Conditions We Treat
DISC INJURIES
At a glance
Spinal disc injuries range from disc bulges (the outer fibres protrude) to herniations (the inner gel pushes through), most commonly in the lower back or neck. Despite the alarming sound, most disc injuries heal with conservative care, combining manual therapy, targeted exercises, education and load management. Imaging often shows disc changes in pain-free people, so symptoms matter more than scans alone.
Few diagnoses cause as much anxiety as 'you have a disc problem.' Disc herniations, bulges and degenerative changes sound serious, and the fear of needing surgery or being permanently limited can be overwhelming. The reality is more reassuring than most people expect. Most disc injuries respond well to conservative care, and many improve significantly over time.
The intervertebral discs sit between each vertebra in the spine, acting as shock absorbers and allowing movement. A disc bulge occurs when the outer wall of the disc extends beyond its normal boundary. A herniation is more significant: the outer layer tears and the soft inner material pushes through, sometimes pressing on nearby spinal nerves. This is what causes radiating pain like sciatica (into the leg) or brachialgia (into the arm). Degenerative disc disease refers to the gradual loss of disc height and hydration that occurs naturally with age.
The evidence for conservative management of disc injuries is encouraging. A 2014 prospective cohort study found that the majority of patients with confirmed lumbar disc herniation reported meaningful improvement with chiropractic care. Repeat MRI research shows that many herniations shrink or reabsorb naturally over time. Surgery is typically reserved for cases with severe or progressive neurological deficits, such as significant muscle weakness or loss of bladder or bowel control.
One of the most important messages in modern spine care is that imaging findings often do not correlate with symptoms. A large 2015 systematic review found that disc bulges are present on MRI in 30% of 20-year-olds and over 80% of 80-year-olds, most of whom have no pain at all. This means that a disc finding on your scan does not necessarily explain your symptoms, and it certainly does not mean you are 'damaged' or fragile.
Treatment focuses on reducing pain and nerve irritation through spinal mobilisation and specific directional exercises, restoring normal movement patterns and progressively building the strength and endurance needed to support the spine. We also place great emphasis on education, helping you understand your condition so you can move with confidence rather than fear.
COMMON SYMPTOMS OF DISC INJURIES
- Sharp pain in the lower back or neck
- Pain radiating into the leg (sciatica) or arm
- Numbness or tingling in the limbs, hands or feet
- Pain that worsens with sitting, bending forward or coughing
- Muscle weakness in the affected leg or arm
- Stiffness in the spine, particularly in the morning
- Pain that eases when walking but worsens when seated
- Difficulty standing upright after bending
- A feeling of the back 'locking' or 'giving way'
- Gradual onset of back pain with increasing leg symptoms
Our approach to disc injuries combines hands-on treatment with progressive rehabilitation and thorough patient education. We focus on getting you moving confidently again rather than reinforcing fear about your diagnosis.
Located on Rivonia Road in Morningside, we serve patients from Sandton, Bryanston, Fourways, Randburg and surrounding areas.
Book an appointment at our Sandton practice and let us help you get back to moving well.
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Frequently Asked Questions
Yes. Chiropractic care is a widely used conservative option for most disc herniations. Treatment includes spinal mobilisation, nerve mobilisation techniques and progressive exercise. The majority of patients with lumbar disc herniation experience meaningful improvement with conservative care including spinal manipulative therapy.
A bulging disc involves the outer wall of the disc extending beyond its normal boundary, but the inner material stays contained. A herniated disc occurs when the outer wall tears and the inner gel-like material pushes through. Both can cause pain, but herniations are more likely to irritate nearby nerves and cause radiating symptoms like sciatica.
In most cases, no. The majority of disc herniations improve with conservative care. Surgery is typically only recommended for severe or progressive neurological deficits such as significant weakness, loss of bladder or bowel control or failure to improve after several months of appropriate treatment.
Yes. Repeat MRI studies show that many disc herniations reduce in size or reabsorb over time, and larger herniations tend to have higher rates of spontaneous resorption than smaller ones. However, this does not mean you should simply wait. Guided rehabilitation helps manage pain and prevents secondary problems during the healing process.
Yes, and in fact it is strongly encouraged. Current guidelines advise against prolonged rest for disc injuries, as staying active supports better outcomes. Controlled movement and specific exercises help reduce pain, improve function and support healing. We design exercise programmes appropriate for your stage of recovery and gradually increase the intensity as you improve.
References
- Leemann S, et al. Outcomes of acute and chronic patients with magnetic resonance imaging-confirmed symptomatic lumbar disc herniations receiving high-velocity, low-amplitude, spinal manipulative therapy. Journal of Manipulative and Physiological Therapeutics. 2014;37(3):155-163.
- Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology. 2015;36(4):811-816.