Many people suffer from back and leg pain. For some, it may be intermittent, while others may experience pain on a daily basis. It can be easy to dismiss these types of pain as a simple part of growing older, but it is important to consult a physician or a physical therapist to discover the true source of the pain. Herniated discs are one of the most common causes of neck, back, and leg pain. Although these occur most often in the lower part of the spine (lumbar), they can also occur in the neck (cervical).

What is a herniated disc?

The spine is made up of a stack of bones called vertebrae. Intervertebral discs are found between each individual vertebrae, and these discs have a soft center protected by a thick outer layer. These discs act as shock absorbers, and a herniated disc occurs when significant pressure causes a tear in that protective outer layer, resulting in the soft center pushing out and irritating nearby nerves.


What causes a herniated disc?

One common cause of herniated discs is disc degeneration. Disc degeneration occurs because of normal wear and tear that happens as you age. Spinal discs become less flexible over the years, which means they are more likely to tear or rupture from the most minor strain. This usually occurs in people over 35 years old.

Some herniated discs are caused by a sudden impact on the spine. A fall down stairs or on a hard surface, a serious blow to the back (such as a tackle when playing football), or a car accident could all cause a disc to rupture. Accidents like these are the most common cause of herniated discs in people younger than 35.

Most of the time, it is difficult to pinpoint exactly what caused a herniated disc. There are a variety of movements and circumstances that put excessive pressure on the back and neck, such as lifting heavy objects, twisting suddenly, or even excessive body weight.

There are certain risk factors that increase the chance of herniated discs, including:

  • obesity
  • physically demanding jobs that require excessive lifting, bending, pushing, pulling, or twisting
  • genetics

What are the symptoms of a herniated disc?

The most common symptom of a herniated disc in the lower back is radiating pain through your buttocks, legs, and feet (sciatica). A herniated disc in the neck will cause neck pain that radiates into your shoulder, arm, hand, or fingers. Herniated discs in both areas can cause numbness and pain that intensify with sudden movements (such as sneezing or coughing).

How is a herniated disc diagnosed?

Your physician or physical therapist may use a combination of a physical exam, neurological exam, medical history, and imaging tests to diagnose your condition. An MRI is the most common imaging test used to diagnose disc problems, but it must be combined with thorough physical and neurological examinations. An MRI will reveal a herniation, but there could be a combination of factors causing your pain. Imaging tests such as an x-ray, CT scan, or myelogram may be used to rule out a variety of other possible conditions such as infections, tumors, and broken bones. In many instances, diagnostic testing is not necessary and proper treatment can be rendered based on the findings of a thorough examination by your physician or physical therapist

What are the treatment options for a herniated disc?

There are a few possible treatments for herniated discs, some less invasive than others. Unfortunately, some physicians are quick to suggest medications, injections, or surgery as treatment–these options are invasive and have serious side effects. Most herniated discs will heal very well with physical therapy, which is non-invasive and should always be the first course of action.

Physical therapy not only heals a herniated disc but also provides immediate pain relief to the patient and teaches them valuable techniques for avoiding a similar injury in the future. Physical therapy for a herniated disc usually combines passive and active techniques. Most therapists will begin treatment with passive therapy such as deep tissue massage, hot and cold therapy, hydrotherapy, transcutaneous electrical nerve stimulation (TENS), LASER (see pic below), and traction. Many of these techniques reduce inflammation and relieve tension that causes muscle spasms.


Active physical therapy treatments include core stabilizing exercises, flexibility, hydrotherapy, and muscle strengthening. These active treatments help build strength and improve flexibility. A strong, flexible body can help prevent future disc problems. Physical therapy is non-invasive and doesn’t pose any serious side effects. Not only will it help heal a herniated disc, but it will also benefit the patient’s overall health.

Other treatments for a herniated disc include injections, medication, and surgery. Mild pain may be treated with over-the-counter medications such as ibuprofen or Tylenol, but in many cases, patients may be prescribed more serious narcotics such as Percocet or Oxycontin. These have side effects such as nausea, confusion, and constipation and there is a serious risk of becoming addicted to these drugs. Cortisone injections may be used to reduce swelling and inflammation of nerves, but they are painful and often require more than one treatment. Surgery is rarely necessary and should only be considered after more than six weeks of alternative treatment has failed to improve the injury.

A herniated disc is a common injury and has a variety of causes, from simple aging to serious accidents. These cases rarely require surgery, and usually heal very well with simple, non-invasive physical therapy. Physical therapy treatments help relieve pain while healing the disc, and they also provide overall improvements to your health and wellness.

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