Uploaded February 2017 | Updated September 2026, 1 day ago
Lumbar Spine Disc Herniations - What are they? How are they treated? Our orthopaedic physiotherapists provide answers.
Video Transcript: What Is A Lumbar Disc Herniation?
You have been told that you have a low back disc herniation or bulge and you are understandably concerned about what this means for your health going forward. Here at cornerstone we have put this video together to give you the information you need to understand what is happening and to point you in the right direction to manage the problem.
Incidence
Who Gets Disc Herniations?
At any given time between 1 and 3 percent of the population is dealing with a symptomatic lumbar disc herniation. Twice as many men are affected as women and most are between 30 and 50 years of age. The vast majority of lumbar herniations occur in the bottom two discs of the spine.
Up to 3% of people
Men more than Women
Usually lowest 2 discs
Anatomy and Physiology
Lumbar discs are interesting structures that help aid shock absorption and mobility of the spine.
They have a tough outer layer called the annulus and a softer and more fluid centre called the nucleus. A disc bulge occurs when the nucleus is working its way through the layers of the annulus but has not yet broken out of the disc
A herniation occurs when the inner nucleus breaks through the outer annulus and is released from the disc
Symptoms
Disc herniation and bulges present with a wide variety of symptoms. In fact, many herniation and bulges have no symptoms at all.
This is why we can often find them on an MRI in people who were totally unaware of the condition. However, for people who do experience symptoms they may include low back pain, leg pain, leg weakness, numbness and/or tingling. (recite these bullet points with 1 sec pauses between each)
Symptoms:
Low back pain
Leg pain
Leg weakness
Numbness +/- tingling
Symptoms that are more serious include numbness of the genitalia and surrounding area and changes in bowel or bladder function. If any of those symptoms occur it is important to be examined by an orthopaedic physician as soon as possible to ensure that the problem is managed appropriately.
And while the symptoms of a herniation can be severe and disabling, in the vast majority of cases the problem can be managed with the help of an experienced Physiotherapist.
Causes
For many people herniations and bulges are a part of the degenerative – or arthritic – process that a lumbar spine goes through over time. So many are caused by a combination of factors including wear and tear on the joints and genetic factors.
Disc herniations and bulges may also be caused by trauma. Typically, a movement involving low back flexion, or forward bending coupled with some rotation is the culprit. Think of the movement you would do to lift a shovelful of snow and throw it, or the bending and turning involved in helping a small child into a car seat. Disc pressure increases when your back is flexed and the outer annulus is weaker when your spine is rotated.
Treatment
The specifics of a treatment plan depend a great deal on the details of a comprehensive clinical examination. An experienced Physiotherapist will be able to assess your problem and develop a plan to reduce pain, improve mobility and return you to your usual activities. Only a very small percentage of people with disc herniations or bulges cannot be managed effectively with Physiotherapy.
Your treatment should be active. This means that you will need to patriciate in the form of exercises, and modifications to posture and activities. Your Physiotherapist may also suggest some hands-on treatment to help you to restore your mobility and relieve pain. Passive treatments, like ultrasound, laser or electrotherapy are not particularly valuable in the treatment of this problem. In short….if you are not working…..it is not working!
Prognosis
Once again, the vast majority of people who suffer from a disc herniation or bulge will recover. However, the condition does have a tendency to recur.
Your Physiotherapist can help you not only recover from this episode of back pain but can be a wealth of knowledge on how you can prevent further episodes. When your therapy is complete you should have a plan for managing the problem that includes lifestyle modifications, strength and mobility exercises.
Physiotherapy at Cornerstone
At Cornerstone Physiotherapy in Toronto we have treated thousands of people with disc bulges and herniations. Our Physiotherapists have specialized training to evaluate, accurately diagnose and treat patients with this problem and other causes of spinal pain. If you are suffering from a back problem, come and see us, we would be happy to help.
Lumbar Spine Disc Herniations - What are they? How are they treated? Our orthopaedic physiotherapists provide answers.
Video Transcript: What Is A Lumbar Disc Herniation?
You have been told that you have a low back disc herniation or bulge and you are understandably concerned about what this means for your health going forward. Here at cornerstone we have put this video together to give you the information you need to understand what is happening and to point you in the right direction to manage the problem.
Incidence
Who Gets Disc Herniations?
At any given time between 1 and 3 percent of the population is dealing with a symptomatic lumbar disc herniation. Twice as many men are affected as women and most are between 30 and 50 years of age. The vast majority of lumbar herniations occur in the bottom two discs of the spine.
Up to 3% of people
Men more than Women
Usually lowest 2 discs
Anatomy and Physiology
Lumbar discs are interesting structures that help aid shock absorption and mobility of the spine.
They have a tough outer layer called the annulus and a softer and more fluid centre called the nucleus. A disc bulge occurs when the nucleus is working its way through the layers of the annulus but has not yet broken out of the disc
A herniation occurs when the inner nucleus breaks through the outer annulus and is released from the disc
Symptoms
Disc herniation and bulges present with a wide variety of symptoms. In fact, many herniation and bulges have no symptoms at all.
This is why we can often find them on an MRI in people who were totally unaware of the condition. However, for people who do experience symptoms they may include low back pain, leg pain, leg weakness, numbness and/or tingling. (recite these bullet points with 1 sec pauses between each)
Symptoms:
Low back pain
Leg pain
Leg weakness
Numbness +/- tingling
Symptoms that are more serious include numbness of the genitalia and surrounding area and changes in bowel or bladder function. If any of those symptoms occur it is important to be examined by an orthopaedic physician as soon as possible to ensure that the problem is managed appropriately.
And while the symptoms of a herniation can be severe and disabling, in the vast majority of cases the problem can be managed with the help of an experienced Physiotherapist.
Causes
For many people herniations and bulges are a part of the degenerative – or arthritic – process that a lumbar spine goes through over time. So many are caused by a combination of factors including wear and tear on the joints and genetic factors.
Disc herniations and bulges may also be caused by trauma. Typically, a movement involving low back flexion, or forward bending coupled with some rotation is the culprit. Think of the movement you would do to lift a shovelful of snow and throw it, or the bending and turning involved in helping a small child into a car seat. Disc pressure increases when your back is flexed and the outer annulus is weaker when your spine is rotated.
Treatment
The specifics of a treatment plan depend a great deal on the details of a comprehensive clinical examination. An experienced Physiotherapist will be able to assess your problem and develop a plan to reduce pain, improve mobility and return you to your usual activities. Only a very small percentage of people with disc herniations or bulges cannot be managed effectively with Physiotherapy.
Your treatment should be active. This means that you will need to patriciate in the form of exercises, and modifications to posture and activities. Your Physiotherapist may also suggest some hands-on treatment to help you to restore your mobility and relieve pain. Passive treatments, like ultrasound, laser or electrotherapy are not particularly valuable in the treatment of this problem. In short….if you are not working…..it is not working!
Prognosis
Once again, the vast majority of people who suffer from a disc herniation or bulge will recover. However, the condition does have a tendency to recur.
Your Physiotherapist can help you not only recover from this episode of back pain but can be a wealth of knowledge on how you can prevent further episodes. When your therapy is complete you should have a plan for managing the problem that includes lifestyle modifications, strength and mobility exercises.
Physiotherapy at Cornerstone
At Cornerstone Physiotherapy in Toronto we have treated thousands of people with disc bulges and herniations. Our Physiotherapists have specialized training to evaluate, accurately diagnose and treat patients with this problem and other causes of spinal pain. If you are suffering from a back problem, come and see us, we would be happy to help.
