Disc Herniation Part 1: Best Self-Treatments To Help Your Lumbar Disc Herniation  

By Dr Ken Nakamura+

Do you have a disc herniation?

Do you need a way to relieve the sciatica from a disc herniation, that is sending sharp pains into your buttock, thigh and leg? 

Are you feeling you can’t do your daily routine with your disc herniation?

The good news is you aren’t stuck with a disc herniation forever. Most people can be helped without surgery. In this post, I’ll show you the best ways to change your everyday life to help your disc herniation. In the next article I will go over the best exercises to put the disc herniation back into place and the exercises you need to stabilize your lower back.

Mary got up one morning, and it was like any other morning. She started doing her toe touches she had done everyday for over 10 years, then wham!

It felt like a hot poker of electricity radiating from her lower back down to her buttock, thigh, and leg to her toes. Mary felt her leg was numb, and tingly, just like pins and needles. Mary just had a disc herniation. Sometimes its called a slipped disc, or a ruptured disc.

For Mary it happened in the lower back so it’s called a lumbar disc herniation. When the pain radiates down the thigh and leg people often refer to this as sciatica, or radiculopathy by doctors. Doctors love to give big names for simple things

Lumbar Disc Herniation-Downtown Toronto Chiropractor

Lumbar Disc Herniation          Picture from neurosciences.beaumont.edu

Mary’s disc, like most people’s, has two parts including the hard annulus and the inner nucleus which is more like sticky phlegm according to Dr. Stuart McGill. Have a look at the parts of the picture above and note the annulus and nucelus.

When she bent forward that morning it was like squeezing a jelly doughnut at the front. She squeezed the disc and forced the stuff on the inside backwards.

After many years of repetitive toe touching and sitting slouched at her desk as a project manager for 12 hours a day, she squeezed the nucleus back through the many layers of the protective annulus, squeezing her nerve. Ouch!

The pressure on her nerve pinched enough causing her to feel pain from her lower back all the way to her big toe or little toe.

Does this sound familiar to you?

Mary didn’t hurt her disc this morning, or last week when she lifted that bag of cement. She hurt her disc everyday. By doing her toe touches and sitting slouched with a rounded back all the time Mary made her disc gradually break down. It only reached the painful point when the disc was so broken down that it bulged out and pushed on the nerve.

Why didn’t she feel it earlier then? Well, here’s the problem, there are no nerves inside the disc, only on the outside of the disc. Without nerves in the disc you can damage it quite substantially and not even know about it.

Mother was right, when she told you to sit-up straight, sitting slouched damaged Mary’s back don’t let this happen to you. I would modify what mother said a bit, but she had the right idea. Just remember to keep the curve in your back.

Disc Herniation Stages

Disc Herniation Stages-        Picture from Morphopedics

You often can’t feel a disc bulge or even prolapse (see picture above) even when you can see them on an MRI. Many times the disc has extruded (extrusion) out before you can fee the pain.

See Also: MRI, CT scan and X-rays: Is an MRI, CT Scan or X-ray Best For My Pain?

The four stages of disc herniation are: see picture above

  • Bulging Disc

  • Prolapse Disc

  • Extrusion of the Disc

  • Sequestration

Bulging Disc: The annulus breaks down with your bad movements and starts to degenerate, allowing the nucleus to start to bulge at first.

Prolapse Of The Disc: After the disc bulges, a few more layers of the disc breaks down causing it to bulge even more, but the nucleus stays within the last layers of the annulus.

Extrusion of the Disc: When all the layers of the annulus have broken down and there is substantial pressure on the nerve this is called an extrusion of the disc.

Sequestration: The disc bulges very far and pieces break off and are left near the nerve or spinal cord.

Why Did Your Disc Herniate When You Don’t Do Toe Touches Like Mary? You probably won’t like the answer, but I’ll tell you anyways. It’s you and your parents.

Two major things affect your discs:

1.      How you move your body.

2.      What genes you inherited from your parents.[1]

You can’t do anything about your parents or your genes, however you can change your habits to help your lower back

To start, you should learn to lift properly using the butt lifting technique. If you haven’t read this article on lifting, you should: Lifting Technique: Weight lifters Vs Chiropractors Back Saftety Lifting Technique.

After learning to lift properly you should also learn how you move your body during daily activities. Most people that this downtown chiropractor sees aggravate their lower back everyday.

Here’s how to change your daily activities so you don’t damage your disc.

1. Doing Daily Activities Correctly helps you stop pushing the disc further and further out.

2. Disc Exercises Help by pushing the disc back in.

3. Stabilization Exercises Help by keeping the disc from coming out by normalizing how your spine moves.

Here is a list of the daily activities that you should change to improve the disc your lower back.

All these things except for driving and sitting have something in common. These daily activities push your disc out toward your nerve when you bend forward or go into flexion.

You don’t need to learn how to do all these daily activities over again. You simply need to learn one basic move. This basic move is the basis for all of the daily activities.

Practice it over and over like a skier making a new path through fresh snow. After ten times you have a nice little groove through the snow. After 30 times the groove has become deep, icy and set.

Disc Herniation: Learning to Squat Using A Broomstick

Perfect This  Basic  Butt LIfting Technique To Help Your Disc Herniation

See Also: Lifting Techniques: Weight Lifting vs. Chiropractors’ Back Safety Lifting Technique

Practice butt lifting by placing any long piece of wood or pole behind your back.

  • Make sure it touches your butt, your mid back and back of your head
  • Look in the mirror or get someone to watch you
  • You should stay in contact while you bending down at all three points.
  • Practice 30 times.

Then you integrate this into everyday life. Initially, whenever you do any of these activities, use the same basic move and you will stop pushing out your disc.

At the beginning you will need to be conscious each time you are doing any of these activities. To speed things up you can practice each activity like picking up your socks 30 times and it will become even more automatic. In fact, you can deepen the groove during all of these activities.

For sitting in a chair and driving I recommend that you roll up a towel and tape it on either end and put that in the arch of your low back

Guide for disc herniation daily activities.

  • Remember to do all these movements pain-free. Always stop whenever you run into pain with any movement of the spine.
  • Disc herniations are linked with long periods of sitting, especially prolonged driving.
  • Disc herniations are caused by repeated flexion.
  • Prolonged trunk flexion or twisted or bend sideways cause disc herniations.
  • Too much lifting, pushing/pulling causes disc herniations
  • Vibration while sitting is linked to disc herniations.
  • After prolonged stooping or sitting, you should stand. For example, a gardener lifting bags of peat moss after having a prolonged period of rounded lower back, or a driver getting heavy loads out of trunk after a long drive is not recommended. You should remember to stand for a few minutes before attempting to lift. Studies have shown that ½ hour is even better.

Here are some more exercises that can cause a disc herniation.

Yes, it’s very surprising that toe touches, Yoga and Pilates can cause disc pressure leading to disc herniations. I have personally treated dozens of Yoga teachers with varying degrees of experience. The fact is some of the exercises involved in Yoga are great for helping a disc herniations while others directly push the disc out.

I personally know many Yogis that have had to stop many of their exercises due to the pain it causes them in various parts of the body, including their disc.

Next week’s article will go over the second and third way to help your disc. Remember, you need to do #1 “Daily Disc Activities Correctly” first so that your disc doesn’t keep getting aggravated.Then you can move on to next week’s article which goes over #2 Disc Exercises to Push the Disc Back In and #3 Stabilization Exercises help by keeping the disc from coming out by normalizing how your spine moves.

Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section.


Author

Dr Ken Nakamura


598 Responses to Disc Herniation Part 1: Best Self-Treatments To Help Your Lumbar Disc Herniation  
  • Rakesh says:
    March 21, 2022 at 3:12 pm

    Hi dr , I lifted something wrongly in Aug 2021 , I felt pain 4 days later no , after few months i was standing for 30m talking frnds , a pain started in right leg till down .

    Jan 24 ,2022 ,So i went to doc my mri report says mild disc Bulge at L5/S1 ,causing thecal sac , with no stenios no nerve impingement.
    Ap diameters are all 13.x L1-L3, l4 is 12.5 , L5 is 11.5 mm.
    I’m getting pain in leg fingers , 2nd and 3 finger both legs . Sometimes I’m getting pain while sitting at buttock areas sometimes left sometimes right . I’m getting pain in joints and at Front of thigh and front calf sometimes .

    One physico said ur bulge will not go back as scar tissue is created and disscated .

    I’m worried about life , a lot from India . Can u tell me what to do.im 27 not married no job .

  • Saravanan says:
    July 9, 2021 at 8:28 am

    i Ken,
    I have lower back pain which radiates to left foot. Doctor recommended for 3 weeks physiotherapy after doing a MRI.
    Now I’m in my 1st week of physio. I can bend forward backward and both side ways. Only from left to right sideway movement i have pain on left hip.
    Mostly the pain is on my left Hip.
    Im Correcting my sitting posture to 100 degrees and cant feel any pain in back. But a discomfort or a small pain radiates in my left leg to feet.

    The MRI reveals as below /

    At L4/L5 level,
    Diffuse disc bulge abutting the thecal sac and bilateral L5 traversing nerve roots.
    The bilateral neural foramens are narrowed.
    The exiting nerve roots are intact.
    Central canal measures 1.2cm.
    No facet arthropathy or ligamentum flavum hypertrophy.
    At L5/S1 level,
    Diffuse disc bulge abutting the thecal sac.
    The bilateral neural foramens are narrowed.
    The exiting and traversing nerve roots are intact.
    Central canal measures 1.2cm.
    No facet arthropathy or ligamentum flavum hypertrophy.

    Need ur advise if the physio will help reducing the pain.

  • Can says:
    March 21, 2021 at 8:04 pm

    Hello, I’m a 23-year-old young patient with a plica on my knees and an extruded hernia on my waist, doctors recommend surgery, please recommend me a treatment method

  • Karleigh says:
    April 25, 2020 at 10:01 pm

    Hi Dr. Ken!

    I need your help, I am having a hard time finding a professional during this crisis to provide an opinion.

    I just received my MRI results from my doctor. She wants me to go back to the Physio but no Chiro.

    –T12-L1 small paracentral disc protrusion.

    I have been suffering with mid-lower back pain for about 10 years, with the last year being the worst. I am 29 years old.. The pain radiates from my mid back down the sides to the lower back and down to my hips. Before my MRI, I have tried stretching, yoga, physio, chiro, I even lost weight (190 lbs to 140 lbs, I am 5’5″). Nothing helped.

    I have been quite sedentary the last few years and I work at a desk. I have the worst posture and I cross my legs. I have tried to stop these bad habits but I always find myself doing them because I am so focused and concentrating on my work. My job is extremely stressful with tight deadlines.

    I believe my pain is due to my lifestyle and lack of muscle strength. I had gotten a gym membership last year and hired a personal trainer, in the 6th session. I had a really awkward experience. I was doing an Abdominal workout with a medicine ball. A few muscles contracted in a place that should not have been contracting like below the waist. It was the most humiliating experience ever. So I stopped seeing that personal trainer. I had a really hard time on my own at the gym, I ended up quitting. I felt like I didn’t know what I was doing and that I was wasting my time. I had given up on myself, i had become unmotivated and I gained about 30 lbs.

    Since working at home during this quarantine I am finding more energy to start moving and I want to develop a better routine and incorporate healthy exercise at home. (I feel less stressed from not having to go into work).

    For the T12-L1 small paracentral disc protrusion, what muscles do you recommend strengthening? What exercises would you recommend to help fix my issues? Is there any advice you could give me?

    Thank you so much for reading this. I hope I hear from you 🙂

  • Suparna says:
    November 2, 2019 at 8:41 am

    Dear Sir,
    Please advise the steps to cured from the following details of MRI.
    Mild diffuse bulge of L4-L5 and L5-S1 discs are seen with broad based posterior disc protrusions causes thecal sac compression and mildly impinging on the bilateral traversing nerve roots.
    Vertebrae show normal size, signal intensity and alignment.
    Spinal canal is of normal dimension.
    Conus ends at normal level with normal cauda equina & conus medullaris.
    Lower dorsal cord is normal in size and signal intensity.
    Facet joint and ligamentum flavum are normal..
    Paraspinal muscles are normal in size and shape with normal signal intensity.
    Rest of the intervertebral discs are normal in height and signal intensity.
    Spinal Canal measurement at various levels.
    L1-L2 Level – Canal – APD 19.0 mm
    L2-L3 Level – Canal – APD 20.0 mm
    L3-L4 Level – Canal – APD 18.0 mm
    L4-L5 Level – Canal – APD 13.0 mm
    L5-S1 Level – Canal – APD 12.0 mm
    IMPRESSION :
    MRI of lumbo sacral spine shows :
    Early degenerative disc disease with
    Mild diffuse bulge of L4-L5 and L5-S1 discs with broad based posterior disc protrusions causes thecal sac compression and mildly impinging on the bilateral traversing nerve roots.

    • Dr Ken Nakamura says:
      January 28, 2020 at 9:50 pm

      Thanks for your question. By only posting your MRI I cannot give you an opinion as I need context. The MRI isn’t a diagnosis. The MRI result has to correlate the history and exam, thus I have nothing to correlate.

      Sorry that I cannot give you an opinion in your case.

  • Deanne says:
    August 19, 2019 at 10:42 pm

    I have a torn ligament at L5 S1, allowing a mildly bulging disc to touch the nerve causing sciatica with pain in the right buttock and tingling in the toes of my right foot. I’m doing physiotherapy for the next 6 weeks and have been told to limit activity, avoid lifting and household chores etc. Is there anything else I should be doing so that the ligament will heal properly and should I avoid sitting or laying down? At my first visit they had me do 50 straight leg raises with my right leg which was not painful and then put the ultrasound/magnetic pad on me for a while. I’d like to know what to expect and if this treatment sounds appropriate for a torn ligament.

    • Dr Ken Nakamura says:
      August 22, 2019 at 4:04 pm

      Thanks for your question, Deanne. Sounds like your physiotherapist is trying to floss your nerve meaning trying to move the nerve back and forth just like you would dental floss back and forth between your teeth. The idea is that the nerve will be freed from the adhesions thus helping your sciatica. As long as it doesn’t cause increased pain afterwards this is appropriate. When you say “torn ligament at L5S1”. I haven’t come across this. Usually, it’s simply called a disc bulge. My opinion is that an MRI or CT doesn’t show the full extent of the disc herniation as you are lying down in an MRI / CT thus it looks like there is no pressure on the nerve. When in fact when sitting and lifting puts more pressure on the disc and thus the nerve. Thus the MRI or CT doesn’t show the extent of the problem in real life unless you get an MRI taken while sitting or lifting.

      Sound like extension exercises are likely helpful but I haven’t examined you in your particular case. You should seek the opinion of someone that can actually examine you. What I am giving you is an opinion and not a recommendation. Hope that helps your disc herniation.

  • shreyansh says:
    February 26, 2019 at 2:19 pm

    Hello sir, hope you will answer my problem. Actually i started gym in sep’18 but i know some psoture or hamstrings crunches something really affects me in low back, after that i took homeopath medicine and leve gym and the pain went out. After 1 month i again joined gym and it didnt started paining but after sometime my pain started and till today i can say i can do gym but i feel something is there in my back causing me uncomfortable after waking, causing not to stand more time. I do some yoga but it didnt relief me and am overweight as BMI is 27%. But plz if you can help plz do.

    • Dr Ken Nakamura says:
      February 27, 2019 at 3:07 am

      Thanks for your question Shreyansh. I think you are saying you don’t do any hamstring stretches and crunches. Also, you need to have good posture. If you don’t then you need to have a lumbar support roll for your chair if you are in an office job. With the support roll you need to lean back in your chair not 90 degrees but approximately 100 degrees. This way it doesn’t take any effort to keep your posture. In addition, you need to stand up once an hour. The other thing to keep in mind is at this time to avoid deadlifts, squats and military presses at this time as they will compress your spine. Exercises like pull-ups pulldowns, dips are helpful while the ones I mentioned are usually not helpful when the pain is too acute or you are recovering. Later on most of these exercises can be done if they are done properly.

      The above is an opinion and not a recommendation.
      Hope that helps. If you have any more questions for this chiropractor I will do my best to answer them.

  • sompal says:
    March 16, 2018 at 12:09 am

    Sir Namste
    Sir my MRI report show that
    “Mild disc desiccation, diffuse bulge with postero-central protusion of L4-L5 disc indenting the thecal sac and causing mild impingement of left traversing L5 nerve root. Bilateral foraminal stenosis mild foraminal stenosis with no evidence of neural compression seen”
    What is do sir. plz give me suggestions.

    • Dr Ken Nakamura says:
      March 30, 2018 at 12:10 am

      Thanks for your question Sompal. I cannot give you an opinion solely based on an MRI. You will have to write a lot more about your symptoms so that I can get a proper history of your condition.

      Hope that helps your possible disc herniation.

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