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.


Dr Ken Nakamura

589 Responses to Disc Herniation Part 1: Best Self-Treatments To Help Your Lumbar 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.

  • Daniel says:
    February 14, 2018 at 9:31 am

    Tuve una hernia de disco hace ya un año y no hice reabilitacion y me cuesta moverme

    • Dr Ken Nakamura says:
      February 28, 2018 at 6:22 pm

      Thanks for your question Daniel.
      Google translate: “I had a herniated disc a year ago and I did not re-habilitation and it’s hard for me to move”.

      It’s not clear if you have pain or just from stiffness or you have pain and stiffness as a result of the pain. It may be beneficial to do the exericses in this article and here. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      However, it is always best to have an opinion from a local professional since they can examine you and I cannot.

      Hope that helps your possible disc herniation.

  • KAVEH says:
    January 16, 2018 at 11:07 pm


    • Dr Ken Nakamura says:
      January 24, 2018 at 6:27 am

      Thanks for your question Kaveh. You should try these exercises first. You should do extension exercises like this: https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      Also the fact that diclofenac helps means that you have inflammation in your body, otherwise it would not work. So you should not use vegetable oil. Use coconut oil, eat fish every day, no meats and eat plenty of fruits and vegetables.

      Hope that helps your lower back. The above is an opinion and not a recommendation.

  • Abay says:
    December 7, 2017 at 8:55 pm

    Dear Dr. Ken,
    I have this peculiar pain in my left leg, starting from the center of my lower back to my left buttock and all the way down to my feet, it has swollen a bit under my ankle and ends in the sole of my feet.
    I notice that my left hip bone is a bit “out” than the right, does this mean the bone has missed its spot?. What should I do to relieve the pain?.

    Hoping on your prompt reply,

    May God Bless you!

  • Kathi says:
    November 17, 2017 at 9:54 pm

    I have S1 hernniation on the left and cannot to a toe raise. My calf muscle is shrinking and gait with limp. Numbness in foot, heal and pain in button and behind the knee. I am still active, can climb 10 flights of stairs. What should I do? Note I had a previously hemi Kanu L5 4 years ago with excellent results.
    Hemi laminectomy I meant. Thanks for any insight you might have. Kathi

    • Dr Ken Nakamura says:
      November 20, 2017 at 6:29 am

      Thanks for your question Kathi. I would have a consult with a neurologist first before doing anything.

      Hope that helps your disc herniation.

  • khalid says:
    November 16, 2017 at 1:40 pm

    After reading this post and comment i have clear my mind about this topic such a great post thank you for this information.

  • Saeedeh says:
    November 15, 2017 at 1:45 am

    Hello Doctor,
    My name is Saeedeh.
    I live in the Netherlands and diagnosed with herniatedd disc L5/S1 6 months ago.
    I had FT and heavy painkillers for months. The exercises in part 2 of your blog are the same as which I got from my therapist. IT is 6 months and I am better, however, I have still alot of pain in my leg and feet. Recently I have noticed that when I do Cobra pose and the extension both my legs feel a little numb. Furthermore, my vertebral column feels vers stiff.
    Is it possible that I have done these exercises for too long.
    How van I reduce the pain in my feet?
    Sorry for my English!

    • Dr Ken Nakamura says:
      November 15, 2017 at 3:37 am

      Thanks for your question Saeedeh. I assume that when you say FT you mean physiotherapy or fysiotherapeut in Dutch. Likely your disc has changed. I think you need a new FT or chiropractor. When you have leg and feet pain and no low back pain that is clearly worse, not better. If your FT or physiotherapist said this is better that is generally not the case. There are exceptions but from what you have told me you are worse.

      Hope this leads you in the right direction for a disc herniation. I cannot give you exercises to do as you are worse and I would need to examine you to determine which exercises to give you. If you have any more questions for this downtown Toronto chiropractor I would be my best to give you a good answer.

      • Saeedeh says:
        November 15, 2017 at 3:50 pm

        Tank you very much for your respond. Now I am very confused and sacred. My fysiotherapist and neurologist told me that I can begin to work as I have progress. They say that the pain in my feet will take at least one year to go a way. Now I am sure that this is not right.
        I just like to explain that I have now only pain under my right feet on the both side. It is like burning the entire day while sitting and standing too long. I can only sit for half hour. After that I need to stand up and walk otherwise it will get worse. What should I do?
        Many thanks in advance!

  • Cathy says:
    September 27, 2017 at 1:23 am

    Found advise very interesting and informative

  • Matthew Panighetti says:
    September 16, 2017 at 7:59 pm

    Thank you for your info. I have found it very helpful and insightful. Am in a forgein country at the moment and chiropractic services are not readily available. I had been diagnosed with 2 small herniations of L5/S1. I had no sciatica, but weakness in lower back and some sharp pains at times in the same region with reduced mobility. I have worked up to Cobra after a few days and all pain is gone. Question is, at what point do I slow down on Cobra every 2 hrs? And to how often? And when can I start to do strength exercises for the lower back? Thank you for your help

    • Dr Ken Nakamura says:
      September 22, 2017 at 12:47 am

      You are welcome, Matthew. That’s great that you have no more pain. You can a couple sets a day for a further 6 weeks. After that, you can stop the exercises (Cobra). You can also start these exercises for strength and stability.

      Hope that helps your disc herniation. If you have any more questions for this downtown Toronto chiropractor I would be more than happy to answer your question.

  • Karimi says:
    August 30, 2017 at 4:05 am

    Dear Doc Ken Nakamura
    I am Karimi had L5 S1 Decompression Surgery back in 2001, after recovery had some ups and downs.
    Now I am training to get into Job which involves driving not long distances but the amount of unloading is lot like 30 to 35 Drops per shift weighing max of 18kg some times lifting flights of stairs, basically going to work for an online Groceries, foods and drinks. it’s called Ocado.
    I’m really worried I might fall back and injured my back again please any advice should I continue or quit the job?
    as I already feeling some nume and tingling on my legs.

  • Wyatt says:
    August 18, 2017 at 1:25 am

    Hello Dr.Ken,

    I have a long-standing back problem from over 25 years ago where I ruptured my disc between L4 and L5. Recently I had a hiking accident where I ripped out my AC joint grade 4 / 5 injury. Along with that it seems I have exacerbated my back issue and we are before mild symptoms in my feet have turned into more noticeable symptoms and my right leg and buttock are also getting involved with paresthesia. It would seem there is some sort of nerve root compression . What can I do to help improve this situation without surgery? Currently I try to walk everyday and avoid sitting as much as possible, the rest of the time I’m laying on my bed on a angled cushion with lumbar support. Currently I’m not having any pain. Thanks for any suggestions!

    • Dr Ken Nakamura says:
      August 20, 2017 at 10:25 pm

      Thanks for your question Wyatt. So you are saying that you don’t have any pain but you all your symptoms are paraesthesia in your back, buttock, leg and foot. I am assuming you don’t have symptoms in both feet and only the right foot or if you have symptoms in both feet that they are unrelated to your lower back. You can do the exercises here in this article and also here.


      Hope that helps your disc herniation. If you have any questions for this downtown Toronto chiropractor I would be happy to answer them.

  • Kev says:
    June 22, 2017 at 12:21 am

    Hello Dr. Ken
    I was diagnosed with a bulging disc at L5S1. I had the epidural injection a couple of weeks ago. I don’t think it helped though. I’m up walking but am dealing with sciatica right now. I’ve been doing the cobra and the pain is diminishing in the lower leg and moving to the left cheek. I do the cobra several times a day but sometimes I feel the sciatica pain after doing exercise. After resting a bit the pain is relieved. Again the pain is mostly in my left cheek. I do all the stretches in the morning. I’m starting to be able to stand longer as the pain in lower leg is not as much. So how many times a day should I do the Cobra? I feel that I am improving being that I am walking with no problem just pain in butt cheek. And should I also do the Bird Dog now or wait until the the sciatica is completely gone before I start that exercise. Thanks in advance.

    • Dr Ken Nakamura says:
      June 22, 2017 at 6:42 pm

      Thanks for your question Kev. You should so the Cobra 8 times a day for a set of 10-15. You should also do the bird dog 3-4 sets of 10. This is an opinion, not a recommendation. You should always consult your local chiropractor or physiotherapist.

      Hope that helps your disc herniation.

  • Susan temple says:
    June 21, 2017 at 6:15 pm

    Dr ken nakamura please can you help or advice I have had a slipped disc for 8 wks although pain is at a level that i can deal with I’m very worried about my thigh feels numb and week I cannot walk far and climbing stairs is very hard as leg will not support me so it takes ages my question is do you think the numbness will go as I’m very despondent and feel this is how I’m going to be now

    • Dr Ken Nakamura says:
      June 22, 2017 at 6:39 pm

      Thanks for your question Susan. You don’t need to be concerned so much about the numbness. What’s important is the weakness and pain. Numbness tends to be variable and will get better as long as the weakness (I am assuming that’s what you meant) and pain are getting better. Sound like the pain is better which is a good sign. You should check with your local practitioner to see if your strength is getting better with the treatment you are doing.

      Hope that helps your disc herniation. The above is an opinion and not a recommendation. If you have any more questions for this downtown Toronto chiropractor I will do my best to give you a good answer.

    June 13, 2017 at 9:22 pm

    ir, My name is Dharmendra Parekh and service as a banker my MRI Report says that “IMPRESSION”,
    Diffuse disc bulge and right paracentral disc extrusion with slight inferior migration and bilaeral ligamentum flavum thickening with facetal arthrosis at L4-5 disc causing right lateral recess narrowing with compression over right traversing nerve root and abutting left traversing nerve root.
    Mild diffuse disc bulge with broad based posterocentral right paracentral and right foraminal disc protrusion with bilateral ligamentum flavum thickening and facetal arthrosis at L5-S1 disc causing mild narrowing of right lateral recess and right neural exit foramen with indentation over right nerve root and abutting right exiting nerve root.
    Spondylodisco degenerative changes of rest of lumber spine as described

    Kindly advise me what to do as i have journey 200 kms daily through train,My pain is on right leg from knee to toe .even i can not sleep as my right leg pain whole the night. Please advise me. Thank

    • Dr Ken Nakamura says:
      June 14, 2017 at 9:19 am

      Thanks for your question Dharmendra. You need to tell me more about your symptoms in detail especially what makes you worse.

  • Robbie B. says:
    June 7, 2017 at 12:51 am

    Hi Dr. Nakamura,
    By far the most informative material I’ve found on this matter. I have l4 l5 herniation and l5 s1 bulging, which is restricting the bowel after lifting weight. The bowel works fine if I don’t lift any weight, but even very light weight lifting (any exercise– chin ups, bench press, dips, squats, etc.) results in bowel restriction for a day or two. Seems likes the sphincter won’t open properly. After a few weeks of mainly the “bird dog” and “sphinx pose”, sciatica is gone and low back pain has improved greatly, but I am still experiencing the bowel restriction and worsening of low back pain after any attempt at light weight lifting. Do you have any specific recommendation for how I can improve this issue? Do you think the “bird dog” and “sphinx pose” will eventually help get me there? Thanks a great deal for your info and opinion.

  • Farzona says:
    May 9, 2017 at 2:44 am

    Hi Dr. Ken Nakamara.

    I am having severe back pain with the large herniation of disk for the last 7 month. Did try a lot of things and still doing a research. I am barely walking, can stand only for 5-7 mins of max. The pain radiates to left leg down to foot. I am totally disabled of doing anything at home. However, my leg is very much in pain, it is not weak. Neurosurgeon (of course) opts a surgery., which I am very scared of and don’t want to do. Started doing your recommended exercises.
    Could you please advise how long it might take to come back to a normal life?
    Thank you

    • Dr Ken Nakamura says:
      May 9, 2017 at 9:27 pm

      Thanks for your question Farzona. I can’t answer how long if will take to get back to normal life as you have a serious problem that is severe. My opinion is that lying face down for 5-10 minutes at a time 8 times a day maybe helfpul although it can make you worse. Also, you need to keep mobile and not stay in bed or the couch. Move from position to position like sitting to standing, to walking to lying down. Don’t lie on the couch. Being still all the time will make you worse. This is an opinion and not a recommendation.

      Hope that helps your disc herniation. If you have any more questions for this downtown Toronto chiropractor I will do my best to answer your question.

  • Kayla says:
    February 9, 2017 at 3:20 am

    Hi Dr. Ken,

    I am a 22 year old female who competes in muay thai and 8 months ago I herniated my T3-4 disc, T8-9 disc, I have a bulging disc at L5-S1 and a fractured sternum. I was diagnosed today and have had chronic back pain for the past 8 months. Is physiotherapy the best option for all four issues? Are there specific exercises I could be doing to help relieve the pain? Is it possible to make a full come back and have a healthy back again or is this something I will live with forever?

    • Dr Ken Nakamura says:
      February 9, 2017 at 11:39 pm

      Thanks for your question Kayla. It’s a matter of how badly damaged these discs are as to whether you will make a full come back. Also, not all of those discs may be symptomatic. As for the sternum that will heal by itself. For the profession, a great chiropractor will just as much as the best physiotherapist in your area. Just pick the best person you can find, it’s not the profession.

      Hope that helps your disc herniation.

  • Majid says:
    November 29, 2016 at 7:03 am

    Hello dr, i faced with disc herniation durind sit-up training three weeks ago. I want to know only one thing, how long will take till this herniation healing compeletly. And does dics herniation will be rehabilitated compeletly???
    Thank you

    • Dr Ken Nakamura says:
      November 29, 2016 at 10:46 pm

      Thanks for your question Majid. Sit-ups are the perfect way to put out a disc. The US army eliminated sit-up from training and substantially decreased their incidence of lower back pain. So the first lesson I am sure that you have learned is not to do sit-ups.You can be pain free but not the same. The evidence shows that once you get lower back especially disc herniations you it is recurrent. This means it will happen again from time to time. How long will it take? You haven’t been examined by me so I cannot tell you. I know people that have pain for years and others that come to the clinic that get better within days. Others take weeks.

      The question is depend on hundreds of factors. For example you can get the best physiotherapy or best chiropractic treatment but you can quickly make it worse again. Nothing wrong with the treatment but if you continue to aggravate the problem say by sitting all day with no breaks you won’t get any better, no matter what the treatment including surgery.

      So I cannot give you a timeline as I need to examine you first.

      Hope that helps your disc herniation.

    • solomon says:
      December 4, 2016 at 7:39 pm

      hello dr
      i have recently experienced lower back pain problem and under medications but none of these medicines helped me yet. I undergone MRI and the result is this:
      mild diffuse bulge of L5-S1 IV disc indenting thecal sac and mild left neural foraminal narrowing
      what does this and how can i get treated.
      thank you

  • Andrea says:
    November 23, 2016 at 11:17 am

    I delivered my second child two months ago. Mid-pregnancy I experienced back pain. I saw a physio and their best diagnosis was pelvis pain. The last two months of my pregnancy however I experienced horrible sciatic pain in my right leg. I couldn’t walk, sit or stand for more than a minute without laying down. My OBGYN assumed my pain was normal pregnancy related pain although I knew it wasn’t. I couldn’t take any pain meds. It was the worst time of my life. I’m 34. I had my baby at 40 weeks vaginally. After I couldn’t walk at all with severe leg pain. They have me morphine followed by naproxen and other breast feeding safe drugs. I had to nurse my baby laying down because I couldn’t do it any other way. My OB ordered a MRI on hospital (I live in Canada). It showed a large right paracentral disc protrusion at L5 S1 with nerve compression. Because I had a newborn and two year old they sent me priority for a steroid injection. I don’t think it did much. I started physiotherapy and they followed the Mackenzie protocol. To date I am much better. The leg pain has mainly subsided for a few weeks. Now and then I need to rest when I feel some dull pain in sections of my leg. But my concern is the continued tingling in my foot (heel and little toes), absent ankle reflex, and numb calf. I went from being able to do no calf raises to six. Unjust started lifting my baby. I currently have intense pain in my sacrum and hip on the right side. I physically can’t do the laying down periformsis stretch because of the pain in my sacrum. I had a consult with a surgeon and although he would do the surgery, he recommends I wait and see. I’m struggling so much with the injury and trying to raise my kids. I don’t know where to go from here in terms of treatment. I am seeing as osteopath this weekend. Do you think my nerve is still compressed, hence the foot issue? Will i ever get better? Any other treatment recommendations?

    • Dr Ken Nakamura says:
      November 28, 2016 at 4:20 am

      Thanks for your question Andrea. While it is concerning that you have numbness and tingling it is the pain that is more important. Since the pain is better than you can function better. The tingling and numbness are something that usually takes time. Weeks to months sometimes you are left with some tingling. As long as you can do your everyday things that is the most important.

      Yes the nerve is compressed. I would say carry on with the treatment you are already doing as you have gotten substantially better. If you plateau and can’t go forward than you can think about other treatments. This is an opinion and not a recommendation.

      Hope that helps your disc herniation.

    • Rebecca says:
      January 3, 2017 at 10:55 am

      I had the same experience with my second child. I ended up having a discectomy after a year and a half of intermittent excruciating pain and constant tingling. I did the steroid injections, PT, chiropractor, everything. The surgery gave me tremendous relief from the nerve pain. I walked out the day of surgery when I couldn’t walk in. Also, Gabapentin is an absolute life saver for me. I still have tingling and jolts and the gabapebtin tamesbit enough to raise my kids and stay active. I was doing yoga and overdid it about 2 months ago, now the disc above the one I had surgery on is compressing the nerve and causing sciatica on the other leg. I’m trying amsteroid injectors again. My Dr said a person more likely to herniated a disc above or below the previous herniation after an initial herniation. I’m trying so hard to stay optimistic, going back to eliminating extra salt, sugar, caffeine, doing my PT recommended stretches and exercises again. I’m praying this isn’t just how the rest of life will be. I hope you find your cure. My heart sincerely goes out to you!

  • Nechelle Williamson says:
    November 11, 2016 at 9:08 am

    Thank you for the section. I just had my 2nd back surgery. A microdiscectomy L4/L5. I felt extremely better for 3 weeks straight and now I feel worse than I did before the surgery. Pain down my leg and numbness, tingling (no weakness though). I wass so optomistic after feeling relief after surgery. My surgeon said I may have reruptured. He told me to lay in bed, and go do aqua therapy. I can barely walk I am in so much pain. Is there any hope for someone like myself? I am only 35. History of “soft cartliage” in my genetics according to surgeon. Thank you for your time.

    • Kalyn says:
      November 11, 2016 at 1:33 pm

      This is exactly my situation to a t!! I had my second back surgery, the first being a diskectomy at L4L5 and L5S1 in 2011. Felt immediate relief in the left lower leg pain and weakness. Tough recovery bc it was a large open surgery but I went back to work in 5 weeks. This time, had a huge extrusion at L4L5 and small at L5S1. Did well until I traveled and was doing long periods of sitting and lifting heavy suitcases and walking a ton. By my flight home I was in agony and in tears walking through the airport….I tried to do my job as a sonographer for a little over a week and the pain became so unbearable the doc I worked for contacted a local neurosurgeon to see what we could do for me. I was in the hospital for 5 days, the first of which were spent in a daze bc they did NOT want to do surgery on me and they attempted an epidural injection under CT which never worked for me and it made my pain so severe I couldn’t walk at all. So they finally decided to do the surgery, they did it minimally invasive and now I’m told he just took out enough scar tissue and disc pieces to relieve the nerve. Apparently it was so inflamed it was not like my other surgery where I had immediate relief in my leg. I woke up in agony and my leg was such a hot mess that they had to bring a walker and bedside commode. After two days I finally started to feel some relief! From there on I was on a roll and got better amazingly every day. I felt more amazing than I had in a long time. At my follow up for suture removal they informed me I was to start gentle PT for scar tissue formation and then later in recovery I would do water therapy because I was told I have a totally lax spine and genetically I am prone to these issues for life unless I do things to prevent it . well this person they sent me to decided he wanted to go hard and fast and didn’t agree with what the doctor said….the first session was okay but about 3 days after the second session which was about 3 weeks out from surgery, I woke up in agony again. It got increasingly worse. So now I am in the same or worse position than I was. And they are acting all blase like oh it will get better with time! Like this is the whole reason I had surgery! I need to work to support my family and I can barely move now. So I started aqua therapy and steroids and am hoping for the best but feeling and fearing the worst. I am insisting on a repeat MRI which is scheduled for Monday unless have a miraculous recovery over the weekend! I really feel your pain and I want to know how to fix this asap!! I am terrified I am just on a downward spiral and I will have no true relief! I can’t believe this has happened and I feel totally for you as I am in such a similar state! How do we go on and make this liveable and cured??!??

    • Dr Ken Nakamura says:
      November 13, 2016 at 10:15 pm

      Thanks for your question Nechelle. Sorry to hear about your failed back surgery. Unfortunately, cases like yours are common. You can try to do these exercises https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      However, at this point, they will likely make you worse. Better to go to the best chiropractor in your city. Yes I agree, it sounds like you likely herniated your disc again. I don’t recommend this but many of my Indian patients have been recommended complete bed rest. While it’s not proven in research some have fared better. None are cured but the claim to be better. It’s possible that the research has only looked at bed rest for shorter periods of time vs bed for extended periods like two months. This is an opinion, not a recommendation.

      Hope that helps your disc herniation.

  • Rena Dempsey says:
    November 10, 2016 at 11:12 pm

    I am so impressed with your advice and site and I have been following and reading up. Would you please be able to help me with some advice.

    My problem is, I have a bulging disc at L5 S1, it fully bulged in July 2016, had symptoms prior to of a very sore and achy left calf and foot going tingly/numb. I had the nerve test done, shows no damage. I have seen a Rheumatologist, said I have no stenosis or AI. I have done 2 epidurals (helped a bit yes.) I am no longer in pain. I have done a steroid injection in my pyriformis, as I present symptoms of this as well.

    What I have now is almost constant tingling in foot and tightness in lower calf causing muscle spasm there. It’s annoyingly tight. And get’s sore. As well, sometimes my sacrum area feels tight/sore. Periodically, when i sit, my left butt cheek can feel a bit numb but it goes away when I move. I am guessing the bulge is still healing? So the L5 S1 can cause the butt cheek and soreness?

    I was told I have plantar fasciitis in my left foot. Could this cause the numbing/tingling in my foot? Like the L5 S1 is really not part of the picture? I am scheduled to have an injection done in my calf and/or foot.

    I don’t want more epidurals in back. But the foot/calf get’s painful and bothersome, so thinking i will try.

    Thank you so much. You are incredible to answer all our questions.

    • Dr Ken Nakamura says:
      November 11, 2016 at 7:14 am

      Thanks for your question Rena. First, it sounds like you are simply covering up your pain with the 3 injections. It doesn’t sound like you actually addressed the problem. You will find out as these injections like steroids will last from a couple of weeks to 6 months. If it comes back then you know it was a band-aid. If the pain doesn’t come back then it might have healed.

      My thought is that you likely still have pressure on the disc with pressure on the nerve root. You may have plantar fasciitis along with this problem in the lower back, but is is very doubtful that it is causing the tingling and numbness of the foot. Your foot numbness and tingling are likely from the lower back.

      Hope that helps your disc herniation.

  • jyotshna says:
    November 2, 2016 at 9:11 pm

    i am software employee daily working 10 hours a day I have been suffering from low back pain from since 2 months that time pains are wrost can’t express . now I have taken completely bed rest for 2 months taken medications
    recently new MRI report showin below

    1. diffuse disk bulge with a left paracentral protrusions at the L2-L3 disk impinging on the thecal sac and narrowing lateral recesses(L>R) mildly compressing the nerve root canals,focal canal stenosis is seen at this site

    2. asymmetric diffuse bulges at L4-L5 level causing mild thecal sec,indentation ,compression of the lateral recess and nerve root cancal(L>R)

    3. Right L5-S1 facet joint changes are seen .

    Now I am able to walk some times very small pains in Knee when walking the pain will goes off after 2 mins
    even when I am tensed some time observing small pains .

    can you please let me know best excercises .
    now I am strted to office sitting 8- 9 hours .in mid moving my body left-right standing moving body front to back .only observing little pain when sitting

    can you please advice me is it goes anything wrong by sitting

    • Dr Ken Nakamura says:
      November 8, 2016 at 11:12 pm

      Thanks for your question Jyotshna. From my point of view, bedrest is wrong as the research doesn’t validate it seems that is the standard of care in India and nowhere else in the world that I am aware of yet. However, there are some patients that seem to better. In your case, it doesn’t sound like it helped enough.

      You need to tell me a lot more about your symptoms for me to give you any exercises.

  • christine says:
    October 22, 2016 at 8:13 pm

    What are your feeling regarding ballroom dancing. I have been ballroom dancing for over 10 years now. I wear 3 inch heels and recently i have injured my lower back. Would you suggest to stop or possibly not wear heels. I have a strong passion for this sport and would love to continue.

    • Dr Ken Nakamura says:
      October 24, 2016 at 6:12 am

      Thanks for your question Christine. I think ballroom dancing is great with heels for the lower back unless you have a different type of disc herniation compared to the typical posterior lateral herniation. If you have a typical disc herniation than once you are rehabilitated then you should do fine.

      You can try these exercises.
      Remember you can get worse with exercises. If the pain starts going further down the leg or the back pain gets worse than you should immediately stop the exercises. This is an opinion a not a recommendation.

      Hope that helps your disc herniation.

  • Lyn says:
    October 20, 2016 at 6:41 pm

    I have L3, L4, L5 disc’s bulging out and trapping the nerve’s in my lower back, 5 being the worst according to the Doctor. The problem i’m having at the moment is the muscle’s in my lower back keep going into spasm and i can barely walk, struggle to get up once i am sat down. Please could you give me some advice on what to do, and also if i went to see a Chiropractor would they be able to help? Thank you

    • Dr Ken Nakamura says:
      October 20, 2016 at 9:31 pm

      Thanks for your question Lyn. Sounds like you have are having an acute problem with your lower back. It’s really the skill of the person that determines if they can help or not. The profession chiropractor or physiotherapist does not matter. Either one can potentially make you better or worse. That is why you should find the best chiropractor or best physiotherapist in your area. This is an opinion and not a recommendation.

      Hope that helps your possible disc herniation.

  • Jean-Claude says:
    September 30, 2016 at 4:31 pm

    You’re a GREAT Man.


    • Dr Ken Nakamura says:
      October 6, 2016 at 11:22 pm

      Thanks for your great comment. Hope that helps your disc herniation.

  • roger payne says:
    September 12, 2016 at 5:53 am

    Hello and I hope you are well and maybe help me
    Actually ,forget the maybe as I would not be here otherwise on a sunday night at 11.40 pm.
    I have had a micro discectomy in 2007,l4/l5 seems very common.
    Now I`ve reached breaking point,
    I hear and see all different things that could help me but I am so confused.
    My parents have died recently,tried jobs,tried reflecology,yoga,pilates,reiki,chiropracters,u name it,good chance I`ve tried it.
    I am in pain from when I awake and wish when I do I was still asleep.
    Painkillers from gp is all they offer and occasional physio and maybe 1 acupuncture.
    I is nearing 1s wits end and would love some feedback and reassurance.
    Roger from Wolverhampton.UK

    • Dr Ken Nakamura says:
      September 12, 2016 at 9:06 am

      Thanks for your question Roger. I will give you an opinion and not a recommendation. You can do these exercises. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
      You may get worse with the exercises. So you know you are getting worse if the pain, numbness or tingling goes further down the leg or the above symptoms increases. If you get worse you should stop right away. These exercises should be supervised by a chiropractor or a physiotherapist in your case due to the probability that you will need the exercises customized to suit your body.

      Hope that helps your disc herniation.

  • M. Mathur says:
    September 11, 2016 at 5:56 pm

    Hey…thank you for the article its very helpful. I have a herniated disc in my L4 and L5-S1 lower back. The pain has already reached my right leg…in the knees and ankle. I am a student and need to sit for long hours. what should my posture be while sitting ? should the back of the chair be straight or curved ? should it cushioned?
    I don’t want to sit in a wrong way and make it worse.

    • Dr Ken Nakamura says:
      September 12, 2016 at 8:48 am

      Thanks for your question Mathur.
      1. The back of the chair curved is generally better. But with almost any chair using a lumbar support roll is almost always better with the exception of great chairs.
      2. Cushioning is generally better.

      Hope that helps your disc herniation.

  • Darian Parker says:
    September 6, 2016 at 3:10 am

    Can you speak a bit about the advantages and/or disadvantages of inversion table?

    • Dr Ken Nakamura says:
      September 6, 2016 at 11:00 am

      Thanks for your question Darian. Inversion tables seem to help some people with some lower back pain. Most of the time though I find that exercises that you can do at home usually more effective than the table. This is based on numerous patients that have inversion tables that come to me as things aren’t working out the way they thought. Often I give them some treatment and exercises and the vast majority of the times they get better. However, if you don’t have someone in your area that can customise exercises for you then you may be better off with an inversion table.

      Hope that helps your disc herniation.

  • Darian Parker says:
    September 6, 2016 at 3:09 am

    Thank you very much for sharing your knowledge so generously. I have been dealing with a bulging disc for 12 years, and have found that, along with chiropractic, proper education is the best treatment. I’ll incorporate these exercises immediately!



    • Dr Ken Nakamura says:
      September 6, 2016 at 10:56 am

      You are welcome Darian. Hope that helps your disc herniation.

  • Ronald Gibson says:
    August 22, 2016 at 3:16 am

    I have bad knees to bend the way you suggest here hurts. Do you have any other suggestions?

  • Salman says:
    August 20, 2016 at 10:52 pm

    hey doc..
    I have read your article and comments below in detail . I had L4 disc herniation 3 months ago. Now I am moving, walking around and feeling much better and pain free. I also do some of the exercises you mentioned in Disc herniation part 2. Now my question is should I have to do these exercises for some time like 1 month , 6 months etc or for whole life ?
    Also I was doing Gym at that time , and now can I join Gym again and run on treadmill ? Can I run easily or not?
    I have read in comments you advised not to do dead lifts,rows, bent over rows and squats etc . Should I avoid these kind of exercises for some time or for whole life ?

    • Dr Ken Nakamura says:
      September 6, 2016 at 8:07 am

      Thanks for your questions Salman. I will give you my opinion, not a recommendation.
      1. You should do the exercises for 6 more weeks.
      2. You can join the gym and run
      3. You can do all the exercises if you do them properly. From my observations though the above exercises are done wrong by the vast majority of people or they lift too much weight. I would avoid those exercises altogether if I were you.

      Hope that helps your disc herniation.

    • Mahesh P Parmar says:
      January 27, 2017 at 2:51 am

      Sir my name is Mahesh and age is 37 from India.My MRI report shows
      Posterior… left paracentral extrusion of L5-S1 intervertebral disc indenting theca sac, causing lateral canal stenosisand left sided nerve root compression. Size is 8mm.
      Posterior protrusion of L4-L5 intervertebral disc with annular tear at right foraminal level indenting thecal sac and abutting bilateral traversing nerve roots.

      Sir. Doctor says to do surgery and I am not to do that what can i do to relieve pain.

      • Dr Ken Nakamura says:
        January 27, 2017 at 10:09 am

        Thanks for your question Mahesh. There is no way to tell you if the case is surgical when you only write about your MRI. Maybe you have no symptoms maybe you cannot walk. Details, details, details are needed. If your history of symptoms is not detailed enough I won’t be able to give you an opinion.

        Good luck with your disc herniation.

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