Herniated disc from A to Z: Our complete guide

disc extrusion

Herniated discs come in different forms. L4-L5, L5-S1, multi-stage, associated with a sciatica, etc. Regardless, it is often debilitating and causes a lot of anxiety in people who suffer from it.

Is a herniated disc serious? When should you worry? Can we treat it? What can you do concretely to avoid the operation and prevent recurrences?

By reading this article written by a physiotherapist, you will have a global understanding of your condition, from the anatomy of your spine to various natural treatments allowing you to relieve your pain and avoid injury.

Herniated Disc: 5 Key Points to Remember

  1. A herniated disc refers to the migration of the gelatinous nucleus of a disc between 2 vertebrae towards the periphery.
  2. It is difficult to identify a specific cause of disc herniation, although several biomechanical and environmental factors are believed to be involved.
  3. Symptoms vary greatly between individuals, and include lower back pain, radiation to the leg, paresthesias and feeling of weakness.
  4. The diagnosis is made through a clinical examination by a health professional, as well as tests ofmedical imaging in addition.
  5. The treatment will be adapted according to your particular situation, and mainly aims to avoid surgery.

What is a herniated disc? (Definition and anatomy)

Impossible to explain the herniated disc to you without making a simplified anatomy lesson. As this diagnosis is related to intervertebral discs, let's start by identifying the main structures that are part of the spine:

The spine (or vertebral column) is made up of vertebrae superimposed. In the lumbar region (lower back), there are 5 vertebrae called L1, L2, L3, L4, and L5. Note that the spine ends with the sacrum, this triangular bone also composed of 5 welded vertebrae (S1, S2, S3, S4 and S5).

Between each vertebrate, there is a intervertebral disc. For example, the L4-L5 disc is the disc located between the L4 and L5 vertebrae. The L5-S1 disc, on the other hand, is located between the last lumbar vertebra (L5) and the first sacral vertebra (S1).

In summary, the intervertebral discs are structures located between 2 superimposed vertebrae. When we study the composition of these discs, we see that they look like pads. More specifically, they are composed of a gelatinous core (Nucleus pulposus) in the central region, and surrounded by a fibrous ring (annulus fibrosus).

Role of intervertebral discs

But what are the intervertebral discs for? Here are their main roles:

  • The separation of the vertebrae from the spine
  • Shock absorption during movements involving impact (walking, running, jumping, etc.)
  • The distribution of pressures thanks to the gelatinous core
  • Mobility between the vertebrae

What happens in the presence of a herniated disc?

Essentially, the discs deform and come out of their envelope. As the ligament behind the vertebrae (called the “posterior longitudinal ligament”) is very strong, it is rare to observe a purely posterior disc herniation.

Note: In the presence of posterior disc herniation, it is possible to observe damage to the spinal cord, or a cauda equina syndrome. Please note that this is a medical (and sometimes surgical) emergency.

Thus, herniated discs are generally posterolateral, that is to say the disc migrates backwards and to the side.

Where does your herniated disc come from? (potential causes)

At the risk of surprising you, know that it is difficult to identify the exact cause of a herniated disc.

Obviously, if the hernia and lower back pain appear after an accident (such as a car accident or lifting a heavy load), the cause will then naturally be attributed to this event.

On the other hand, if the pain appears gradually, it becomes more complicated to pinpoint the exact cause responsible for the symptoms.

Most often, a herniated disc is believed to be caused by a combination of biomechanical and environmental causes such as:

  • Unsuitable postures (such as prolonged static positions due to sedentary work)
  • Weakness of trunk muscles
  • overweight
  • Genetic factors
  • Previous injury and history of low back pain
  • Repeated efforts
  • Stress
  • Biomechanical changes (such as lower limb length discrepancy, flat feet, lumbar hyperlordosis, etc.)

Note: It should be understood that many of these causes are not necessarily scientifically proven, although they may have an indirect link with disc herniation.

What are the symptoms of a herniated disc?

Given the picture so far, you may assume that a herniated disc is a serious illness. Although this is sometimes the case, let me reveal something that will surprise you…

Not all herniated discs are painful!

In other words, it is possible to observe a herniated disc in a patient (on MRI, for example) without them complaining of lower back pain.

Why a Herniated Disc May NOT Cause Pain (In Some Cases)

Whether you suffer from pain or not, you must understand that not all herniated discs are symptomatic.

This information is important because the goal of conservative treatment will not necessarily be to completely eliminate the hernia, but rather to reduce symptoms and improve quality of life. We will come back to this when we discuss treatment strategies for herniated discs.

In the meantime, here are causes that explain why some people do not feel any discomfort despite the presence of a herniated disc between 2 of their vertebrae:

  • If the herniation does not compress surrounding nerve roots, it may not cause pain.
  • If the hernia is small, it will not cause symptoms in some.
  • Each individual has a different pain threshold, and some may not feel pain even in the presence of a herniated disc.
  • In some cases, the body may adapt or change the way it moves to minimize pain.
  • If the patient is in excellent health, they can better manage the injury by compensating with strong abdominal muscles.

Note: Although pain may not be present, a herniated disc should always be monitored to ensure that it does not cause complications in the future.

Symptoms of a symptomatic herniated disc (when it hurts!)

A large number of people suffering from herniated discs complain of symptoms that affect their quality of life.

The symptoms will depend on several factors, including the location of the herniated disc within the spine.

When it is present in the lower back (between the L1 and L5 vertebrae), we speak of a lumbar disc herniation. Symptoms may then include:

  • Lower back pain
  • Pain in the buttock, thigh, or lower limb
  • Tingling and numbness in the foot
  • Feeling of weakness in the leg
  • Sciatic-like pain or cruralgia
  • Daily limitations (walking, sports, sleeping, etc.)

In typical cases, the pain is aggravated by prolonged sitting, driving, and standing. lean forward.

Often the patient also complains of pain worsened by walking and standing. Coughing or sneezing can increase the pain, as can sudden movements (especially twisting).

When to worry

In some rare cases, a herniated disc can constitute a medical emergency. If you ever experience any of the following symptoms, you should consult a doctor immediately.

How can you be sure that it is indeed a herniated disc? (Diagnostic)

Several lower back conditions can reproduce symptoms similar to herniated disc, such as:

How then can we ensure that our back pain comes from a herniated disc, and not from another diagnosis?

Ultimately, it is themedical imaging which will identify the presence of a herniated disc. Magnetic resonance imaging (MRI) is the test of choice, although some specialists prescribe the following imaging in certain cases:

  • Scanner
  • X-ray
  • Discography
  • Myelography

Now, is MRI enough to explain your symptoms accurately? Not really.

Remember when we mentioned that some herniated discs are asymptomatic? So, two people can have identical MRI findings (e.g. L4-L5 disc herniation), but have completely different symptoms!

This is why it is important to consult a health professional in order to have an accurate picture of your condition.

The practitioner, in addition to analyzing your imaging exams, will carry out several tests and examinations to guide treatment.

Following the subjective assessment of your symptoms, the clinician will perform a complete physical examination. These more objective tests will be able to clarify the diagnosis and thus guide treatment.

Here are some things your doctor or therapist will want to look at:

  • A review of your general health, as well as your injury history
  • A subjective examination of your symptoms, and their impact on your daily life
  • Your posture
  • Movements of your spine
  • The strength of your abdominals and other core muscles
  • Un neurological examination to identify sciatica, cruralgia, or other nervous condition
  • A more holistic general exam that takes into consideration related joints, your respiratory pattern, etc.

What to do to relieve your pain? : Treatment of herniated disc

The treatment of herniated disc must be done early, and must absolutely be adapted to the condition of each patient. 

Before discussing the modalities available to treat a herniated disc, let's start with some good news.

Can a herniated disc heal?

Yes ! Herniated disc can heal. This healing takes place via various phenomena.

On the one hand, a large proportion of herniated discs heal spontaneously (the scientific studies speak of 62 to 83% of cases of disc herniation!).

Strangely, it seems that large herniated discs take LESS time to heal than hernias that are smaller in size (11 months for large herniated discs vs 7 months for small ones).

Otherwise, Following a herniated disc, the body may begin a process called disc resorption, where material from the herniated disc is gradually removed by the immune system.

Eventually, the excluded gelatinous nucleus can return to the initial position (inside the disc). Moreover, certain treatment techniques such as Mckenzie method ou physical activity precisely try to promote the migration of the intervertebral disc into the original position.

What if the herniated disc doesn't go away?

As mentioned previously,If the hernia does not cause an inflammatory response and/or nerve irritation, it can be expected that it will not cause pain or impaired function.

The goal of treatment will then be to reduce the inflammation caused by the herniated disc, and ensure that the disc does not come into conflict with a surrounding nerve.

How to treat a herniated disc?

When we talk about the treatment of a herniated disc, there are only 2 possibilities.

Either we use a so-called “conservative” treatment, or we use more “invasive” techniques (such as infiltration or surgery).

In order to avoid surgery and regain optimal quality of life, let's focus on natural treatment techniques that will allow you to relieve your symptoms.

Repos

Following a painful episode of back pain, the first instinct is to rest until the pain passes.

Although rest is often necessary, it is important to understand that too much rest can make your condition worse rather than better.

For what ? Because the harmful effects of long-term inactivity (like muscle weakness or joint stiffness) can limit your recovery, and make pain worse over time.

Medication

To relieve pain, inflammation and muscle tension, the doctor may prescribe appropriate medications.

Among the medications prescribed are:

  • Anti-inflammatories
  • Pain relief
  • Muscle relaxants
  • Anti-epileptics
  • Anti-depressants

Note: The doctor will choose the type of medication to prescribe to you based on your symptoms, and will adjust the doses. Do not hesitate to consult if your pain persists.

Physical therapy

Several therapists and practitioners are involved in the treatment of back pain. The doctor often refers to physiotherapists, although some patients also consult osteopaths. Overall, the goals of these therapies are similar, and include:

  • Reduction of inflammation via massages, gentle mobilizations and analgesic modalities
  • Reduction of muscle tension through massages and relaxation techniques
  • Improve mobility and flexibility through active and passive stretching
  • Strengthen the core muscles through specific and adapted exercises

Note: Each therapist can bring unique expertise. It is important to find a practitioner you trust who has experience with herniated disc cases.

Accessories and products

In addition to treatments received by a therapist, many patients opt for back pain relief products and accessories because of their effectiveness on their pain.

Although we often observe beneficial effects linked to various accessories, we must realize that they have limits.

Mainly, the products available on the market do not treat the cause of the herniated disc, and are mainly useful for reducing pain in the short term.

They should therefore not replace comprehensive care including appropriate and progressive physical exercises. Obviously, it is best to consult a health professional so that they can suggest the best tools to use, as well as other treatments specific to your condition.

Some of the most popular accessories include (click on the item you are interested in for purchase options):

acupressure mat
Wellax acupressure mat with cushion – specifically relieves tension and promotes circulation – massage mat in a set including acupressure cushion and carrying bag
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  • 🧘 𝐋𝐈𝐁È𝐑𝐄 𝐃𝐄 𝐋𝐀 𝐓𝐄𝐍𝐒𝐈𝐎𝐍 – Our fakir mat stimulates the muscles, promotes circulation and can thus effectively relieve tension. This is how you fight annoying back and neck pain!
  • 🧘 𝐃𝐈𝐒𝐒𝐈𝐏𝐄 𝐋𝐄 𝐒𝐓𝐑𝐄𝐒𝐒 𝐑𝐎𝐔𝐓𝐈𝐍𝐈𝐄𝐑 – Whether after a training session, a match or a hard day work: The Wellax acupuncture mat is the ideal support for releasing daily tension. Pure relaxation for body and soul!

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Lumbar belt heated
GINEKOO Heated Back Belt, Breathable Back Belt with Rechargeable Battery Heating to Relieve Lower Back Pain, Lumbar Support for Herniated Discs, Sciatica(XL)
  • 【Powerful 360° Support】With 4 stainless steel supports and 2 steel springs placed along the waist, the back brace for heavy lifting provides strong 360° vertical support for the lower back and allows for optimal decompression of the spine, thereby preventing back injuries caused by lifting dumbbells, prolonged standing or sitting, household chores and work.
  • 【Relieve Pain】The ergonomic back support provides strong support for the lower back and abdominal muscles, increasing pressure around the waist to prevent fatigue, strain and other back-related injuries. Relieve waist muscles, herniated discs, sciatica, scoliosis, etc. when wearing the back support belt.
  • 【3 Heating Modes】The back brace for lower back pain contains a heating pillow fixed by Velcro, which you can easily operate via the controller. There are 3 heating settings (low, medium, high) that allow you to adjust the temperature as needed to promote blood circulation and relieve back pain.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Ergonomic back cushion
Car Lumbar Cushion for Back Back Support for Office and Car Chairs, Ergonomic for Back Seat
  • ✨Premium Material: Our lumbar support cushion is filled with new temperature sensitive sponge, the lumbar support can adjust the contour of your back according to the temperature. The outer layer of lumbar cushion is made of high quality breathable fabric. The back support cushion fabric is comfortable and soft, not easy to fade. The parts of the lumbar cushion have been certified and are safe and harmless to human health.
  • ✨High-quality design: The back support cushion for chair is ergonomic, and the pillow for back pain has a partitioned design, the memory foam back cushion can support your back curve and promote healthy posture. The lumbar support cushion for chair uses elastic straps to keep the lumbar support cushion for sofa firmly fixed on the seat.
  • ✨Protect your health: With our car back support, you can better protect your spine, car back support office chair Helps relieve lower and middle back tension caused by prolonged sitting or driving. If you often experience back pain due to prolonged sitting, you should definitely try an office chair back cushion.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

massage gun
Muscle Massage Gun ALDOM Deep Muscle Massager Massage Device with 30 Adjustable Levels, 6 Massage Heads and LCD Display for Relieving Muscle Aches and Stiffness
  • DEEP TISSUE MASSAGE GUN – ALDOM Muscle Massage Gun for Athletes is ideal for relieving muscle pain, soreness and stiffness, promoting blood circulation and helps speed up warm-up and cool-down. It also helps restore the body faster and can be used as your percussion massager at the gym or sports club, is held with one hand and has a comfortable handle.
  • 6 MASSAGE HEADS + 30 SPEED - The deep tissue massage gun comes with 6 different massage heads to help relieve sore muscles, 30 adjustable speed modes, Choose the speed and massage heads that best suits your needs. your needs (1 to 800 pulses per minute) to target different body parts and muscle groups, Integrate a percussive massage experience. Reduce muscle recovery time.
  • SUPER QUIET AND POWERFUL MASSAGE GUN - Professional handheld percussion massager. Featuring a powerful, high-penetration motor, the deep tissue massager is designed to send waves of relaxation and relief throughout the body, and increase everyday mobility and flexibility with percussive therapy for pain relief joints and muscle pain and prolongs the duration of muscle massage
BURNNOVE Muscle Massage Gun 99 Adjustable Speeds Massage Gun Electric Deep Muscle Massager Portable 8 Heads 2550mAh 3300 RPM LED Touch Screen Low Noise Relieve Pain
  • 💪RELIEVE MUSCLE PAIN – Our massage gun can help relieve tight muscles, aches and stiff backs, relaxes tender tissues. The deep muscle massager quickly removes lactic acid produced after exercise, significantly reducing muscle recovery time.
  • 💪8 MASSAGE HEADS + 99 SPEEDS – The powerful massage gun contains multiple easy-to-replace massage heads that can care for different body parts and muscle groups. The 99 speed adjustment parameters allow you to better choose the vibration speed to reach you the most comfortable state.
  • 💪LED TOUCH SCREEN – The muscle massage gun is equipped with an LED screen, which can display the speed and battery percentage. You can increase or decrease the speed of the electric massager by simply pressing the "+" or "-" button, and it can be adjusted quickly with a long press, which is easy and convenient to use.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Natural products

Like accessories and anti-back pain products, natural products and grandmother's remedies are very popular with people suffering from back pain.

Often, these remedies include anti-inflammatory properties to relieve various body pains.

On the other hand, it should be noted that most of these natural products are not scientifically proven. It is therefore important to speak to your doctor before using them, particularly to avoid any interaction with your medications.

Natural remedies that may relieve symptoms include (click on the product you are interested in for purchasing options):

Turmeric

Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.

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Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Ginger

In addition to the particular flavor it brings to cooking and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. THE gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).

Ginger Foot Patches, Pack of 30 Ginger Detox Patches, Anti Swelling Ginger Detox Patch, Foot Detox Patch for Deep Cleansing, Improve Sleep
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Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Omega-3

Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove to be very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Since sciatica is most often linked to inflammation secondary to a herniated disc, it can also respond to omega-3s if you consume them regularly. 

Omega 3 Wild Fish Oil 2000mg – 240 Capsules (120 Days) – High Concentration of EPA (660mg) & DHA (440mg) Supports Heart Function and Normal Vision – Manufactured by Nutravita
  • ✔ WHY NUTRAVITA OMEGA 3 FISH OIL? – Our omega 3 comes naturally from the rich waters of the Peruvian coast. The oils are then distilled for increased purity to provide the highest levels of contaminant-free acids – EPA and DHA, removing metals, PCBs and other toxins. 2 capsules daily, our supplement provides a maximum strength of 660 mg EPA and 440 mg DHA. 240 capsules per bottle for a 4 month supply.
  • ✔ WHY OMEGA 3? Each recommended daily dose of our premium Omega 3 fish oil supplement provides high-potency essential fatty acids – Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) which both help support various functions bodily, especially in the normal functioning of the heart. DHA supports the maintenance of normal brain function and normal vision. All these claims are supported by EFSA
  • ✔ WHAT INGREDIENTS ARE USED AT NUTRAVITA? – We have a dedicated team of pharmacologists, chemists and researchers who work to find the finest and most beneficial ingredients, allowing us to provide advanced, high strength vitamins and supplements that do not contain dyes or flavorings artificial. From *fish* which may NOT be suitable for people with allergies. The soft capsule is made from (bovine) gelatin.

Last updated on 2024-06-17 / Affiliate links / Images from the Amazon Partners API

Lemon eucalyptus

Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.

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Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

wintergreen

Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the essential oils most used in aromatherapy. This oil, extracted from the shrub of the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

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Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

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