Got a Herniated Disc? What Causes It and How to Treat It

There are many possible causes for herniated discs. Learn more about treating pain from a herniated disc and get exercises from physical therapists.

Published Date: Jan 20, 2023

Our Hinge Health Experts

Steven Goostree, PT, DPT
Physical Therapist
Dr. Goostree is a Hinge Health physical therapist and board-certified orthopaedic clinical specialist.
Jonathan Lee, MD, MBA
Orthopedic Surgeon and Medical Reviewer
Dr. Lee is a board-certified orthopedic surgeon and an Associate Medical Director at Hinge Health.
Dylan Peterson, PT, DPT
Physical Therapist and Clinical Reviewer
Dr. Peterson is a Hinge Health physical therapist who focuses on developing clinical exercise therapy programs and member education.

Got chronic back pain? You may suspect a herniated disc as the culprit. Maybe a doctor told you that you have one after doing an MRI, or you strongly suspect it based on your symptoms and a visit with Dr. Google. Herniated discs are very common, but they’re not always the reason for your back pain.

Here, learn more about what a herniated disc is, how to prevent and treat it, and which exercises can help relieve your back pain, recommended by our Hinge Health physical therapists.

What Is a Herniated Disc? 

Your spine is made up of 24 vertebrae (bones) stacked on top of one another. In between them are flat, round discs that are about a half-inch thick. A disc herniates when its center pushes against the outer ring, causing pressure that can lead to back pain. 

“A herniated disc sounds a lot scarier than it really is,” says Steve Goostree, PT, DPT, a physical therapist at Hinge Health. “I like to compare it to a sprained ankle. After a sprain, your ankle is swollen, red, and sensitive to the touch. The exact same thing happens with a herniated disc. Except in this case, when the disc swells and expands, it can push against nerves in your spine, which can cause pain to radiate down your leg, as well.” 

Just like a sprained ankle usually gets better on its own with some rest, ice, and gentle exercise, your back will usually bounce back from pain from a herniated disc within a few days to weeks.

Herniated Disc vs. Bulging Disc: What’s the Difference?

A common question is: What’s the difference between a herniated and a bulging disc? They are pretty much the exact same thing, says Dr. Goostree. It’s also sometimes called a protruding or ruptured disc.

The Truth About Herniated Discs and Back Pain

Herniated discs are incredibly common: Most adults have at least one herniated disc. But they often aren’t the cause of low back pain. “If you were to randomly take 10 people off of the street and have them undergo an MRI, about nine of them would have a herniated disc, but only one or two would actually have pain,” says Dr. Goostree. “While a herniated disc can contribute to chronic low back pain and make it worse, it’s likely not the main cause.” In fact, research shows that 30% of 20-year-olds and 84% of 80-year-olds with no back pain show signs of a disc bulge on an MRI.  In other words, because herniated discs are easy to see on imaging of your back, it’s easy to assume they are causing your back pain. But it can be the case that you can have herniated discs that aren’t causing any symptoms — along with other reasons your back is bothering you. 

Herniated Disc: A Hinge Health Perspective

You may have a herniated disc diagnosis, or you might have back pain that feels like a herniated disc. That label may make you feel stuck, like your pain is something you just have to live with. If there’s one thing we want you to know about your herniated disc, it’s this: You’re not stuck with your pain and there are always steps you can take to get back to doing what you love. You may not be able to control every issue involved in your back pain, but you do have the power to change some important things. You can always take action to improve your situation — and that often starts with moving more. As our Hinge Health care team says, movement is medicine.

Causes of Herniated Discs 

The most common cause of a herniated disc is natural, age-related changes in your spine. The same way your skin gets more wrinkly and your hair gets peppered with gray, the discs in your spine start to shrink and become less flexible. This causes the spaces between your vertebrae to narrow. 

Here are other common reasons you may experience a herniated disc:

An injury. As you get older, even a minor strain or twisting movement — for example, from lifting a heavy object — can cause a disc to herniate.

Genetics. Research shows that some families have a higher risk of developing herniated discs along their spine. It’s not clear why this happens.

Age and sex. Men between the ages of 20 and 50 are more likely to have disc herniation than other groups.

Symptoms of Back Pain from a Herniated Disc

Remember, herniated discs don’t always cause back pain. But if they do, you might experience the following: 

  • Sharp or burning pain on one side of your body 

  • Leg pain that spreads from your low back to your buttocks, thigh, calf, and possibly foot 

  • Numbness or tingling

  • Muscle weakness that may cause you to stumble 

If you’re prone to pain from a herniated disc, the pain may flare and subside on occasion. “It’s important to remember that a herniated disc in the lower back is no reason to panic,” says Dr. Goostree. “They do have a tendency to heal, so that you’re not burdened with them your whole life.” The herniation should naturally resolve over time and be reabsorbed by your body. In the meantime, you can use the treatments below to reduce pain while your back heals and reduce the chances of future pain flares.

How to Prevent a Herniated Disc

There are a lot of things you can do to reduce your chances of developing a herniated disc. They include:

  • Maintain a healthy weight for you. Excess body weight can put added stress on the discs in your lower back.

  • Prepare your body to lift. If you need to lift heavy objects, practicing is important. Exercise and movement can make your discs thicker and stronger. But avoid lifting drastically more weight than you are used to or, when you are tired. Ask for help or find some equipment to help you.

  • Stay active. A sedentary lifestyle makes it more likely that you’ll end up with a herniated disc. When you have to sit for long periods of time, take frequent breaks to move or stretch. “I also recommend patients use a pillow or support behind their back when they sit,” says Dr. Goostree. This can support the natural curvature of your spine and reduce strain on your back. 

  • Don’t smoke. Nicotine decreases blood and oxygen flow to your spinal discs, which can cause them to age more rapidly. 

  • Stay hydrated. Discs are made up mostly of water, so dehydration might make you more prone to herniation. 

Treatment for Herniated Discs

Most of the time, a herniated disc gets better on its own after several days or weeks. But you can help speed the process along with the following tips from our Hinge Health physical therapists and medical doctors:

  • Return to usual activities. It’s fine to take it easy for a day or two, says Dr. Goostree. But after that, you want to get moving again. In fact, pain researchers say it’s best to stay at work or go back to work as soon as possible. This encourages blood and oxygen delivery to tissues for healing, keeps muscles strong and limber, and helps reduce pain. Once you become active again, avoid sitting for long periods. 

  • Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for back pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

  • Physical therapy. A physical therapist can teach you exercises to strengthen your back and surrounding muscles. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

  • Prescription drugs. Commonly prescribed prescription drugs for herniated discs are neuropathic drugs, which affect nerve impulses to decrease pain. These include gabapentin (Neurontin), pregabalin (Lyrica) and duloxetine (Cymbalta). Some doctors prescribe muscle relaxers if you also have muscle spasms, but they do carry side effects such as drowsiness and dizziness.

  • Steroid injections. If over-the-counter medication and conservative treatments don’t offer sufficient pain relief, your doctor may suggest cortisone steroid injections. They can offer back and leg pain relief by decreasing inflammation near the nerve roots. “It’s important to remember that injections won’t heal a herniated disc,” explains Dr. Goostree. “They will just help reduce inflammation that may temporarily be contributing to pain.”

Surgery for a Herniated Disc

The good news is that about 90% of people with a herniated disc get better with the above treatments and surgery is usually not necessary. You may be a candidate for surgery, though, if your pain does not improve with non-invasive treatments and you experience any of the following herniated disc symptoms:

  • Muscle weakness

  • Difficulty walking

  • Loss of bladder or bowel control

If you have surgery to treat a herniated disc, your surgeon will remove part or all of the disc that is damaged. This is known as a microdiscectomy. It may help you feel better faster than you would without surgery, but it comes with risks such as nerve injury and infection.

After surgery, you’ll likely start a regular walking regimen and physical therapy to help restore strength and flexibility to your back and legs.

Talk to your doctor about whether you’re a good candidate for surgery. 

At-Home Exercises for a Healthy Back

While all of the above steps can help back pain, one of the most effective is exercise therapy. These gentle exercises from Hinge Health are great for stretching your back. You can do them when you’re experiencing a pain flare and on a regular basis to keep your spine mobile and healthy.

Standing Back Extension

This backward bending exercise helps lessen the pressure on the discs in your back for pain relief.

Standing Back Extension

This backward bending exercise helps lessen the pressure on the discs in your back for pain relief.

Standing Back Extension

This backward bending exercise helps lessen the pressure on the discs in your back for pain relief.

Standing Back Extension

This backward bending exercise helps lessen the pressure on the discs in your back for pain relief.

Seal Stretch

This gentle exercise is great for counteracting disc pain that is worsened by everyday activities that involve bending forward at the spine.

Seal Stretch

This gentle exercise is great for counteracting disc pain that is worsened by everyday activities that involve bending forward at the spine.

Seal Stretch

This gentle exercise is great for counteracting disc pain that is worsened by everyday activities that involve bending forward at the spine.

Seal Stretch

This gentle exercise is great for counteracting disc pain that is worsened by everyday activities that involve bending forward at the spine.

Seated Back Extension

This stretch is a good one to do if you’re at your desk and can’t easily stand up. It forces your spine into an extension position, but while you’re seated, says Dr. Goostree.

Seated Back Extension

This stretch is a good one to do if you’re at your desk and can’t easily stand up. It forces your spine into an extension position, but while you’re seated, says Dr. Goostree.

Seated Back Extension

This stretch is a good one to do if you’re at your desk and can’t easily stand up. It forces your spine into an extension position, but while you’re seated, says Dr. Goostree.

Seated Back Extension

This stretch is a good one to do if you’re at your desk and can’t easily stand up. It forces your spine into an extension position, but while you’re seated, says Dr. Goostree.

PT Tip: Lift Smart

Practicing good technique when lifting heavy objects can help reduce the risk that you’ll worsen pain from a herniated disc, says Dr. Goostree. Here’s how: Spread your feet apart to give your body a wide base of support. Stand as close as you can to what you plan to lift. Squat down to pick the object up, holding it as close to your body as you can and tightening your stomach muscles as you lift. As you rise, use your hip and knee muscles. To set something down, squat rather than bend forward, once again using the muscles in your knees and hips.

Learn More About Hinge Health for Back Pain Relief

Our digital programs for back and joint pain are offered for free through benefit providers. Click here to see if you’re eligible.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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  2. Lumbar Disc Herniation with Radiculopathy. (2012). North American Spine Society. Retrieved from https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LumbarDiscHerniation.pdf

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  4. Herniated Disc—Symptoms, Causes, Prevention and Treatment. (n.d.).American Association of Neurological Surgeons. Retrieved from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc 

  5. Yoon, W. W. & Koch, J. (2021). Herniated Discs: When is Surgery Necessary? EFORT Open Reviews, 6(6), 526-530. doi:10.1302/2058-5241.6.210020

  6. Surkitt, L. D., Ford, J. J., Hahne, A. J., Pizzari, T., & McMeeken, J. M. (2012). Efficacy of Directional Preference Management for Low Back Pain: A Systematic Review. Physical Therapy and Rehabilitation Journal, 92(5), 652-65. doi:10.2522/ptj.20100251

  7. Ma, C. B. & Zieve, D. (July 28, 2021). Lifting and Bending the Right Way. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000414.htm 

  8. O'Keeffe, M & O'Sullivan, K. (2019, April 9). All you ever wanted to know about back pain. Raidió Teilifís Éireann, Ireland’s National Public Servivce Media. https://www.rte.ie/brainstorm/2018/0130/937071-all-you-ever-wanted-to-know-about-back-pain/