A herniated disc is one cause of low back or lumbar pain. It’s estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery—and conservative care such as physical therapy usually gets better results than surgery.

Your spine is made up of 33 vertebrae (bones) that are stacked on top of one another. Between each vertebra is a cushion-like piece of cartilage called an “intervertebral disc.” Imagine the disc as a tire, with gelatin filling the hole in the tire. The rubbery outer part is called the “annulus,” and the gelatin is called the “nucleus.” When we’re young—under 30 years of age—the disk is made mostly of gelatin. As we age, we start to lose some of that gelatin. The disc becomes flatter and less flexible, making it easier to injure. In some cases, the gelatin can push out through a crack in the rubbery exterior and lead to a herniation (bulge) or rupture (tear).

Herniated discs are most common in the neck (cervical spine) and low back (lumbar spine). In the low back, disks may become damaged by excessive wear and tear or an injury.

Your physical therapist’s overall purpose is to help you continue to participate in your daily activities and life roles. The therapist will design a treatment program based on both the findings of the evaluation and your personal goals. Your treatment program most likely will include a combination of exercises.

Your therapist will design:

• Exercises that involve specific movements to relieve nerve pressure and decrease pain and other symptoms, especially during the early stages of treatment
• Stretching and flexibility exercises to improve mobility in the joints and the muscles of your spine, arms, and legs—improving motion in a joint can be key to pain relief
• Strengthening exercises—strong trunk muscles provide support for your spinal joints, and strong arm and leg muscles help take some of the workload off those joints
• Aerobic exercise, which has been proven to be helpful in relieving pain, promoting a healthy body weight, and improving overall strength and mobility—all important factors in managing a herniated disk

This might sound like a lot of exercise, but don’t worry: research shows that the more exercise you can handle, the quicker you’ll get rid of your pain and other symptoms.

Your physical therapist also might decide to use a combination of other treatments:

• Manual therapy to improve the mobility of stiff joints and tight muscles that may be contributing to your symptoms
• Posture and movement education to show you how to make small changes in how you sit, stand, bend, and lift—even in how you sleep—to help relieve your pain and help you manage your condition on your own
• Special pain treatments—such as ice, traction, and electrical stimulation—to reduce pain that is severe and not relieved by exercise or manual therapy

Once your pain is gone, it will be important for you to continue your new posture and movement habits to keep your back healthy.