Managing Disc Herniation and Alleviating Sciatica: Tips and Tricks 1


Suffering from disc herniation? Experiencing sharp pains shooting through your buttock, thigh, and leg due to sciatica? If your daily routine is disrupted by the discomfort of disc herniation, there’s hope. Many people find relief without needing surgery. This post will guide you through lifestyle changes to support your recovery from disc herniation. Stay tuned for our next piece, where we’ll explore exercises to correct and stabilize your condition.

Ultimate Guide To Exercises For Lumbar Disc Herniation Relief

Mary’s Story: A Wake-Up Call

Imagine starting your day like any other, performing your routine toe touches, when suddenly you’re hit with an excruciating pain radiating from your lower back down to your toes. This was Mary’s reality when she encountered a lumbar disc herniation, commonly referred to as a slipped or ruptured disc. Such incidents can lead to what’s known as sciatica or radiculopathy, terms doctors use to describe the pain that extends down your leg.

Understanding Lumbar Disc Herniation:

Lumbar Disc Herniation-Downtown Toronto Chiropractor
Lumbar Disc Herniation          Picture from

A glimpse into the anatomy of a herniated disc reveals two main components: the tough outer annulus and the softer, inner nucleus. Dr. Stuart McGill likens the nucleus to sticky phlegm. When Mary bent forward, it was akin to squeezing the front of a jelly doughnut, pushing the inner material backwards and eventually causing the disc to bulge and press on a nerve.

The Culprit Behind the Pain:

Mary’s disc herniation wasn’t a sudden mishap but the result of years of repetitive motions like toe touching and prolonged slouching at her desk. These habits gradually weakened her disc, leading to the moment when it finally herniated and impacted her nerve. The lack of nerves within the disc itself means significant damage can occur without immediate pain, explaining why the problem might not be felt until it’s severe.

A Lesson Learned:

The story underscores the importance of posture and the dangers of neglecting spinal health. While the advice to “sit up straight” might seem simplistic, maintaining the natural curve of your back is crucial. Mary’s experience serves as a potent reminder of the long-term consequences of poor posture.

Disc herniations don’t have to dictate your life. By understanding the causes and adopting preventive measures, you can manage and alleviate your symptoms.

Disc Herniation Stages
Disc Herniation Stages-        Picture from Morphopedics

Understanding Disc Herniation: Pain, Prevention, and Care

The Unseen Progression of Disc Herniation (see picture above)

  • Bulging Disc: Early stages where the disc starts to protrude due to wear and tear.
  • Prolapsed Disc: The disc bulges more as it degenerates, but the nucleus remains contained.
  • Extruded Disc: The protective layers give way, pressing on nerves and causing pain.
  • Sequestrated Disc: The most severe stage, where disc fragments break away, potentially compressing nerves or the spinal cord.

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

Why Me? The Role of Movement and Genetics in Disc Herniations

Surprisingly, your daily habits and genetic makeup play pivotal roles in disc health. While we can’t choose our genetics, modifying daily movements can significantly reduce the risk of herniation. Proper lifting techniques and posture adjustments are crucial first steps.

Simple Changes, Major Impacts: Daily Habits and Exercise

To protect your spine:

Daily Aggravators of Disc Herniations:Downtown Chiropractor Toronto
  1. Adjust Daily Habits: Learn to perform everyday activities in spine-friendly ways to prevent further disc damage.
  2. Disc-Specific Exercises: Exercises can help reposition the herniated disc.
  3. Stabilization Routines: Strengthening your core helps maintain spinal integrity, preventing future herniations.

Lifting Techniques: How Weight Lifters Should Lift

Master the Basic Butt-Lifting Technique for Disc Health

Disc Herniation: Learning to Squat Using A Broomstick
Perfect This  Basic  Butt LIfting Technique To Help Your Disc Herniation
  • Practice with a long, straight object to ensure your back remains aligned.
  • Ensure it touches your butt, mid-back, and the back of your head during the entire motion.
  • Squat down and maintain contact with 3 areas and keep the lower back arched the whole time.
  • Aim for 30 repetitions to embed this healthy habit into your daily routine for 10 days

Daily Activity Guide: Protecting Your Discs

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

In 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 using the butt lifting technique and it will become even more automatic. You can deepen muscle memory during all of these activities.

For sitting in a chair and driving I recommend that you roll up a Mckenzie Lumbar support roll and put that in the arch of your lower 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 the 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 disc herniation.

Exercises That Cause Disc Herniations

Activities That Put Out Lumbar Disc Herniations

Yes, it’s very surprising that toe touches, Yoga and certain 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 disc herniations while others directly push the disc out.

Many Yoga Exercises Put Out Disc Herniations

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

Next week’s article will go over the second and third ways 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.

Looking Ahead: Comprehensive Care for Disc Health

Next week, we delve deeper into specific exercises for disc realignment and stabilization techniques, in this article called Ultimate Guide To Exercises For Lumbar Disc Herniation Relief. Remember, starting with correct daily activities is essential to prevent aggravating your condition further.

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.

Leave a Reply

  • Hello Sir. I am 32 year old ,my MRI result shows 1)Diffuse disc bulge at L4-L5,L5-S1 causing indentation on thecal sac bilateral moderate to severe lateral recess narrow impinging on exiting and traversing nerve roots. 2) Diffuse disc bulge at L3-L4 causing indentation on thecal sac bilateral mild lateral recess narrowing.complications

  • Dear Doctor Ken Nakamura,
    Thanks for the superb supportive information and advice on the web site.
    Have a small bulge in L4-L5 as per MRI. Suffered low back pain (no pain down the leg) almost two years back with upper body tilt as well (lateral shift) and it settled in 10 weeks. Now have no active pain but on sneezing / coughing I feel pain on right lower back. Morning time activities feel stiffness and lifting up knees for dressing also feel slight pain on lower right side. Need your advice. Once again thank you.

  • Thanks for a great article. I see you reply to comments and I’m always looking for help !! I’m 20 year old diagnosed with disc herniation l4 l5 two years ago. I haven’t gotten much better. I can do pretty much everything without pain, the big exception is sitting and that’s how I got it(from driving). I have sciatic in left leg, and I really can’t figure out if flexion or extension is better for sitting. Flexion or more slouching seems to give less pain, but maybe this is because I have some lordosis in my lower back. (Chiropractor agreed flexion can be relieving although not optimal) I’ve tried manual therapists, physical therapy and several chiropractors. Chiropractors just seem to do their regular adjustments procedures, physical therapist told me to stretch my tight hamstrings which really made everything worse. Manual therapist told me I should only stretch softly or muscles will go into defense mode. Also read a lot about Mckenzie methods, and sentralization of pain in lower back. I’m sceptical due to my lordosis and don’t want to further increase this imbalance, although my spinal erectors are very weak compared to the rest of my body. I study medicine and find it very hard to avoid sitting. My core is decent, but no improvement in sciatic pain. I’m starting to think the only solution is to avoid sitting completely, which is nearly impossible for me. Since I don’t have certain things that clearly aggravate the herniation it’s very hard to cure. Thank you again.

  • Dear DR. Ken, I had disc herniation L4/5 back in year 1999, was healed after doing physio. But now I have recurring disc herniation at the same location with mild dessication without protrusion at L3/4, after having my baby 4 months ago, with L5 herniation pressure on nerve causing sciatica pain on left leg, both feet pain and on and off numbness.Seen two orthopedic, were adviced to go for TLIF or IDET. Went to see a chiropractor, the Dr. said need not surgery and recommended me to do DTS LUMBAR decompression, TEN n physio. Please help.

    • Post

      Thanks for your question Leslie. TLIF is an extensive procedure often used for degeneration while IDET is for disc degeneration or small disc herniations. You should always do conservative therapy as any surgical procedure will have permanent effect ie extensive scar tissue etc… You cannot undo surgery. They should always offer conservative therapy first as it does help many people.

      Except if you have progressive neurological symptoms such as drop foot that is getting worse, bowel and bladder function that is working properly, pain or numbness on the inside of your legs.

      As for the chiropractor I would personally give it one month with type of therapy than move on to the next. I would personally do the exercises in part 2:

      At the same time I would try the decompression. Traction is the same as decompression.

  • Doctor
    My L4-5 & L5- S1 slip disc issue and already taking the acupressure treatment but my pain will be same. First, he said completely bed rest for a week. After a week he said u just walk as much as you can. I did the same but, now the problem is increased by walking. Plz suggest what should I do to recover from this problem. If any option in in or site than I can send u my reports to understand the issue…


    • Post

      Thanks for your question Swati. First your doctor is out of date. Research has shown that bed rest is reserved for the most severe cases and than only 1-2 days. If you go longer the discs get larger and when you go to stand your problem will be worse. This is what doctors did 30 years ago. You should try the exercises here:

      Hope that helps your slipped disc.

      • Hello Dr Ken,
        Firstly, your site is very informative and motivational. I suffer from herniated disc at L4 – L5 and L5 – S1 from 3 weeks. I had severe pain in my right leg specially my ankle . It was very painful to sit or stand or walk. It was a nightmare to go to the toilet. I have been on bed since then. Now the pain is little reduced. When should I start exercising.

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          Thanks for your question. Pallavi. You should trying lying prone (lying face down) even now. When your pain tolerance allows try doing the sphinx. If the pain is sharp or causing pain to go further into the foot than you should stop right away. If the pain in the back increases but the pain in the leg decreases. Keep going according to the instructions.

          Here are the exercises.

          Hope that helps your disc herniation.

          • Thanks for your early reply doctor. I had forgotten to inform you that I have no pain in my back at all . Though pain in the leg has slightly reduced, numbness in my foot still exists. I tried doing prone exercise and walking a few steps. But I felt the pain to increase. Why isn’t my lower back not paining at all though I have herniated disc.I will send you my detailed report in my next mail.

          • Post

            Thanks Pallavi. When the disc herniations are very bad many people don’t feel much back pain but a tremendous amount of leg pain. Likely in your case that’s as far as exercises will take you at this time. You will probably have to get the cortisone injections than try the exercises. You may be able to get further. If not than surgery is one of the options when you have irreducible disc herniations.

            Also you should get another opinion from someone that can examine you.

            Hope that helps your disc herniation.

  • Hi Sir, I am suffering L5S1 mild Disc bulging since 2 years, since 2 weeks I am having severe pain in my left leg, tingling, numbness in 2 legs, while sitting and driving 2 wheeler, getting inconvenience in testicle area, feeling mild pain while urination, could you please suggest me the right exercises to reduce my pain and coming back to normal life. Thanks in Advance

    • Post

      Thanks for your comment. When you start getting pain in your testicles and feel pain while urininating this is possible red flag. Especially if you have pain or numbness in the areas that touch when you are sitting on your two wheeler. Mainly the buttocks, inside of your legs and groin. Also if it changes the way you urninate or have bowel movements than you need to see a professional right away. You should see a competent medical doctor or orthopedic surgeon today. Exercises are not for you at this time.

      Hope you get the right professional help for your disc extrusion or disc sequestration.

  • hello sir, got so much relief after reading your article. got proper definition what actually slip disk is , i am 30 years old doing weight exercise since i was 20 , from last two and a half years i have not been able to do these daily exercise due to lower back pain , i got ok with two three months rest , but a soon as i try join the gym again and perform weight exercise i feel having very slight pain running through my thigh ,
    last two and a half years i have join the gym four to five times but result always the same , one thing i noticed this time as soon as i start perform the biceps & shoulders exercise even with small weight after two three days gap i start felling the heavy ness in lower back & a slight pain running through my thighs
    with two three days rest i get ok . one thing to assure i do not require a pain killer to stop the pain
    please suggest what to do so that i be able to perform my exercise on my rutin basis,
    i do some of these exercise you have shown in your article & i feel no pain while doing so ,

    • Post

        • Post

          Thanks for the question Gagan. You should know that exercises especially these exercises are an essential part of getting better from a disc bulge. The first part is avoiding the problems that you do every that cause you pain (this article which you must do in order to get better). The second part is doing the exercises. The exercises are designed to put the disc back, some of the exercises are designed to stabilize the lower back.

          After your lower back is stable you can go back to doing light weights.

          Hope that helps your disc bulge.

  • Hey Ken,

    Great tips and Thank You so much for posting this. I have a question on sleeping posture,

    If S2 or S3 and S4 are adjusted, then do we have to sleep on the sides for it to heal or is sleeping on the back ok?

    Also, Do you keep a pillow under your knees or not after an adjustment.

    I sleep on my back without a pillow to the head but one under the knees so the knees are slightly elevated.

    On the side, I keep a pillow between the legs and a pillow to the head to ensure the head and spin are correctly levelled?

    There is so much debate around this. Will be great if you can throw some light into this.

    I am very interested in the situation when S2/S3 amd S4 are adjusted and what’s the best way to let it heal by not putting pressure on it.

    Thanks, Sara

    • Post

      Thanks for your comments Sara. First the sacrum can be adjusted but only adjusted as a whole. A chiropractor will adjust either L5S1 or sacrum (sacroiliac). You can’t really adjust S2, S3 or S4 separately. If those nerves are affected than sleeping on the side with a pillow between the knees is helpful. Also if you want the complete information just put your email in the side bar on the right to get the “sleep better report” when you first come to my page.

      Hope that helps your sleep.

  • Thanks a lot for this informtive blog I have learnt a lot about disc herniations and their various stages.
    In a recent MRI report my mom was diagnosed with the following “DISC prolapse C5-6 with mild compressive radiculopathy on right side” -focal protrusion and narrowing of right lateral access. I read your article and was surprised to learn about certain side effects of yoga and pilates that she practices. What exercises would you suggest? I would better ask her to avoid sun salutations if I have correctly understood your article.
    thanks in advance for your response

    • Post

      Thanks for your comment Peter. It’s a little different in the neck compared to the lower back but the principle of flexion is bad and extension is good is a good general principle to go by, assuming the disc bulge or disc herniation is in the back of the disc vs. the front of the disc. Most of what we do with our neck and lower back is bend forwards so it damages the back of the disc. eg. pushing on the front of the doughnut causes the jelly to come out the back.

      In other words if she has a “regular” type of disc herniation the following exercises will help her.

      If she feels sharp pain she is going to far. If the pain is gradually getting worse while she is doing the exercises than she should stop. If there is pain for more than 1/2 hour than she should stop.

      Hope that helps her cervical disc herniation.

  • I’m a 42 year male I have pain going down my left leg. I got a MRI And it’s said my L4 L5 have a disc bulg moderate to severe. Can you please help me.

  • Hello Sir , I have C5-C6 right para-central disc protrusion which compresses right side nerve , Also I have multilevel disc dehydration. Could.Could you please suggest appropriate exercise(s) in addition to chin tucks ?
    Thanks in advance.

    • Post

      Thanks for your comment KD. You could also do some neck extensions to see they will help. Extend or bend your neck backwards until you feel pain. Stay within the pain-free range and do this 8 times. If you feel sharp pain, increasing pain while doing the exercises or pain for more than 1/2 hour after the exercises you stop the exercises.

      Hope that helps your cervical disc herniation.

  • Sir, i have discs bulge at l4 l5, l5 s1 n i don’t have pain but i experienced little numbness on my left leg, please advise

  • Ken, I am an anesthetist with really not much physical demand on my back. I herniated a disc at L4-5 years ago. Pain lasted a few weeks, then subsided. I have since injured it a half dozen times over the years with pain lasting from a couple of weeks to several months. Eight weeks ago I played golf on a Saturday , no problem, worked out as usual at the gym on Monday. I woke up Tuesday morning with the worse back pain. After an MRI found a herniation at L4-5 and L5-S1. Hard to sit for any length of time. Doesn’t seem to be a lot of leg pain just some generalized right leg aching with on and off sensation differences. Have been doing your extension exercises a lot, but still uncomfortable to sit. Have been alternating heating and icing. Any other tips. Going to see a neurosurgeon in a few days just to hear alternatives. Anything you would recommend differently? Very nice of you to devote your time to help others out. Thanks, Eric

    • Post

      Thanks for your question Eric. First keep in mind that many people with no symptoms what so ever have disc herniations including disc bulges, disc protrusions and even disc extrusions. What I am saying is that I hope you were diagnosed not based on MRI but clinically diagnosed first and the MRI was used as a confirmation.

      Try these exercises

      As for surgery please keep the following in mind.

      1. You have foot drop that is not getting better. You likely don’t have this
      2. You have progressively worsening neurological symptoms. Doesn’t sound like it.
      3. Your disc herniation is 8 mm or larger. You will know from your MRI report, Disectomies less than 8mm result in poor outcomes.(ie no better or sometimes worse)
      4. If you have multiple bulges and herniations both discectomies and fusion outcomes not good.

      Spinal fusion surgery involves removing the nucleus and most of the annulus. Bone from the pelvis is transplanted where your disc was so that the two vertebrae become one.

      Sometimes spinal fusion surgery is effective for treatment of pain but increases the rate of degeneration in the adjacent vertebrae, usually significantly within 10 years after the surgery.[19-21]

      If your surgeon isn’t telling you this that is a yellow flag. Your surgeon should freely tell you all the pros and cons of fusion surgery.

      Danger: Bone Morphogenetic Protein (BMP) is sometimes used instead of taking some of your own hip bone to fill in the space vertebrae for fusion. Instead they use BMP as a bone graft substitute.

      In 2008, the FDA published a public health notification about potentially life-threatening complications associated with use of BMP in cervical spine fusion [25].

      In Europe this is the gold standard for disc replacement. What’s troubling is that two studies found that there was no advantage of fusion over exercise therapy and cognitive therapy in the short and long term.[26]

      Hope that helps your disc herniation.

    • Hi Eric. I just posted a note to dr ken. I seem to be struggling with similar issues as you. Basically sitting triggers my left lower back pain (near the si joint) and I also feel tightness on my left it band area and also on and off pain near my left sitbone. But no pain shooting down the leg, just tightness. I too am able to play sports and do weights etc without much discomfort but sitting really kills me, especially if there is no back support or if the surface is hard. Some bit of Physio focused on hamstrings, psoas etc plus some core work helped me a bit but still sitting is a killer, thus my post to dr ken. Do share your experience and progress and maybe we can share some notes. I am 41. Cheers

  • I have herniated my disc at L5-S1 and have a bulge at L5-S4. Luckily the MRI shows it not too severe, possibly as the discs were already partially dessicated.

    In 2 weeks I have 90% eliminated the pain in my legs and hips and only rarely get any sensations in my leg.. The new posture is good, but the muscles further up my back get very tired by the end of the day and I’m getting pain radiating from my spine around my lower ribs. I guess this will improve with more time and exercise.

    My passion is cycling. Its how I keep fit and its how I keep sane! Do you think there is any way to get back on a road / touring bike after this if I work on my core strength and flexibility, further improve my discs and re-learn my cycling posture (which probably contributed to this)? I am 54 years so so I know things may repair more slowly, but I can put the effort in if the right outcome is possible. I know it’s hard to be certain with limited information, but would appreciate your thoughts.

    PS Thanks for putting up one of the clearest and most informative web sites on the subject of disc recovery!

    Kindest Regards


  • Post

    Thanks for the comment Nishant. Sorry to hear you have been suffering so long from your disc herniation. If you make sure you avoid the things that make your disc herniation worse written in this article and practice these exercises.

    To lift properly read this article.

    Hope that helps your disc herniation Nishant.

  • Sir i am suffering from a disc herniation from around two month. I am seeing an ortho and going for physio sessions as well. and regular exercise.The pain is less but i am not being able to sit for more than 15 mins. how long will it take to recover? what extra can be done? do i need a surgery? i am 22

  • Hi Dr Ken. I have a L4-L5 and L5 S1 herniated disc problem and I read here that crunches and sit ups cause dsic herniations. My question is, if i want to still train my abs, what are the recommended exercises?

    • Post

      Thanks for the comment Pau. You are welcome here anytime. You can still do front planks in various forms. ie. Lift one leg while doing the front plank, use a medicine ball (picture at very end)

      You can use a medicine ball and lift your leg up. Finally you can move your elbows out further in front to make it harder.

      You can also do yoga side plank. Here is an image of a yoga side plank. This will strengthen the internal and external obliques as well as your gluteus medius muscles.

      If that isn’t hard enough try touching your heel with hand 20 times. If you still need harder there are at least 2 notches to go.

      Push ups also help. That should keep your abs strong without damaging your lower back.

      • Thankyou so much Dr. Ken for helping people living better life without back pain.I would be very thankful if you guide me what to avoid and what I can do in my this condition. I am 40 years old I have been suffering from sciatica and lower back pain for last 13 year and having Physio and wearing lumber support belt but since April 2014 I had it severe I am unable to walk,stand straight or sit for more than an hour.I had sever pain in my both butocks,front of right thigh and back of left thigh and calf. My X-ray says A lucent line is seen at pars interarticularis at L5/S1 level raising the possibility of pars break. Mild anterolisthesis of L5 over S1 noted. My DORSAL LUMBER MRI SHOWS, Mild circumferential disc bulge at L4/L5 level indenting into thecal sac lateral recess and neural foramina bilaterally more on left side compressing existing nerve. I am not doing any sort of exercise as if I try any the pain get worse and I became unable to move even go to washroom for couple of hours. Sometimes it gets even really very painful that I cant change my side on bed , Is my bulging disc causing me that much pain? I am living with this condition almost a year Will my bulging discs can heal doing the right exercises without breaking the par at L5/S1 level? I just want to get rid of this lower back pain.
        My Cervico Dorsal MRI shows , Mild broad based disc bulge seen at C6/C7 level indenting the anterior thecal sac. I had a severe pain in my right shoulder and hand My neuro decided these test after physical examination and watching my reflexes

        • Post

          Thanks for the question Mrs. Amir. It looks like you have a pars fracture. If it is a pars fracture then you should get surgery to help your case. As for the the cervical disc bulge you should try these.

          Warning though you can get worse with these exercises. You have to have someone that knows what they are doing watch you or guide you.
          I cannot do this. Go to your physio or chiropractor to help you do this.

          Hope that helps your lumbar pars fracture and your cervical disc herniation.

          • Thanks for your advise. I already had talked to my neuro about surgery but he said that as pars are intact and had not left their place there is no need of surgery at the moment. He prescribed some medicine to help my pain to stop nerves from sending pain signal to brain but it resulted in lost of my control on my body that I start felling I am falling or cant move my left or right leg any one at the movement of standing or walking. My family and I myself are not willing for surgery due to the possibility of negative result in lower body paralysis or lost of sensation and control of lower body. Any possibility of making situation better that can help.

          • Post

            Thanks for your question Mrs. Amir. I have never seen a pars fracture heal on it’s own. That means the sharp pain will continue for the foreseeable future until the bones grow enough spurs to stabilize itself. This will take many months to years. Even then there will likely be significant pain although it depends on the person.

            I would get at least two more opinions if I were in your shoes and look at the reason.

            You can try these exercises but they will likely aggravate your situation. If they do you should stop.

            If you try the exercises and you cannot do them due to the pain than there is nothing you can do from an exercise point of view.

            Hope that exercises help your pars fracture.

          • Thank you very much for you guidance I again contacted my neuro Dr. and also made an other appointment with an orthopedic both advised a second MRI to check any changes in the condition. what do you think MRI would show my condition correctly or I should go through a 3-d CT scan that will exactly show the bone situation.My hubande also worried about rediation effect on pars break.. My last x-ray MRI that I discussed with you was dated 11th Aug. 2014. I also need your good advice on which type of belt and how long should I wear to support my back condition.

          • Post

            Thanks for your question Mrs. Amir. An MRI is fine to show a pars fracture.It’s not going to make a difference as a pars fracture especially one that has displaced will be easily seen on MRI. I cannot give you advice

            Here is a belt that can help you. However a belt will only help with pain and if you get used to the belt your back muscles will weaken and you will become dependent on the belt. You should only use the belt occasionally.

            Hope that helps your lower back pain and pars fracture.

    • Post
      • My teenage (15) son has a protrusion at L5S1 and L4L5. He plays basketball competitively. He has been doing exercises like those in your article. Recently, his coach started having him bench press, biceps curls, tricep barbells, and military press. He now is having back spasms and it hurts to sit. What can we do? Should he never lift weights? He can’t do the exercises now that ask him to raise his legs to his chest or stretch his hamstrings without severe pain. Should we be icing? heat? what exercises? He is taking Ibuprofen and just hurt this yesterday.

        • Post

          Thanks for your question Kirsten. Your son should not do anything in flexion (bending forward). He should ice to decrease inflammation. He should also do the Sphinx exercises and Cobra. He probably won’t be able to do the cobra at this time he do what he can.

          If the pain is sharp or progressively painful while doing the exercises or painful for more than 1/2 hour after doing the exercises the exercises are not for him.

          You can find the exercises right here.

          Hope that helps your son’s disc herniation.

          • Hello Dr. Ken. My lower back was compressed according to my chiropractor and x ray. I was almost better to where I was walking again. I walked for too long one day and everything was very sore the next day and I began having sciatic pai . I went to my chiropractor the next day and he suggested that we start decompression to relieve the nerve pai . The day after he put me on decompression I am so sore that I can barely get up out of bed and have even worse pain when I go to lay down. I have been in bed for 3 days icing and seem to have no improvement. Is there any exercise you suggest I do to relieve some of this pain? Bed rest seems not to help but the pain of walking is unbearable. Please hel .

          • Post

            Thanks for you question Jordan. You can try these exercises.
            They can make you worse so you should have a health care professional supervise you. Bed rest has been shown not to be helpful for lower back pain in research studies and obviously you have found out.

            You see it really depends on the type of back pain. If you have a disc herniation the exercises will make you better. If your disc herniation is posterior or posterior lateral the exercises will likely help. If it is a lateral or anterior disc herniation they will make you worse. An MRI is usually not the answer to helping your pain most of the time. There are too many people being treated by looking at their MRI and not treating the person. Since we know through research that there is no correlation of an MRI to pain. You have to correlate your history and examination with the MRI.

            Most of the time a thorough examination and history is good enough.

            If the exercises make the pain worse or increase symptoms further down the leg like tingling, numbness or pain then you should stop.

            Hope that helps.

      • Dear sir,my sister (25)had a slip disk 6 month ago,we get a treatment in which doctor gives injection on the disk,she got relief..i just want to ask that is the problem is completely cures if she is not feeling pain from last 6 months and now can she do aerobic exercises to reduce weight?

      • I have mild bulging discs in my lower back Dr. Ken, particularly L4/L5 and L5/S1. I have been suffering from sciatica but for the last 2 months I haven’t experienced any. I’ve been doing some excercises like cobra and swimming. The pain is a lot less now, but I still get this annoying pain in my lower back, sometimes it gets really painful, but like I mentioned before no sciatica. Will my bulging discs heal given time and doing the right excercises ? I just want to get rid of this lower back pain. Thank you.

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            Thanks for your question Mohammed. First the exercises may not be for you or you may not be doing the exercises correctly. This is a very common problem. The other possibility is that the disc herniation is not the problem. Also there are different kinds of disc herniations. There are anterior, lateral and posterior disc herniations with different degrees of herniations. They all require different exercises. Having said that exercises don’t help everybody with disc herniatons. There are a lot of variables and I am going by very little information.

            Without an examination I cannot tell. I would recommend that you get an another opinion from someone that can examine you.

            Hope that helps your possible disc herniation.

          • Sorry for asking you too many questions Dr. Ken, but I have a lateral broad bulge pressing on my right sciatic nerve, so the pain is mainly on the right buttock and right leg. I am sure that the bulge is the root of my pain. I used to lift weights and I am fit by the way. Are there any specific exercises for my case ?

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            Thanks for the question. If you are worse. It depends if you are worse and stayed worse or just while doing the exercise or for one minute after the exercise and you returned to normal. Also you need to give me what it says on the whole MRI.

            I am not convinced that it is a disc herniation Mohammed. You need to give details of your symptoms.

          • Thanks for your help Dr. Ken. Here is the MRI result :
            L4/L5 and L5/S1 broad disc bulges resulting in relative canal stenosis, and bilateral impingement of the exiting roots, more at L4/L5 space.
            Associated facet joint arthropathy seen at both levels.
            Normal ligaments and soft tissues.
            Normal appearance of the lower cord and cauda equina complex.

            The main symptom I’m complaining of is lower back pain in the middle of my back, it’s an intense burning pain. Also from time to time I feel burning pain in my right leg. No weaknes, no numbness ( there was slight numbness in my right big toe, but it’s gone ).

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            Thanks for your comment Mohammed. I don’t see any evidence that this is a lateral bulge. You should try 10 knee to chest movements without stopping, and let me know if it makes things worse, better or remains the same. Here is the link.

            Remember this is not a stretch. Go into that position than let go of your knee and let your knee out and tell me how you feel.

            Hope that helps.

          • Hi Dr Ken,
            I found your article very informative and helpful.

            I am 37 years old and have been suffering from lower back pain for 3 months now. The pain is localized to lower back and does not spread to the legs.
            MRI results show L4-L5 degenerative dosc changes. Disc buldge with Central protrusion and annular tear. Facet arthropathy and slight canal stenosis.
            L5-S1 : Degenrative disc changes and disc buldge with annular tear inferiorly on the undersurface of the left central aspect of the disc with facet arthropathy and slight canal narrowing . The desending left S1 nerve root ,ay ne slightly crowded of the T2 sequence.

            I have been doing physical therapy excercises eg- pelvix tilt, cobra etc for 3 months now. It helps a little but for a short period. Also, went for Chiro massages but no relief. I have been taking Naprosyn 500mg 2 times a day and that helps with the pain.

            Please let me know what excercises I must do for my condition. Thanks! Rita

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            Thanks for your question Rita. I am not aware of chiro massage. I assume you mean chiropractic treatment. You should try these exercises if it’s a disc.
            You shouldn’t do these exercises if it increases the pain or causes symptoms down the leg.

            Keep in mind many people without pain have disc herniations. In fact 30% of 30 year olds and 60% of 60 years have disc hernaitions. It is very possible that it is not the cause of your pain. To look at an MRI and says that’s the cause without looking at your symptoms is not the right thing.

            It is very possible that you have facet irritation or facet imbrication. If the above exercises don’t help try these exercises.

            Hope that helps your possible disc herniation or possible facet irritation.

        • Hi Dr. Ken. Thanks for your help. I don’t think the disc is the root of my pain, I think it’s piriformis, because I did some yoga piriformis stretches and I already feel better. The pain is gone instantly. Should I try the exercise you recommended or should I just stick to those yoga stretches ?

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            Thanks for your question Mohammed. You are the perfect example why so many doctors including chiropractors and physiotherapists make mistakes by treating the image and not the person. The image is the MRI, CAT scan or X-ray. It’s been proven that pain and how bad the MRI looks has no correlation.

            Good for you for finding the best way to help your pain. I am happy you found something that helps.

            Do you see why I kept questioning you?

            Just keep what you are doing. Glad your piriformis syndrome is better.

          • You are right Dr. Ken because I tried all bulging disc exercises but they didn’t help. I think the bulges in my lower back are the result of me lifting heavy weights, and that’s normal, but the pain and sciatica are cause by piriformis syndrome. I already knew from the beginning that the bulges aren’t the cause of the pain, because every doctor tells me it’s a small bulge, so why is it causing me that much pain ? It sure is a misdiagnosis. Thank you.

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          • Thanks Dr. Ken for the quick response. I have been doing the exercises you suggested for 2 months as my physical therapist asked to me do those and a few other. The cobra and pelvic tilts provide some relief but only temporary. Also, I have pain sitting at my desk and driving to work. Driving makes it worse. Heat packs and hot water jaccuzzi does give some relief but again temporary. Also, I have been taking Aleve 500 mg twice a day.

            By chiro massage, I meant my physical therapist gave me 20 min deep tissue massage which hurt a lot afterwards. Do you think Chiropractor could help me with my pain or you suggest avoiding it? I appreciate your help. Rita

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            Thanks for the question Rita. First doing all the exercises I recommended in both articles is not what I meant. You either do the disc herniations exercises or the other not both. That would cause you not to improve. The problem is you are also doing a “few other exercises”. For example you are doing pelvic tilts. Pelvic tilts and Cobra counter each other. Pelvic tilts makes a “normal disc worse” while the other the cobra makes it better.

            The point is do one set of exercises see if it makes you better or worse. If it makes you worse do the other set.

            A chiropractor may help depending on their experience.

            Hope that helps your possible disc herniation.

          • Ah! That makes sense. Cobra helps me a lot. I will start with the herniated disc exercises from today n ll let u know how I did. Do you also suggest walking or biking on the back rest machine for 10 mins?
            Thanks to all your guidance, I seem to be understanding my condition so much better now. I wish every doctor was as knowledgable and helpful as you

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            Thanks for your question Rita. Walking is fine if it’s not for long periods like an hour. Biking will make you worse if you don’t keep the arch in your back. Also if you hit a bump than you will get worse. If you are talking about a stationary bike you need to keep upright and keep the arch in your back. 10 minutes should be fine.

            Hope that helps your possible disc herniation.

        • Hi again Dr. Ken,
          For the past 5 days I’ve been experiencing severe pain in my lower back and sciatica, I never stopped doing the piriformis exercises but they didn’t give the relief I used to get from them, so I tried the exercises you recommended and the pain decreases instantly. I feel so much better now. My hamstrings and buttocks are so stiff. Do u think the origin of this pain is the disc or the stiff muscles providing that your exercises get rid of the pain instantly. Thank you.

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          • Dr. Ken,
            I have been doing the herniated disc exercises for about 12 days now and my condition seems to be getting worse. I have more pain now as compared to before. Also, I went to a chiropractor 3 days ago and was very sore for the next 2 days and have been getting mild pain in my lower leg and foot inner side especially when I am in bed. Is pain after Chiro spine adjustment normal? Also, is this a red flag that now I am experiencing pain in my leg when I was not getting any pain in leg earlier? Also, the leg pain was in right leg first and now also in left leg. I seem to have tried everything under the sun and my condition is now worse after 3 months of pain. Pls help. Thanks, Rita

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            Thanks for your question. You need to stop the exercises. No it’s not a red flag but you are making yourself worse. You need a second opinion from someone that can examine you.

            Hope you get better soon.

      • oh man. best article I’ve ever read re: disc herniation! thank you so much, dr, for sharing this information! you explained the logistics very well, detailed & easy to comprehend. I look forward to trying the ruler technique & will let you know how it works out. with gratitude, laura

      • Thanks for your reply Dr. Another questio . I have been icing for a few days trying to get the swelling down. It looks like my torso is crooked my Dr says because of the way I am in spasm. Do you think I should try heat? The ice hasn’t seemed to help any.

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          Thanks for your question Jordan. The crooked posture is not from spasm, it’s from the disc. The disc gets out of shape as it is a semi-flexible material a little bit like hard rubber on the outside while like a heavy mucus on the inside. With improper sitting. lifting, forward bending. like putting on our socks and shoes, washing your face you can put out your disc.

          Heat will make you feel good like a pill will for a short period of time but will do nothing to help solve the problem. Same with ice it will be temporaily.

          You need to try these exericses.

          If the exercises give you more pain or produce pain further down the leg like tingling, numbness or pain than you should stop the exercises. You should have these exercises supervised by a health professional.

          Hope that helps your likely disc herniation.

      • I have a L4-L5 disc bulge, which I have had for years and never bothered me, but is now touching a nerve. I also found 3 small cervical bulges. I had my 3rd child 2.5 years ago and a few months after started having severe pain in my upper lumbar spine. I have been given Norco 10, then fentanyl patch 75. I recently had to switch docs and had to go off the patch for a weekend and got very sick. My new doc tried to put me on suboxone but I declined. I felt like drug addict. He opted to give me tylonel 4. Im tired of this pain and I think that my pain may not even be caused by that bulge. I really don’t think they know. I’m looking for something I can try or alternative methods that wont break the bank. I thought about going to a chiropractor. Any thoughts

      • Hello, I have been suffering with back and leg pain for 8 months now. I have tried physiotherapy and steroid injections but even just a sneeze has made it worse and I no longer feel the effect of steroid injections. I have tried doing exercises and going on walks but I’m not sure what exact exercises would help my type of injury. This is what my mri scan results have shown.

        At L4-5 level, there is a prominent central protrusion of the disc with no significant impingement on the nerve root. There is a small annular tear in the protruded disc. There is a mild hypertrophy of the facet joints with no evidence of spinal stenosis.

        At L5-S1 level there is a large right paracentral protrusion of the disc impinging on the right S1 nerve root in lateral recess. There is a mild hypertrophy of the facet joint with no significant spinal stenosis.

        Advanced degenerative disc disease in the L5-S1 with impingement on the right S1 nerve root as described above. 

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          Thanks for your question Elisa. You need to try a chiropractor or another physiotherapist. Perhaps one with a good reputation. That isn’t a guarantee but you have a better chance of getting better.

          Hope that helps your disc protrusion.

    • going in for an op on Friday for a microdisectomy on l5 s1.latley the sciatic pain on my right leg is not as bad.but bending trying to raise my leg and straight my leg is impossible .even when I look up it causes pain.but if I do nothing I feel nothing.would the slipped disc still be there even if the sciatic pain is not there when I do nothing.but comes back when I do something.

      And the other thing I get is when I sit down or lie down my outer thigh gose numb.and the back of my leg and calf this normal

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        Thanks for your question Alasdair. Hopefully you have done 3-6 months of chiropractic, physiotherapy or rehabilitation exercises. Also trying several different reputable practitioners till you find one that can get you better is important as not everyone is competent. Just like there are good and bad mechanics the same goes for the professions. Even surgeons are the same in that sense.

        Sounds like the pressure on the disc has come down. My sense is that if you find someone good you can get better as the disc has been reduced some by small change you have made. This means that the disc is likely reducible.
        Remember though I haven’t examined you though and am going by the little information you have given me.

        Here are some exercises I would do.
        Always ask a health professional to supervise your exercises.

        Hope that helps your slipped disc.

        • I have lived with this for 8 months now.i tried PT but they had to stop cause they could not go any further.and my leg even now won’t straighten up.what I ment to say is if I do nothing I won’t feel much sciatica.but when I do it hurts.for example when I bend down slightly then straighten my back shooting pain goes down my leg and to my foot.and the numbness on my outer thigh to.

          You see the situation I’m in is that I work on the oil rigs and they won’t let me go on the rig with the meds I’m on gabapentin and naproxen .iv been off work since December .i had to wait along time for the surgery and if I took a different root ie PT wich I did and did not work.and osteopath and that did not work I would have to wait on a waiting list for 3 to 6 months as you do when you are with the NHS.So surgery is the best.and sucsses rate is 95%.

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            Thanks for your question Alasdair. Getting back to your original question which is:
            Question: “would the slipped disc still be there even if the sciatic pain is not there when I do nothing.but comes back when I do something.”
            Answer: The disc is still there and but putting less pressure on your nerve.
            Your Statement: “So surgery is the best.and success rate is 95%.”
            Answer: Surgery does not have a 95% success rate for microdiscectomy. More like 50% in the shorter term and after 10 years no different from people that don’t get surgery. These are based on research and not my opinion. I treat numerous people after having surgery and I always have when I worked in England and here in Canada. The question is why I have to treat so many people after microdiscectomy surgery. Many of these surgeries were deemed a “success” as they were pain-free for a month, 3 months, 6 months, while some had their pain reduced or their leg pain disappeared but their lower back pain remained.

            Just trying to keep you informed.

            Hope that helps answer your question about your disc herniation.

          • Thank going in tomorrow .i just wonderd about some days it will press against the nerve and some days not so much.i just thought the longer it stays on the nerve the more damage the nerve will get and leave you with permanent nerve damage.and the other thing is the numbness in my outer thigh when I sit and lie down and when I stand in a certain way is that due to the L5 S1 slipped disc

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            Thanks for your comment Alasdair. Unless you are getting bladder retention or bowel problems or progressive neurological problems like a drop foot that is getting worse you will not likely have permanent damage. In your case I am personally not worried that you would get permanent nerve damage from the information that you have given me so far.

            Good luck with your disc surgery tomorrow.

Dr Ken Nakamura downtown Toronto Chiropractor
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Dr. Ken, has been recognized as the Best Toronto Chiropractor in 2024, 2023, and 2018, here in downtown Toronto. As a sports chiropractor, he excels in treating a wide range of conditions including concussions, temporomandibular joint disorders (TMJ), sports-related injuries, and spinal issues. Beyond his clinical skills, Dr. Ken is an accomplished athlete, having represented Ontario in the Canadian Judo Championships and completed the Toronto Marathon on two occasions. He employs the innovative C3 Program to provide targeted and effective care to his patients, ensuring a holistic approach to their well-being and athletic performance.