A bulging or herniated disc can sometimes contribute to back pain, leg pain, sciatica, numbness or weakness.
At Isis Chiropractic Centres, we assess your symptoms and neurological function, explain what may be contributing to the problem and discuss the treatment, rehabilitation or investigation options that may be appropriate.
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A disc problem in the lower back can cause back pain and, when a spinal nerve is irritated or compressed, symptoms such as sciatica, numbness, tingling or weakness in the leg.
However, finding a disc bulge or herniation on an MRI does not necessarily mean that it is causing your symptoms. Disc changes are common in people without back pain and become increasingly common with age. The important question is whether the findings on a scan correspond with your symptoms and clinical examination.
At Isis Chiropractic Centres, our first priority is therefore to understand what is causing your symptoms, rather than simply treating something seen on a scan.
Following an assessment, we will explain our findings and discuss appropriate treatment, rehabilitation or further investigation where needed.
Intervertebral discs sit between the vertebrae of the spine. Each disc has a softer central region, called the nucleus pulposus, surrounded by stronger outer layers of fibrous tissue, called the annulus fibrosus.
The discs help distribute loads through the spine while allowing movement between the vertebrae.
Like other structures in the body, discs change with age. These changes are not necessarily a sign of damage or disease and do not always cause pain.
Looking for local assessment and treatment for a disc problem? Find out more about disc herniation treatment in Milton Keynes, disc herniation treatment in Northampton or disc herniation treatment in Aylesbury.
A disc herniation occurs when disc material extends beyond the normal boundaries of the disc through a localised area of its outer layers.
You may also hear terms such as slipped disc, prolapsed disc, bulging disc or disc protrusion. These are sometimes used interchangeably, although they can describe different findings.
A disc bulge describes a relatively broad extension of disc tissue beyond its usual boundary. Bulging becomes increasingly common with age and does not necessarily cause symptoms.
A disc protrusion is a form of herniation in which disc material extends beyond the normal disc boundary in a more localised area. Other forms of herniation include disc extrusion, where disc material extends further through a defect in the outer disc.
The size or appearance of a herniation alone does not determine how much pain someone will experience.
Disc changes can develop gradually. Sometimes symptoms start after lifting, bending or another activity; in other cases, there is no obvious triggering event.
A disc herniation on an MRI is a finding, not automatically proof of what is causing your pain.
Disc bulges and herniations are also found on scans in people who have no symptoms. A scan therefore needs to be interpreted alongside your history and clinical examination.
Disc-related problems can present in different ways.
Some people primarily experience lower back pain. Others develop symptoms because disc material or associated inflammation irritates a spinal nerve root.
This can produce sciatica, with pain travelling into the buttock or leg, sometimes accompanied by numbness, tingling or muscle weakness.
Not all leg pain is sciatica. Pain can also be referred into the buttock or leg from structures in the lower back without a spinal nerve root being affected.
This is why establishing the likely source of the symptoms matters before deciding on treatment.
Read more about Sciatica: Symptoms, Causes & Treatment →
No. Disc abnormalities are frequently found in people who have no symptoms at all. Disc degeneration, bulging and protrusion become increasingly common with age and do not necessarily require treatment.
Even when a disc herniation is producing symptoms, surgery is not automatically necessary.
Conservative management is usually considered first when there is no cauda equina syndrome, significant progressive neurological deficit or another condition requiring urgent specialist treatment.
Many people improve over time with appropriate advice, activity modification and rehabilitation.
Treatment should therefore be based on the person and their symptoms, not simply the appearance of an MRI scan.
A thorough assessment is particularly important when symptoms include pain travelling into the leg, numbness, tingling or weakness.
At Isis Chiropractic Centres, assessment may include:
We also assess for warning signs that might indicate the need for urgent medical investigation or referral.
Following the examination, we explain our findings and discuss appropriate treatment, rehabilitation or further investigation where needed.
Back pain and sciatica can have several causes. Even when an MRI shows a disc bulge or herniation, it is important to establish whether that finding explains your symptoms.
Our clinicians in Milton Keynes, Northampton and Aylesbury can assess your symptoms, explain the findings and discuss appropriate treatment or rehabilitation options.
Not necessarily.
MRI can be useful when the results are likely to change how a condition is managed. However, routinely scanning everyone with back pain or sciatica is not recommended.
This is partly because disc abnormalities are common in people who have no symptoms.
Imaging may be appropriate where there are concerning neurological findings, suspicion of serious underlying disease, persistent symptoms where specialist intervention is being considered, or other circumstances in which the result would influence management.
An MRI can show discs and nerve-related structures in considerably greater detail than a conventional X-ray. X-rays do not directly demonstrate disc herniations or nerve-root compression.
Although Isis Chiropractic Centres has on-site X-ray facilities at all three clinics, we do not routinely recommend X-rays for uncomplicated back pain or sciatica.
If your assessment indicates that MRI or specialist investigation would be appropriate, we will explain why and discuss the next step.
Chiropractic care at Isis is not simply spinal manipulation.
Our approach is based on the individual patient’s symptoms, examination findings, neurological status and ability to move and function.
Depending on what we find, a programme of care may include:
The purpose of treatment is not to “put a disc back in”. That is not an accurate description of spinal manipulation or conservative treatment.
The aim is to manage symptoms, improve movement and function, and help patients return to normal activities.
This broader approach is consistent with NICE guidance for low-back pain with or without sciatica, which recommends considering manual therapy only as part of a treatment package that includes exercise.
Not everyone with a disc problem needs manipulation, and treatment decisions are made following assessment and discussion with the patient.
Not automatically.
The presence of a lumbar disc herniation does not, by itself, mean that spinal manipulation is inappropriate.
What matters is the clinical presentation of the individual patient.
Before considering manipulation, the chiropractor assesses the patient’s symptoms, neurological findings, severity and progression of the condition, medical history and any relevant imaging.
For appropriately selected patients, manipulation may be considered as one possible component of conservative care. In other cases, mobilisation, exercise, rehabilitation or referral may be more suitable.
Spinal manipulation is not suitable for every disc-related problem. Progressive neurological deficits, suspected cauda equina syndrome and other serious spinal conditions require medical assessment rather than routine manipulation.
Published research on manipulation for lumbar disc herniation has limitations. In particular, reliable estimates of uncommon but serious adverse events are difficult to establish.
We therefore consider the potential benefits, risks and alternatives with each patient before deciding whether a particular treatment is appropriate.
The important question is not simply “Is there a disc herniation?” but “Which treatments are appropriate and safe for this particular patient?”
Exercise and rehabilitation are important parts of managing many disc-related problems.
Initially, this may involve relatively simple movements and advice about maintaining normal activities as symptoms allow.
As symptoms improve, rehabilitation can progress towards mobility, strength, physical conditioning and the activities that matter to the individual patient.
Prolonged bed rest is generally discouraged. Patients are usually encouraged to remain active and gradually resume normal activities where possible.
At Isis, rehabilitation does not necessarily start after hands-on treatment has finished. It can form part of the management programme from the beginning.
The programme is adapted to the patient’s symptoms, neurological findings and progress rather than following the same set of exercises for everyone.
For some patients with persistent disc-related symptoms, we may discuss Intervertebral Differential Dynamics (IDD) Therapy as an additional treatment option.
IDD Therapy is a computer-controlled form of motorised spinal traction or decompression. It is different from spinal manipulation and may be considered alongside other conservative treatments.
However, research into motorised spinal decompression and traction has produced mixed results, and high-quality evidence demonstrating a consistent additional benefit over established conservative care remains limited.
IDD Therapy should therefore not be presented as a proven method of reversing a disc herniation or as a guaranteed alternative to surgery.
When discussing this treatment, we explain its proposed role, available evidence, limitations and suitability for the individual patient.
Learn more about IDD Therapy →
Symptoms from a lumbar disc herniation can improve considerably with time and appropriate conservative management. Many people do not require surgery.
In some cases, follow-up MRI scans show that herniated disc material has reduced in size or been partially reabsorbed.
However, improvement in symptoms does not always correspond directly with changes seen on imaging.
Recovery varies depending on the nature of the problem, neurological involvement, severity of symptoms, general health and individual circumstances.
We therefore monitor progress and adapt the management plan rather than promise a particular recovery time or scan outcome.
Most people presenting with a lumbar disc herniation do not automatically need surgery.
Specialist surgical assessment may be appropriate when non-surgical management has not adequately improved pain or function and imaging findings correspond with the patient’s symptoms.
In some circumstances, particularly when there is significant or progressive neurological weakness, earlier specialist assessment may be necessary.
Suspected cauda equina syndrome requires emergency medical assessment.
Our role is to recognise when conservative management is appropriate and when referral for further medical or surgical opinion is needed.
Most disc-related back pain and sciatica are not medical emergencies. However, certain symptoms can indicate serious pressure on the spinal nerves.
Go to A&E immediately if you develop:
These symptoms may indicate cauda equina syndrome or another serious neurological condition requiring immediate medical assessment.
New or worsening leg weakness without these emergency features also requires prompt medical assessment.
Back pain accompanied by fever, feeling seriously unwell, unexplained weight loss or other concerning symptoms should also be medically assessed.
Do not wait for a routine chiropractic appointment if you develop any of these warning signs.
If you have back pain or sciatica, or have been told that an MRI shows a disc bulge, protrusion or herniation, the first step is to establish whether the disc finding is relevant to your symptoms.
Our clinicians will assess your condition, explain what we find and discuss appropriate treatment, rehabilitation or further investigation.
Our Milton Keynes clinic provides assessment and treatment for disc-related back pain and sciatica, with on-site X-ray facilities, rehabilitation facilities and free parking.
For selected patients with persistent symptoms, IDD Therapy may also be discussed as part of a broader management programme.
Disc herniation treatment in Milton Keynes →
Our Northampton clinic provides assessment and treatment for disc-related back pain and sciatica, with on-site X-ray facilities, rehabilitation facilities and free parking.
Management may include appropriate manual therapy, exercise and rehabilitation. IDD Therapy may also be discussed for selected patients.
Disc herniation treatment in Northampton →
Our Aylesbury clinic provides assessment and treatment for disc-related back pain and sciatica, with on-site X-ray facilities and free patient parking.
Our approach is based on individual assessment and may include appropriate manual therapy, exercise, rehabilitation or referral where indicated.
Disc herniation treatment in Aylesbury →
Chiropractic care may be appropriate for some people with disc-related back pain or sciatica. Care at Isis is not limited to manipulation and may include advice, manual therapy, exercise and rehabilitation. Treatment is selected according to individual clinical findings.
A disc herniation is not automatically a contraindication to spinal manipulation. Whether manipulation is appropriate depends on the patient’s symptoms, neurological examination, risk factors and other clinical findings. It should not be used routinely for every disc problem.
No. A herniated disc is not simply a structure that can be pushed back into position. This is not an accurate explanation of how spinal manipulation works.
No. Disc abnormalities are common in people without pain. MRI findings need to be interpreted alongside the person’s symptoms and clinical examination.
Not necessarily. Conservative management is generally considered first when there is no cauda equina syndrome or serious progressive neurological deficit. Surgery may be considered in selected patients when symptoms and function do not improve sufficiently and imaging findings correspond with the clinical problem.
Yes. Many people experience substantial improvement without surgery. In some cases, herniated disc material also reduces in size over time. Recovery varies, and management should be guided by symptoms, neurological findings and progress.
Prolonged bed rest is generally discouraged. For most uncomplicated cases, continuing gentle movement and normal activities as tolerated is preferable, with temporary modifications where needed.
You do not need to know whether your symptoms are caused by a disc, joint or nerve before booking an assessment.
That is what the assessment is for.
Our clinicians in Milton Keynes, Northampton and Aylesbury will assess your symptoms, explain the findings and discuss the treatment, rehabilitation or investigation options that may be appropriate.
Whether you have persistent back pain, sciatica or an MRI showing a disc herniation, our team can help you understand your symptoms and discuss appropriate treatment and rehabilitation options.
Book an appointment or request a callback from our team.
Clinical content reviewed by Per Kleberg BSc, DC, FRCC – Chiropractor
Per Kleberg has more than 30 years of clinical experience and is registered with the General Chiropractic Council.
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