Herniated disc treatment L5-S1 with 3 exercises to avoid surgery

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A herniated disc in your lower back is a well-known cause of lower back and leg pain. The prevalence of the injury is about 1 to 3%. It means that at any given point in time, 1-3% is suffering from a herniated disc.

It happens primarily between the age of 30-50.

And the L4-L5 and L5-S1 segments are the most common.

Remember that a herniated disc is only a problem when you suffer from radiating pain in your lower leg.

A herniated disc rarely causes only back pain.

Luckily, most of these herniated discs are treatable without surgery. You have to do the right things.

And that is what I will teach you today.

First, I’ll show you some common myths about herniated discs.

After that, I’ll show you the anatomy of your lower back to show you what is causing the problems. It makes it easier to understand the cause and treatment of your herniated disc.

Then I tell you precisely what to do and also what not to do.

Finally, I’ll show you the procedure for a herniated disc surgery. Unfortunately, this is sometimes necessary.

For fast pain relief, you can wear a back brace to reduce pressure on your back, the disc and the nerve. It will help you to do the exercises you need to do to recover.

So keep reading:

Common herniated disc myths
What is a herniated disc?
What causes a herniated disc?
What are the symptoms of a herniated disc?
Herniated disc treatment with three exercises
Herniated disc exercises and activities to avoid
Herniated disc surgery treatment

Common herniated disc myths

Unfortunately, there are still some myths and beliefs about herniated discs that are not true.

Many people believe that a herniated disc can’t heal on it’s one. But research shows that about 80% of people with a herniated disc recover entirely within three months.

You can see this in the picture below.

herniated disc

As you can see, the two herniated discs on the left picture disappeared at the right image.

Als, MRI findings don’t predict symptoms. I will tell you more about this later in this post.

A herniated disc is a common MRI finding, but it is only relevant if you also feel radiating pain in your lower leg. If this is not the case, then the MRI finding very likely is not the cause of your back pain.

Furthermore, a herniated disc doesn’t cause paralysis.

Now it’s time to start healing the radiating pain and teach you the right things to do.

What is a herniated disc?

Your lower back consists of 5 vertebrae. We call them lumbar 1 -5.  Between these vertebrae lies a discus or intervertebral disc. It results in a lumbar disc between L1-L2 to L5-S1, which is the last lumbar intervertebral disc.

So let’s start with the anatomy of your lower back.

The intervertebral disc consist of 2 parts:

 

    • The nucleus pulposus
    • The annulus fibrosus

 

The nucleus pulposus is the inner layer, and the annulus fibrosis is the outer layer.

The nucleus pulposus is a gel-like substance that can move freely within the annulus fibrosus.

The annulus fibrosus is the hard outer layer of the intervertebral disc.

Due to different reasons, sometimes the annulus fibrosus weakens. When this happens, the nucleus pulposus starts to push the annulus fibrosis into the vertebral canal.

When this happens, we speak of a bulging disc or disc protrusion. It is a pre-stage of a herniated disc.

When you don’t treat it the right way, the outer layer of the intervertebral disc can rupture completely. It results in a herniated disc.

Now it enters the intervertebral foramen. These are the holes you can see in the picture. It results in compression of the nerve leaving the back on that level. The nerve runs through the intervertebral foramen.

It can also cause an inflammatory reaction. The inflammatory response happens because the nucleus pulposus never comes in contact with other parts of your body and is considered an intruder.

The most common levels for a herniated disc are the L4-L5 and L5-S1 levels. These levels receive the most pressure.

After the age of 60, it’s becoming less likely that a herniated disc or disc bulge will compress a nerve. At that age the disc no longer contains water. The lack of water makes the inner layer as hard as the outer layer so that it can’t move much anymore.

An MRI can show the presence of a herniated discus.

However, the findings on your MRI don’t have to cause your pain.

In a study done in 2014, they analyzed over 3000 people without back pain.

You can find the results here.

asymptomatic MRI findings

As you can see, a disc protrusion is pretty standard in people without back pain.

That is also a reason why you shouldn’t undergo surgery right away because it might just not be a problem. A disc protrusion on an MRI is only a problem when you also feel radiating pain in your lower leg.

What causes a herniated disc?

So the cause of a herniated disc is the rupturing of the outer layer of the intervertebral disc.

There are several causes for this to happen:

 

    • Natural degeneration of the intervertebral disc
    • Heavy work
    • Poor posture
    • Overweight
    • Weak back muscles

 

Degeneration of the intervertebral disc is a natural process.

Degeneration happens because your body produces fewer glycosaminoglycans as you get older. These are the water binding substance that keeps the intervertebral disc healthy. This process weakens the discus, making it vulnerable.

This degeneration can also lead to other forms of lower back pain, such as throwing out your back or back pain when bending.

Strong back muscles can reduce the pressure on the disc preventing the herniated disc from happening. It makes weak back muscles in old age a risk factor for a herniated disc.

When you combine this with heavy work and a poor posture, it can eventually result in a herniated disc.

What are the symptoms of a herniated disc?

A herniated disc can appear both slowly or suddenly.

When symptoms slowly start to develop, you suffer from a bulging disc as mentioned before.

The symptoms are as follows:

 

    • Nagging back pain
    • Radiating pain in the back of your leg not further than your knee
    • The radiation and distress increases with bending and lifting
    • It reduces in an erect and lying position

 

When the bulging disc develops into a hernia, you will notice an increase in back pain and also start to feel pain in your leg. The radiation now goes down to your foot.

The radiation happens because the compression on the nerve can cause an inflammatory reaction of the nerve because of the damage or to remove the pressure of the disc.

You may also experience:

 

    • Weakness in your leg
    • Possible shooting pain in your leg during coughing or sneezing
    • Loss of sensation in your leg

 

If you experience the following symptoms you should consult a doctor as soon as possible:

 

    • Loss of feeling in your thighs on both sides
    • Loss of bowel and bladder control
    • Difficulty walking

 

These symptoms may indicate a severe condition in your lower back which could lead to lifelong problems if not treated quickly.

Sitting, bending and lifting also aggravate the pain and symptoms of a hernia.

Walking and lying down will reduce symptoms.

These symptoms sometimes look like piriformis syndrome.

Herniated disc treatment with three exercises

So when you suffer from a herniated disc, you would want to do something about it. Surgery is usually not the first thing you want to do.

Instead, you would want to treat your herniated disc with exercises. And in many cases, this is very well possible.

Research even suggests that after a year in about 90% of the cases, there was no difference between surgical and nonsurgical treatment in terms of effect. Both recovered equally.

That’s why I will show you the three exercises that can help you to treat your herniated disc without surgery.

I’ll also tell you what to do and what not to do in terms of activities.

So let’s start.

As you already know, compression of the nerve in your back causes your pain. This compression causes inflammation of the nerve, which causes the pain in your leg.

To reduce the pain, you want to reduce the inflammation. You can do this by applying anti-inflammatory creme like this one. You can use it directly to the skin in your lower back to reduce the pain in your leg.

You also want to reduce the pressure on the intervertebral disc. Bending forward usually increases the radiating pain in your leg, which slows down your recovery. So this is something you would want to avoid until the disc repairs, and you’re free of symptoms. Then it is oke to bend and do everything as you did before.

Also, lifting heavy weights will increase the radiation. The pressure on the intervertebral disc causes this — the load results in flattening of the discus. If the discus is still intact, this is not a problem. But when the discus breaks, this will increase the pressure on the nerve.

If you need heavy lifting for your work, or when you have small children, then you can wear this back brace. It reduces the pressure on your back and the nerves resulting in less pain.

What you want to do instead are exercises that reduce the pain in your leg. Usually, this is possible by bending backward. The first exercise will teach you how to do this.

But remember, if any other activity or exercise reduces radiating pain, then you should do this instead.

Herniated disc exercise 1: Reduce the radiating leg pain

The first thing you have to do is to try to reduce the radiating pain. You can do this by stretching your back backward as far as possible. It is called extending your back.

You can do this in two ways: While standing or while lying in a prone position. I’ll discuss the one in when you stand because that’s the easiest one for most people.

Perform the exercise like this:

 

    • Place your index fingers on the painful spot in your back
    • Apply pressure in a forward direction
    • Now bend all the way backward
    • Make sure also to extend your neck for maximum result
    • Hold this position for 3 seconds
    • Repeat this ten times

 

You can also see how to perform the exercise in the video below:

Make sure that you perform this exercise several times a day. It’s especially important to complete the activity every time you’ve to bend forward or lifted something.

When you’ve performed the exercise, you will notice that the radiation in your leg reduces and sometimes even totally disappears.

It is what you want to achieve.

When you feel the radiation coming back into your leg, it’s time to do the exercise again. You want to keep the radiation away so that the intervertebral disc has time to recover.

You can also use this back stretcher to reduce the pressure on your nerves. It does the same as the exercise but it easier to do for some people.

Herniated disc exercise 2: Increase lower back stability

The second exercise is designed to reduce the pressure on your lower back and the affected disc. We will do that by training the little muscles around your back.

The increased stability will also reduce the pressure on the disc. The muscles will take over some of the weight, which helps the disc.

You can perform this exercise in the following way:

 

  • Lay down on your back
  • Bend your knees
  • Cross your arms over your chest
  • Now lift your pelvis
  • Hold this position for 10 seconds
  • You can increase the difficulty by extending one leg and keep it slightly above the ground

 

You can also see how to perform the exercise in the video below:

Try to perform this exercise 2 times a day. Also, try to increase the time you hold your pelvis up to 15 or 20 seconds.

Herniated disc exercise 3: Lower back muscle training

The third exercise you should perform is designed to increase the strength of your big back muscles.

Because of the pain in your back, muscles tend to get weaker. Also, stronger back muscles will reduce the pressure on the disc.

You will notice that this exercise is pretty heavy. Therefore you’ll have to see if you can already perform this exercise or that you have to stick with just the other two first. When it causes more radiation in your leg, you should wait with this exercise.

Perform the exercise like this:

 

    • Lay down on the ground with your face facing the floor
    • Place your arms in front of you with your elbows bent
    • Now lift both your arms and your upper body
    • Keep your feet on the ground
    • Repeat this ten times
back strengthening exercises

Try to increase the number of repetitions to 15 or even 20 and repeat it three times.

Perform this exercise 2 times a day.

As you might know, the recovery of your herniated disc can take several months.

It means that you have to be patient and continue the exercises as long as it takes.

Sometimes, however, you can not fully recover by only doing the exercises. That is why I will also go through the surgical procedure of a hernia.

I will also discuss the risks and recovery after.

Herniated disc exercises and activities to avoid

Together with these exercises, that will help you to recover from your herniated disc without surgery; there are also a few exercises that you want to avoid.

These are exercises that push the inside of your disc even further out of the discus against your nerves, which increases the symptoms.

Usually, these exercises include bending forward or lifting heavy weights. These activities will increase the herniation.

Examples of exercises to avoid are:

 

    • Crunches
    • Deadlifts
    • Good morning
    • Squats
    • Shoulder press
    • Straight leg raise
    • Leg press
    • Twisting exercises

 

Avoid these exercises and instead perform the activities I’ve described earlier to cure your herniated disc.

Along with a few exercises that you should avoid, there are also some activities that you have to avoid due to the same reasons.

Unsurprisingly these activities include the same movements as the exercises above do. It means that you should avoid all activities that involve bending or twisting your back.

I would also recommend not to lift any heavy stuff as this will cause more compression in your lower back.

If that doesn’t help within six months, you might need surgery. But this is only a last resort.

Herniated disc surgery treatment

Surgery for a herniated disc should only be a last resort.

Only when your pain is unbearable or if you’re recovery was unsuccessful with the exercises, you should consider surgery for your herniated disc.

The procedure

What the doctor will do during your surgery is that he or she will remove the herniation by cutting away the part of the nucleus pulposus that pushes against the nerve.

The surgeon performs the procedure under general anesthesia.

Now the surgeon will make a small incision at the place of your herniated disc usually a few inches big.

After that, he will pull away the muscles to clear the way towards your vertebral column.

After this, the surgeon will remove the herniation from your disc. Sometimes he will even replace the discus completely.

Finally, the doctor stitches the incision. All together is usually will take about 45 minutes.

Depending on the procedure, you may leave the hospital on the same day or after a few days.

After the procedure

Most of the pain disappears after the surgery. Also, most loss of power in your leg should be solved.

What you still can feel is radiation and some numbness in your leg. The damage to your nerve that still has to be repaired by the body in the following months causes this radiation.

The first day after surgery, the physical therapist will instruct you what you can and can’t do the first few weeks.

The first two weeks, the following movements are prohibited:

 

    • Sitting for a long period
    • Bending
    • Rotation of your upper body

 

The two things you should do is combining walking and lying down.

After two weeks, you can start rebuilding the strength and stability of your back.

Conclusion

As you can see, there are more options for herniated disc recovery than just surgery.

If you still have any question, feel free to send me an e-mail at [email protected]

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