertebrae from grinding against each other, allowing you to move about pain-free.

But, as with all other body parts, these discs can become damaged or broken over time. Sometimes, the outer layer of the disc (called the annulus fibrosus) breaks. This causes the jelly to spill out and forces the vertebrae into direct contact with each other. The jelly may also come into contact with one of the many nerves running up and down the spine.

This can lead to back pain and other uncomfortable, even debilitating symptoms.

Herniated disc vs. bulging disc

Herniation is not the only condition that can affect your spinal discs. A bulging disc occurs when the disc slips from its proper place between the vertebrae. This condition may be completely asymptomatic, or it may cause many of the same problems as a herniated disc, including pain, tingling, and numbness.

The critical difference is that, in cases of a bulging disc, the disc remains intact even as it moves where it isn’t supposed to be. A herniated disc has been damaged in such a way that it is no longer in one whole, undamaged piece. If a bulging disc is left untreated for too long, it may become herniated.

Types of herniated discs

The type of herniated disc you have depends on where it is located. Your back consists of four to five regions, depending on how you divide up the spine.

• Cervical: This refers to the vertebrae in your neck.
• Thoracic: This region covers your upper and middle back, from the base of your neck to approximately just below the ribcage.
• Lumbar: The lumbar region is more commonly referred to as your lower back.
• Sacral: The sacrum is at the base of your spine and consists of several fused vertebrae within your pelvic cavity.
• Coccygeal: Also called the tailbone, the coccygeal region is the very end of your spine. It is sometimes combined with the sacral region rather than split into its own distinct region.

Lumbar disc herniation is the most common type of disc herniation. However, it is possible to suffer disc herniation in the cervical and thoracic regions as well.

What are herniated disc causes and risk factors?

Pretty much anyone can herniate a disc if they are unlucky enough. However, there are certain factors that increase your chances of developing this condition.

Here are some of the most common herniated disc causes and risk factors.

Injury

Herniated disc causes often involve some sort of trauma to your back. This can be something as serious as a fall or sports-related injury, or something as simple as changing positions too abruptly.

The more you put strain on your back, the more likely you are to suffer a herniated disc. This means that athletes and people with physically strenuous occupations are at greater risk than others.

Gender

While herniation can affect people of all genders, males are generally more susceptible to it than females.

Age

As you get older, your bones become more susceptible to injury. This is in addition to the wear and tear that accumulates naturally over a lifetime.

So, while herniated discs can affect people of all ages, they are more likely to occur in people with older, typically more damaged spines.

Lifestyle

Regular exercise is an important part of living a long, healthy life. Without it, your body becomes weaker, making it more likely for something to go wrong.

Being overweight is another risk factor for disc herniation. Extra weight causes the spine to work harder to move your body, and that strain can leave you susceptible to a herniated disc.

What are common herniated disc symptoms?

Herniated disc symptoms may vary depending on the individual and where the herniation occurs. Symptoms often come not from the herniated disc itself, but from its contact with your nerves in the spine.

For many people, this means that there are few, if any, early warning signs or symptoms. If your herniated disc has not come into contact with a nerve, then you may not have symptoms at all. In this case, you probably won’t know you have a herniated disc until symptoms manifest, or until a doctor runs tests for another reason and discovers the herniated disc accidentally.

Pain

Once the herniated disc does touch a nerve, you will begin to experience symptoms, including back pain. But pain is not the only symptom associated with disc herniation. You may also experience the following symptoms.

Tingling

Where you feel tingling will depend on where your disc herniation is.

If it’s in your lower back, as is most usual, then you may experience tingling in your leg and foot. If the herniated disc is in your neck, you may feel tingling in your arm and hand instead.

Weakness

With your spine not functioning the way it’s supposed to, you may notice you have more trouble with certain activities, such as walking or bending, than you did before.

Numbness

Some people with a herniated disc lose feeling in certain body parts.

If you have a herniated lumbar disc, then your leg and foot could be affected. If it is a herniated cervical disc, the numbness may affect your arm and hand. A herniated thoracic disc can affect either your upper or lower extremities.

Do I have a herniated disc?

Back pain, especially lower back pain, is incredibly common. Over 80% of adults will experience back pain at some point in their lives, thanks to a wide range of primary conditions. So how can you tell if a herniated disc causes your back pain, or if it’s something else?

By yourself, you can’t, at least not for certain. Only a doctor can make a formal diagnosis, through the use of one or more diagnostic tests.

At your appointment, your doctor will likely perform some basic tests, such as those measuring muscle strength and reflexes. In some cases, your doctor may also take an image of your spine with an X-ray or an MRI. With these images, they can have a direct look at the herniated disc or other problems causing your back pain.

Is a herniated disc serious?

If you have a herniated disc, the prognosis is generally quite good. Symptoms often become less acute over time. In some cases, symptoms go away entirely without treatment. For the majority of patients, herniated disc recovery time is generally a few weeks to a few months.

Knowing this doesn’t make it easier to deal with the pain and other symptoms you have right now, but know that your current situation is generally not permanent and will likely clear up without drastic medical intervention.

Very rarely, a herniated disc becomes serious enough to warrant immediate medical attention. If your symptoms are so severe that you can’t perform basic tasks, go to a doctor or emergency room right away.

Especially serious herniated disc cases may lead to cauda equina syndrome. This rare condition is characterized by extreme lower back pain, weakness and/or numbness in the groin and lower extremities, and loss of bowel and/or bladder control.

If you’re experiencing these symptoms, it requires an emergency trip to the doctor and, in most cases, emergency surgery. Allowing your case to go untreated may result in permanent damage, including incontinence and paralysis.

What are herniated disc treatments?

If your back pain has bothered you for a while, you have probably already sought out ways to treat it on your own. The best way to approach this condition, though, is under your doctor’s care.

Once you receive an official diagnosis, talk with your doctor before starting any new treatments. They’ll discuss treatments that could work best for your exact condition and symptoms, as well as complementary therapies to help with your symptoms.

Rest

Rest is important when you have suffered an injury. But even with this most basic of pain remedies, there is a helpful way and a harmful way to go about doing it.

Long periods of bed rest, for example, can further weaken your back, which will make it even more difficult to recover. Try interspersing periods of rest with periods of gentle exercise, if okayed by your doctor.

Exercise

Some exercises can help you feel better, while others can actually make a herniated disc worse. Walking, for example, is a cheap form of exercise that can often reduce your lower back pain.

Again, talk with your doctor to get an idea of which exercises are best for you. Basically, if an exercise – or any type of movement – aggravates your symptoms, stop. If possible, don’t perform that activity again until your back has healed more.

Lifestyle changes

Losing weight may also relieve herniated disc symptoms and protect your back from similar injuries in the future.

With the guidance and approval of your doctor, you can reach a healthier weight with a low-impact exercise regimen and regular, nutritious meals.

Medications

Many people use medicine to relieve pain. You may already be taking over-the-counter medicines like ibuprofen.

If you are still experiencing significant pain even while taking these medications, talk to your doctor about what could help during acute pain flare-ups.

Physical therapy

Physical therapy is another common herniated disc treatment. A physical therapist is a professional who specializes in helping people regain their previous range of motion as much as possible, while also strengthening the muscles around the injured area.

To do this, they will take stock of your condition and develop a treatment plan specifically for you. This plan will likely include multiple treatment approaches, including exercises, stretches, heat/cold therapy, and more.

Interventional treatments

In some cases, the treatments outlined above will not be enough to manage your pain. If that is true for you, your doctor may suggest a more interventional form of treatment, such as injections or surgery.

Injections, including cortisone injections, can help when your chronic pain becomes too severe to be managed by more conservative treatments. These injections have the potential to offer effective, long-term pain relief, but they can also cause serious side effects if used too frequently. Your doctor will help you decide if the risks are worth the benefits in your case.

There are also multiple kinds of herniated disc surgery, including partial or total removal of the affected disc or the insertion of an artificial disc to replace the damaged one.

Find help for your pain

Only 10% of herniated lumbar discs require surgery. The majority of patients will heal with more conservative treatment approaches and time.

If you live in Arizona and need help with your herniated disc pain, click below to connect with one of the pain specialists at Arizona Pain. Our team can guide you through the treatment process and help select the approach that’s best for you. Together, you’ll develop a treatment plan that combines complementary, non-invasive treatments for longer-term relief, along with interventional approaches if you’re suffering from severe pain.