Massage therapy · Kitchener–WaterlooDisc Herniation

The vertebrae connect to create a canal that shields and protects the spinal cord. The spine has three main sections, which create natural curves in your back: the neck (cervical), the chest area (thoracic) and the lower back (lumbar). The lowest part of the spine is made of vertebrae fused together (sacrum and coccyx). Every spine should have natural curves in it. The backward curve in your lower back is known as lordosis. Your upper back curves forwards, and this is known as kyphosis, and in your neck the curve is backwards and again known as lordosis.

Spinal nerves travel along the spinal canal to carry messages between the muscles and the brain. The nerves branch out from the spinal cord through openings between the vertebrae.

Each disc has a soft, jelly-like centre (the nucleus) inside a tougher outer ring. A disc herniates when the jelly-like centre pushes against the outer ring. When the disc is injured or worn, the nucleus can squeeze its way completely through the ring (American Academy of Orthopaedic Surgeons, n.d.). If the bulging disc presses on a nerve, it causes pain (NHS, 2024). Because a disc herniation in the lower back often presses on nerves that lead to the leg and foot, such as the sciatic nerve, pain is often felt in the buttock and down the leg (sciatica) (NHS, 2024; American Academy of Orthopaedic Surgeons, n.d.). The condition often occurs when bending forwards, but also when lifting, or twisting while lifting (American Academy of Orthopaedic Surgeons, n.d.).

1. Keep Active

If the pain is very bad, you may need to rest at first, but you will get better more quickly if you gradually start doing gentle exercise, such as walking, swimming or yoga, as soon as you can. The type of exercise is not important, as long as it does not cause pain or make your back pain worse (NHS, 2024). Try not to stay in bed for long periods (NHS, 2026).

2. Medication

The NHS (2024) suggests trying anti-inflammatory painkillers such as ibuprofen to help ease the pain of a slipped disc, and the American Academy of Orthopaedic Surgeons (n.d.) also lists naproxen. These medicines are not suitable for everyone, so speak to a pharmacist if you are not sure whether you can take them (NHS, 2024). Paracetamol on its own is not recommended for back pain (NHS, 2026).

(This medicine information comes from the NHS and the American Academy of Orthopaedic Surgeons, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Options outside my scope

• MRI scan: a scan that may be arranged if your symptoms do not get better (NHS, 2024).
• Epidural steroid injection: an injection of local anaesthetic and steroid near the spinal nerves, which may be considered for severe sciatica that has recently started (National Institute for Health and Care Excellence, 2026; NHS, 2024).
• Surgery: not usually needed, but may be discussed if your symptoms have not improved with other treatments or you have worsening weakness or numbness (NHS, 2024; National Institute for Health and Care Excellence, 2026).

How I can help (see the My Approach tab)

If it's severe, with weakness in your leg or foot, or numbness or other nerve symptoms that are getting worse, see your family doctor or nurse practitioner first. Then I provide supportive care that fits their advice; after surgery, I need your surgeon's okay before any hands-on treatment. If no position eases your pain, I'll also ask you to see your doctor before we go on.

Numbness around your bottom or genitals, new bladder or bowel problems, or symptoms in both legs means no massage: call 911 or go to the emergency room.