Each disc between the vertebrae has a firm outer ring and a softer centre. A herniation is where the softer material pushes through or bulges against the outer ring, sometimes pressing on a nearby nerve root. Most herniations settle without surgery, and the majority of people improve with conservative treatment.

What it feels like

• Back or neck pain that may be severe at first and eases over the following weeks
• Pain travelling into the leg or the arm, often further than the pain in the spine itself
• Pins and needles, numbness or weakness following the path of one nerve
• Worse with sitting, bending forward, coughing or sneezing, in the lower back
• A strong preference for certain positions — standing, lying, or leaning a particular way
• Symptoms that move closer to the spine as things improve, which is a good sign

Common causes

• Age-related change in the disc, which makes the outer ring less able to contain the centre
• Lifting with a bent and twisted spine, particularly something heavier than expected
• Repeated bending and loading over time, rather than one single event
• Sustained sitting, including long drives
• Whiplash and other motor vehicle accident injuries, in the neck
• Often no single moment at all — many people cannot name what started it

How physiotherapy helps

Imaging findings and symptoms match each other poorly, and a disc seen on a scan is not necessarily the cause of your pain. Treatment is therefore built around how you respond to movement rather than around the picture. Treatment commonly includes:

• Directional exercises chosen because they move symptoms out of the limb and back toward the spine
• Spinal decompression and traction to reduce pressure on the disc and the nerve root
• Manual therapy to restore movement in the spine and hips
• Nerve mobility work so the nerve can glide normally again
• Progressive strengthening for the muscles that support the spine, once symptoms allow
• Practical advice on sitting, lifting, driving and sleeping, which often matters more than any one exercise

If your main symptom is pain travelling down the back of one leg, see our page on sciatica treatment.

What to expect at your first visit

Your physiotherapist takes a history, tests your movement, strength, reflexes and sensation, and works out which level is likely involved and whether a nerve is affected. They will explain what they have found, including whether anything needs medical review first, and agree a plan with you. Most people begin treatment in the same appointment.

When to see a doctor instead

Go to an emergency department rather than booking physiotherapy if you have numbness around the groin or inner thighs, loss of bladder or bowel control, or sudden severe weakness in both legs. These are rare but need urgent assessment. Also see your physician if symptoms followed a significant fall or accident, if weakness in a limb is getting worse rather than better, or if the pain comes with fever or unexplained weight loss.

Booking an appointment

You do not need a doctor’s referral to see a physiotherapist in Ontario. Some extended health plans ask for one before they will reimburse you, so it is worth checking your policy.

We are at 2600 Skymark Avenue, Building 3, Unit 102, Mississauga, open Monday to Friday 9:00 AM – 10:00 PM and Saturday and Sunday 9:00 AM – 7:00 PM, with free parking. See our fees or call 647-998-4727.

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This page is general information, not medical advice. An assessment with a registered physiotherapist is the way to find out what is causing your symptoms and what will help.