Lumbar Disc Herniation

What is a Lumbar Disc Herniation?

A disc herniation occurs when the soft inner material of a spinal disc pushes out through its outer layer, sometimes irritating nearby nerves. This may cause localized back pain or sciatica (pain radiating into the leg).

Common Symptoms

• Low back pain

• Pain radiating into the buttock, thigh, or leg

• Numbness or tingling in the leg or foot

• Pain worsened by bending, coughing, or sitting

Physical Therapist Diagnosis

A PT uses history, posture assessment, neurological testing, and special tests such as the straight leg raise. Functional testing reveals movement limitations and compensations.

Why it Happens

Disc herniations may develop gradually from repetitive stress or suddenly from heavy lifting, twisting, or trauma.

Why it Doesn’t Always Heal on Its Own

Some herniations improve as inflammation subsides, but persistent nerve compression can cause lasting symptoms without rehab.

Ideal Physical Therapy Treatment

Rehab focuses on reducing nerve irritation, restoring spinal mobility, and improving stability. Dry needling may be used to reduce muscle spasm around the lumbar spine.

Key strategies include:

• Manual therapy for spinal and hip mobility

• Dry needling to decrease protective muscle guarding

• Core stabilization training

• Gradual strengthening of glutes and hips

• Education on movement and activity modification

Expected Outcomes

Many people improve with conservative care and avoid surgery. A smaller percentage may need surgical intervention, but PT is key both before and after.