A herniated disc, also known as a herniated nucleus pulposus (HNP), is one of the most common causes of lower back pain. It occurs when the inner gel-like nucleus of an intervertebral disc pushes through the outer fibrous ring (annulus fibrosus), potentially irritating nearby nerves. This can lead to localized pain, nerve compression symptoms, and movement restrictions.
At Adaptive Physiotherapy & Massage in Booragoon, we take an evidence-based approach to managing herniated discs, focusing on pain relief, mobility restoration, and long-term strengthening. Our goal is to reduce symptoms and prevent recurrence through manual therapy, targeted rehabilitation exercises, and movement retraining.
What is a Herniated Disc?
The intervertebral discs act as shock absorbers between the vertebrae, allowing for flexibility, movement, and load distribution. Each disc consists of:
- Nucleus Pulposus – A soft, gel-like core that provides cushioning.
- Annulus Fibrosus – A tough, outer layer that contains the nucleus.
A herniated disc occurs when the nucleus pulposus protrudes through a weakened or damaged annulus, placing pressure on surrounding nerves or spinal structures.
Common Causes of a Herniated Disc
- Repetitive spinal loading (e.g., heavy lifting with poor technique).
- Prolonged sitting or poor posture, leading to disc compression.
- Sudden twisting or excessive spinal flexion, stressing the disc.
- Age-related degeneration, reducing disc hydration and elasticity.
Symptoms of a Herniated Disc
- Localized lower back pain, often worsened by movement or sitting.
- Radiating pain (sciatica) into the buttocks, thigh, or leg if nerve compression is present.
- Numbness, tingling, or weakness in the lower limbs.
- Pain relief when lying down but aggravation with bending or prolonged sitting.
At Adaptive Physiotherapy & Massage in Booragoon, we conduct detailed assessments to differentiate herniated disc pain from other lower back conditions such as facet joint dysfunction, sacroiliac joint dysfunction, or muscle strain.
Herniated Disc and Lower Back Pain
Herniated discs are a common cause of lower back pain, but not all cases lead to significant symptoms. Many people with mild disc bulges remain asymptomatic, while others experience debilitating nerve compression.
Key considerations:
- Disc herniation is a frequent MRI finding, even in asymptomatic individuals.
- Pain is often influenced by inflammation and nerve involvement rather than disc damage alone.
- Strength, mobility, and neuromuscular control play a crucial role in recovery.
Evidence-Based Treatment for Herniated Disc
Management focuses on reducing symptoms, restoring mobility, and strengthening spinal support muscles.
1. Initial Pain Management and Activity Modification
In the early stages, the priority is pain relief, inflammation reduction, and avoiding aggravating movements.
- Activity Modification:
- Avoid deep spinal flexion (e.g., prolonged sitting, bending forward under load).
- Reduce excessive twisting or high-impact activities until symptoms improve.
- Pain Reduction Strategies:
- Heat therapy (for muscle relaxation and circulation enhancement).
- Ice therapy (for nerve irritation and inflammation control).
- Anti-inflammatory approaches, including gentle mobility exercises.
2. Manual Therapy: Is It Recommended?
Manual therapy for herniated discs must be approached with caution. While direct manipulation is not always recommended, specific soft tissue and joint mobilization techniques can help reduce muscle guarding, improve movement quality, and promote circulation.
Recommended Manual Therapy Techniques
- Joint Mobilization (gentle, graded mobilizations to improve spinal segmental movement without excessive pressure).
- Soft Tissue Release (reducing tension in overactive muscles such as the erector spinae, quadratus lumborum, and hip flexors).
- Neural Mobilization Techniques (sciatic nerve glides to improve nerve mobility and reduce irritation).
What to Avoid?
- Forceful spinal manipulations (high-velocity adjustments can worsen symptoms in some cases).
- Direct deep pressure on the herniated disc area (can increase irritation rather than relieve pain).
At Adaptive Physiotherapy & Massage in Booragoon, we tailor manual therapy techniques to each individual’s presentation, ensuring safe and effective treatment.
3. Exercise Rehabilitation for Herniated Disc
A structured exercise program is essential to restore movement control, build spinal resilience, and prevent re-injury.
Phase 1: Core Activation & Stability
- Dead Bug Variations (low-load spinal stabilization without excessive flexion).
- Bird-Dog Exercise (promotes controlled spinal movement and core coordination).
- Pelvic Tilts & Lumbar Bracing (engages deep stabilizers such as the transversus abdominis and multifidus).
Phase 2: Strength Development
- Glute Bridges (reduces lumbar strain by engaging the posterior chain).
- Side Planks (improves lateral core stability and pelvic alignment).
- Hip Hinges & Modified Deadlifts (teaches proper load distribution to protect the spine).
Phase 3: Functional Strength & Mobility
- Squat Variations (emphasizes spinal control under load).
- Step-Ups with Core Activation (develops single-leg stability and reduces asymmetry).
- Kettlebell Swings (Late-Stage) (trains explosive hip power while maintaining a stable spine).
At Adaptive Physiotherapy & Massage in Booragoon, we progressively tailor rehab exercises to match individual needs, movement goals, and symptom response.
Return to Activity & Long-Term Prevention
Once symptoms improve, the focus shifts to progressive strengthening, movement retraining, and long-term prevention.
Key Strategies for Long-Term Back Health:
- Ongoing strength training (maintains spinal support and resilience).
- Postural awareness & ergonomic adjustments (reduces daily stress on the spine).
- Mobility drills & active recovery work (prevents stiffness and movement restrictions).
At Adaptive Physiotherapy & Massage in Booragoon, we ensure that rehabilitation programs transition seamlessly into sustainable movement practices to keep patients active, strong, and pain-free.
Conclusion
A herniated disc does not mean permanent disability. With targeted rehabilitation, movement retraining, and strength development, most individuals can return to pain-free activity without surgery.
At Adaptive Physiotherapy & Massage in Booragoon, we provide an evidence-based approach, integrating manual therapy, exercise rehabilitation, and postural education to help patients regain control over their spine health.
If you are experiencing disc-related lower back pain, contact Adaptive Physiotherapy & Massage in Booragoon today for a comprehensive rehabilitation plan tailored to your needs.
References
- McGill, S. M. (2016). Low Back Disorders: Evidence-Based Prevention and Rehabilitation.
- Adams, M. A., et al. (2013). “Biomechanics of the intervertebral disc and the etiology of herniation.” Spine Journal, 13(3), 317-329.
- Standaert, C. J., et al. (2008). “Evidence-informed management of chronic low back pain with disc involvement.” Physical Medicine & Rehabilitation Clinics of North America, 19(1), 163-185.
- Slater, D., et al. (2020). “Exercise therapy for disc-related back pain: A systematic review.” Journal of Orthopaedic & Sports Physical Therapy, 50(7), 369-382.
- Foster, N. E., et al. (2018). “Prevention and treatment of low back pain.” Lancet, 391(10137), 2368-2383.
