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How to Deal with a Herniated Disc

Learn what a herniated disc is and how to treat it from physical therapist Eric Sampson in this Howcast video.


Herniated discs are a very common disorder that we are finding in the clinic. It can vary in terms of the intensity and it can vary in terms of where the symptoms are located. I think the first part of this is to try to understand what the disc is or where it is.

As you can see on the model, the discs are sitting right along your spine from the top to the bottom and as you can see they're running in between your vertebrae, sort of right through here. There is a clear one, and a clear one, and a clear one and obviously down here in the lumbar spine they are a little bit thicker. The disc is a two-part structure. It has a nucleus on the center. It has whats called your annulus, which are your rings, your [cartiliginous] rings, holding the nucleus in. Think of a water balloon or think of a jelly doughnut. That's what usually we refer to when we're trying to explain what it is.

And like a water balloon or a jelly doughnut, if you squeeze on one end of that water balloon or jelly doughnut too much it squirts or protrudes out the other side. If I squeeze over here it's going to bulge or protrude out this way.

So when we talk about a herniated disc, the first step is this sort of protrusion or bulging of the nucleus sort of out towards the annulus and pressing up against the annulus. Sort of distorting the shape of the annulus causing some mechanical pain. If it continues to go on and this pressure continues to build eventually the annulus will tear or rip and the nucleus can then now seep out of it's space and that is what we call a herniated disc.

It's an advanced version of a protruded or bulging disc and the symptoms can vary quite a bit. It can vary from back pain in the middle or on one side or the other, or it can refer or radiate down into the buttock or down into the leg or lower leg and even into the foot. There could be pain and also numbness and tingling, pins and needles, and in terrible conditions you can have some weakness. Now weakness can only occur if there is a tremendous amount of pressure on the nerve root or a sustained pressure on that nerve root for entirely too long creating the weakness. The symptoms will begin to travel or peripheralize and it can get more intense in nature.

The steps in order to recover from a herniated disc can be tricky. My advise is always to seek out a clinician whose dealt with these kinds of problems but even before then if it's time constraints or it hurts too much the best solution is probably to lie down on your stomach, maybe put a pillow underneath your pelvis to support it and eventually take that pillow away and try to lie flat on your stomach. That's going to enable the nucleus to start it's progression or start it's migration back into it's space, back to where it belongs.

The symptoms can start to get a little bit better with that but more importantly mechanically I think the the disc will be helped and then eventually you're going to move on to see a clinician and they can help you further. If it's a very complicated problem and the symptoms can range quite a bit so it usually requires at that point a skilled clinician to help you out.

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