Sciatica, Herniated, Bulging, Slipping, Degenerating Discs, Pinched Nerve – How To Understand Causes and Fix Them Yourself
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Note: This article and all drawings and images are copyright and reprinted courtesy of Doctor Jolie Bookspan from the source site: http://www.DrBookspan.com.
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Dr. Bookspan’s research and methods to fix back pain are used by military and top spine centers around the world. These methods are so successful that Harvard School of Medicine clinicians named her “The St. Jude of the Joints.”
Don’t Worry – Disc pain and sciatica can stop quickly.
This article shows how to stop sources of the pain and damage, instead of masking with remedies or cutting back on things you enjoy. Then you no longer will get the pain and your discs can heal. You can go back to your life, better and more active than before.
People are often wrongly told that a disc injury is a difficult or long-term condition, to accept or “live with” pain and reduced activity, and given pain pills and anti-inflammatory drugs for long periods. News reports quote spine specialists saying that back pain is mysterious, or that no one knows why back pain occurs, or that it is weak muscles. These are not true (even if it sells a lot of products and newspapers). Disc injury and pain is usually simple to understand and simple to fix without surgery, drugs, repeated treatments, strange exercises, restrictions on impact activity, special beds, braces, or equipment.
I developed information to fix your discs in healthy ways through years of research in the lab, and put it here on my web site for benefit of the world. Much cost, time, and worry currently spent in medical treatments are unnecessary, and often unhealthful. It’s not health care if it’s not healthy.
Not all exercise is medicine.
Not all medicine is healthy. We change that. No health insurance needed.
Now go read this article – get better and the world will be better.
Note: If your lower back hurts during and/ or after long standing, walking, and running, and you feel better to sit or lean forward or bend over to touch your toes, start with my separate article to fix standing pain, then come back here later.
A Short Story of My Work Developing These Methods
(skip this if you want to go straight to fix pain with the article below this background story)
This information is not just copied from someone else who said it, or something I heard in a gym or in exercise science school. I am the scientist who researches what really happens. This info is what I found through years of work. I started lab research studies in the 1970s to find why standard back pain exercises and treatments didn’t work. I saw that injury rehab info was not being applied to how people move and live. I applied it. People got better. I had been taught the same as everyone else that discs can’t heal, but my work showed that was not so. When I worked on studies of the human body during immersion for combat swimmers, the experimental subjects, other docs, and others in the lab kept complaining about their back and I saw the treatments and exercises their PTs and docs gave them did not work or made them worse. I fixed them up so that I could continue my work, and because I care and knew from the evidence of my work you don’t have to live with pain. Their doctors started calling me (calling the lab actually, as I don’t have a phone) asking how I fixed them so well. They (and their physicians) started taking classes with me. In the 1980s, class participants asked me to write everything down for them. I was surprised. I thought they should have taken notes. I typed information sheets for them. More doctors came to me after taking my classes, saying they knew their standard Patient Handouts were ineffective exercises. They asked me to make handouts for their patients. 
I was surprised. Again. I thought they could do that themselves. I typed Patient Handout sheets for them. I kept collecting data like a good scientist, doing studies to test and retest methods, and develop better ones. When the internet came out, I sent handouts electronically, instead of photocopies. In the 1990s I typed everything in several training manuals that became books. One is Health & Fitness In Plain English – How To Be Happy, Healthy and Fit for the Rest of your Life. After two different publishers, the new THIRD edition of How To Be Happy, Healthy and Fit… eliminates wrong things previous publishers added over my objections. Another book is Fix Your Own Pain, with patient stories in every chapter showing why patients get better, or don’t, and why. Several more books of my life’s work tell how to make life pain free, stronger, and more fun. Each book is different. I have seen fitness and rehab myths and fads come and go, but these methods remain effective over time. More about me in Research. Limited Classes to train directly with me, and workshop certification by me through AFEM for top students.
Answers In A Nutshell
- Discs can heal. Sciatica can stop without medicines or surgery. It usually takes a week to stop pain if you use these methods right.
- Disc bulging, degeneration, herniation, and sciatica are not a “condition” or something that once you have, you have for life. It is an injury that, like a sprained ankle, usually comes from bad movement habits, and can heal. The term “disc disease” is a misnomer – a wrong and inaccurate term. It is not a disease, not caused by some germ or agent or aging that you can’t control. It is an injury that can heal and you can prevent from returning.
- Disc injury or sciatica are not the cause of the problem – they are the RESULT of what you are doing to injure the area – things you can fix yourself. Even when inflammation and immune response are identified, they are results, not causes. This article will show you how to understand and fix causes instead of using drugs and surgery for the results. Fixing results is like catching blood in a bucket instead of stopping the bleeding.
- You do not need to have surgery or extended medical treatments to relieve disc pain or sciatica.
- You do not need to give up impact activities like running or martial arts, give up weights, heavy occupational work, or other active things you love to do. You do not need to hold rigid position or one posture. Discs can heal, and the right healthy movement is part of that. This is different from doing sets and reps of exercises, then going back to injurious daily habits.
- You do not need special chairs, beds, devices, braces, potions, or gimmicks to “put you” into any specific position.
- Not all back pain and pain down the leg is from bad discs, even if your scans show bulging discs or other disc changes.
- Common medicines and prescription drugs can cause back and body pain. Un-needed treatments and surgeries are done – causing more pain and reduction in physical ability. Easy changes can stop the need for harmful medicines.
- This is not “alternative medicine.” This is standard of care, common sense sports medicine techniques, applied to real life – where you actually need it.
- This article explains all the above. Make sure you understand the concepts (many highlighted in green).
Discs Pain Is Not Mysterious
People do an astonishing number of things every day to degenerate their discs and push them out of place, bit by bit, and irritate and press on the sciatica area. You know you shouldn’t lift wrong, but you do – all day, every day – picking up socks, petting the dog, for laundry, trash, making the bed, looking in the refrigerator, and all the dozens of times you bend over things. You work bent over your desk or bench. You drive bent forward. If you work out, you probably lift weights bent over, do crunches and Pilates which are more bent forward flexion, stretch by bending forward touching your toes, do yoga bending over at the waist, do aerobic kicks and martial arts kicks with your back rounded and pelvis tilted under rather than neutral, bike rounding forward, then bend over to pick up your gym bag to go home.
No wonder your discs are getting banged up.
It’s not aging, but simple mechanics.
Some people think it is a good stretch to bend forward with weight hanging. Bending over may stretch muscles but also puts the leverage on the spine and off the muscles where it belongs, plus slowly shifts discs outward, eventually herniating them. Most people know that bending forward and sitting rounded or bent forward injure the discs. Yet they stand, bend, sit, and lift wrong many dozens of times a day, day after day, then compound the problem with conventional exercises and stretches that bend forward in the gym, yoga and Pilates class.
People may do special “back exercises,” hoping to fix the pain that results but not be aware that strong muscles will not automatically make you bend and lift properly to stop the source of the damage, or make up for all the things you do the rest of the day to hurt your discs. They wonder why they still get pain even though they take their medicine and “do their exercises.” Discs can heal quickly, but you never give them a chance because you spend so much time bending forward, which pushes the discs out to the back. Many people wind up in unnecessary surgery, or long term or recurring pain, not understanding why their physical therapy, pills, or yoga “didn’t work.”
What Are Discs?
Your own body weight from years of unhealthy injurious sitting, standing, and bending habits is enough to injure your discs as badly as a single accident.
Years of forward rounding squashes and degenerates your discs in front and pushes them outward toward the back. Like a water balloon, when you squeeze the disc in front, it bulges out toward the back. Much tougher than a water balloon, it takes years, while the discs eventually break down (degenerate) and push outward (herniate). Think of braces on your teeth. After years of pushing, things eventually move.
Chronic forward bending (flexion) also overstretches the muscles and long ligament down the back, which weakens the back, and makes more room for vertebral discs to protrude.
Left – normal disc between two vertebrae. Right – disc pushed backward (herniated) from years of bad forward bending. |
 Like pressing down on the front of a balloon, squeezing the disc in front bulges it in back. Chronic forward bending gradually pushes discs out. |
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Which Discs Herniate?
It used to be that the most common herniations were in the neck and lowest on the spine. At the neck, people often jut the chin and angulate the neck in unhealthy ways instead of neutral spine. The low back discs are the leverage point of bad bending, bad forward stretches in yoga, and bad sitting.
Now it is becoming common for middle back discs (thoracic) to be pushed outward, with all the sedentary people sitting rounded hours a day, day after day, year after year, and bike riders who compound their workouts with conventional (yet unhealthful) forward-bending abdominal exercises, Pilates, and crunches.
Why Does Pain Go Down One Leg or Arm or Around Your Torso? What Is Impingement and Sciatica?
It takes years of bad bending habits to make a disc start to break down (degenerate) or push a backward so that it finally bulges out of place. When the disc is damaged, that alone can hurt. If you are lucky, you will get this small warning sign – some small pain or pressure in the side or middle of your back and top of your hip.
By fixing your spine positioning to healthy daily habits
and doing some extension described later in this article, you can stop disc damage and pain and keep it from coming back.
If you let more time go by with damaging sitting and body positioning habits, the disc can begin to push outward, and press on nearby structures, like nerves. That is called impingement because the disc impinges on (presses against, or take up the space of) the nerve. That spreads more pain to other places. After years of damaging the disc, you may suddenly feel the pain shoot like electricity when bending wrong just one more time, or just reaching for something small, or sometimes, the disc is so ready to give out, you are just standing or sitting, thinking you have done nothing at all to bring on the sudden bolt of pain. It was years in coming and no mystery.
When a disc herniates enough, it can press on nerves that goes down your leg, sending pain down your leg. Pain may be down the back if the nerve that is pressed it that nerve that goes there, usually the sciatic nerve. Pain may go down the front if the disc presses the front nerves. Several of these nerves work both for feeling and movement of your leg. That means if you squeeze it, it will hurt and may also reduce the function of your leg. Pain may stay high in the torso if you have damaged your discs higher up.
Discs don’t usually protrude straight back. Their path is blocked by a long, tough, band running down the back of your discs called the posterior longitudinal ligament. That is good because that helps keep them in place and protects your spinal cord, which lies behind the discs. Since the disc can’t bulge straight back, if you keep pushing it out, it has to go somewhere and it squeezes out sideways. The long nerves going out of your spine to your body and legs are also on the side. When a disc bulges against these nerves, pain extends down one leg or around one side of your body.
Pain Down Your Arm
If you squash and push the discs in your neck with a forward head posture – letting your head tilt “chin-forward” instead of holding it up straight, the disc in your neck may herniate the same way as discs in your low back, and press on nerves that go to your arm, sending pain down your arm. For what to do to fix that, go to the article on
how to fix neck pain, bad cervical discs, and upper back and shoulder pain.
Sciatic Pain Not From Discs.
You can get back pain and pain down your leg even when scans show your discs are not involved. You can have pain down your arm and numb fingers with no neck discs involved.
Tightness.
Tight muscles in the shoulder, from years of rounding your upper back and keeping your neck hanging forward instead of more upright, and tight hip muscles, low back/hip bad positioning can also press on the same nerves, mimicking radiating nerve pain and sciatica.
Bending forward so much so often, pushes the discs outward until they finally down little by little (degenerate) and move outward (herniate). Standing with your hip bent or turned out shortens the muscles around the nerves in your legs, which can also press on them. These problems are easy to avoid and easy to fix.
One contributor to tightness causing sciatic pain down the leg is standing, walking, and moving with your legs turned out – duck foot. The muscles that turn your leg and feet out are in back of your hip (in your behind). They fasten from the back of your hip bone to your upper leg bone going sideways. The sciatic nerve passes behind, and in some people, through one or more of these muscles (mainly the piriformis muscle). When these muscles get tight from years of walking, sitting, and standing with your hip bent and your feet turned out, the tight muscles can press and add to sciatic pain.
Bad Hamstring Stretching.
Another thing commonly mistaken for sciatic pain is hamstring strain. The pain may be in the backside and can go down the leg. See if the pain is really around the the bump you sit on where the hamstring attaches and goes down the thigh along the hamstring muscle. An even more common source of back and disc pain is the hamstring stretches themselves. Check if you are doing conventional hamstring stretches by sitting or standing bent forward. They are a classic mechanism for pushing discs outward. There are far better and more functional ways to stretch the hamstrings, described below, in other free articles on this web site (like the Stretching Smarter Article), and in my books.
Over-Arching the Lower Back.
A major hidden cause of ache in the lower back comes from allowing too much inward curve in the lower back – called hyperlordosis or swayback. This kind of pain is usually felt during/after long standing, walking, running, lifting overhead. Sitting or bending forward relieves this kind of pain, leading to all kinds of indirect and strange exercise rituals. Preventing the slouching posture will stop the pain and injury from it in the first place – see this article on fixing hyperlordosis. This article also explains relation of this kind of slouching to disc injury.
Other Nerves Than Sciatic Nerve.
Not all pain that goes down the arm or the back of the leg is from pinched nerves. Also, not all pain that goes down the back of the leg is from the sciatic nerves. It can be from other nerves too, and can be also fixed with stopping unhealthful movement habits.
Not A Disease.
Someone with a slipping or degenerating disc, or sciatica, is often told they have “degenerative disc disease” or “disc disease.” But it is not a disease. The condition is misnamed. A hurt disc is a simple, mechanical injury that can heal, if you just stop grinding it and physically pushing it out of place with terrible habits. It will heal and stop pressing on nerves. The disc pain and sciatica will go away. It is simple, and depends a great deal on how you hold your body when sitting, bending, and exercising.
Discs Can Heal
Disc injury is not a life sentence. It is not a condition you must live with. It is an injury that you do not have to allow to continue. Disc degeneration or slippage (herniation) can heal and stop hurting- if you let it – no differently than a sprained ankle. Stop damaging your discs with bad bending, standing, and sitting habits and your discs can heal. It takes years to herniate a disc, and only days to weeks to let it heal it by stopping bad habits.
When Back Pain Isn’t From What Is On Your X-Ray
Often, a person may be in great pain from simple damaging bending and movement habits. They may go for an x-ray or MRI, and the scans show a degenerating or herniated disc. The pain may not be from the disc, but from the strained, tired muscles from bad habits. Just like car tires that are mid-life, but perfectly good, some wear easy show on exam – but may be unrelated to the pain. Pain is falsely ascribed to the disc. Pain continues, but from the poor mechanics. This is no mystery. Change the bad habits to change the pain.
Sometimes, people go for surgery for the “bad disc.” But their pain persists or returns– because they never corrected the bad mechanics that caused the pain. Or they may herniate another disc for the same reasons they herniated the first one – bad sitting and lifting and all the other bad habits that they did not easily change.
What To Do Every Day To Stop Ruining Your Discs and Let Them Heal
First thing every morning, don’t sit on the edge of the bed. Instead of sitting and rounding your back, turn over and lie face down. Prop gently on elbows, but not so high that it strains. Don’t pinch back at the lower spine – allow your entire spine to “unround.” It should feel good and help you start your day with straighter positioning. Get out of bed without sitting.
* When sitting to lift weights, remember that sitting is harder on your discs than standing. Sitting rounded multiplies damaging force. A common exercise injury occurs when sitting rounded on weight machines. After years of unhealthy sitting position, adding pushing against a leg press or other resistance can become too much for the discs and other low back structures, sending pain into the behind and down the leg.
Don’t round your hip and low back against resistance (weighted flexion).
The problem is not as much the amount of weight you lift, or that you are exercising, it is more if you are using injurious positioning. Instead of pushing your lower back against the seat or pad, lift up to sit straight and lean your upper back against the seat.
* Many people hurt from excessive forward bending all day in their real life. Then they go to the gym and add to that problem with the many conventional exercises involving more forward bending: toe touches, knee to chest, leg lifts, and crunches. Ironically, many people do these thinking these will help their back. Motion often temporarily makes you feel better, however, many of the forward bending exercises are not what is needed (like cigarettes – temporary relief but long term grater problems). It is important to strengthen the muscles that pull back the other way and to learn how to use muscles to straighten the back, not only round it. These are the extension exercises (to follow).
* Don’t stretch by bending over at the waist or hip. Many people are surprised to find that they injure their back doing forward yoga stretches. most people know it is injurious to pick up a package that way. It is not really a surprise. Other people think that bending over to pick things up is right and because it stretches the back of the legs. It does stretch, but it is not a healthy stretch. It puts the leverage and pivot point on your discs. Like smoking, it feels good (to some) but the drawbacks are not worth it. For more interesting information on what exercises harm and which help, read the article on How to Avoid Bad Exercises and Section 3 in the Fix Back Pain article explaining Why Yoga Forward Bends Are Like Lifting Packages Wrong.
Ineffective Exercising
Strengthening and stretching are good, but alone will not change posture or lifting habits, and so cannot “cure” back pain or posture problems. Many contribute to the original problem of over rounding and bad posture. Just look around the gym to see people hunching forward and bending over to lift things. This just pressures discs further. Back exercises are supposed to be used to retrain you how you hold your body all the time. Doing exercises for back pain is not like getting a shot of penicillin or going to confession. It does not “fix” bad habits the rest of the time.
One common example is doing “pelvic tilts,” then stopping your “back exercise” and walking away letting your back flop into bad posture, instead of keeping the proper tilt you just practiced. Back exercises are supposed to be used to retrain your thinking and habits when you get back up off the floor. This does not happen automatically. This is where many people have missed the point of back exercises. Strengthening has no effect on posture if you don’t apply the strength the rest of the day to control joint angles for all activities.
Good Exercises to Retrain Muscles and Positioning Habits – Functional Exercise
Back pain exercises are misunderstood. People often injure their back all day then hope to fix it with a few exercises. They don’t understand when this does not work. They lie on the floor to do exercises, then go about their real life bending and sitting wrong and all day. It is like eating butter and sugar all day, then doing 10 minutes of exercises and wondering why it doesn’t “work.” The key is what you do all day.
1. Instead of Crunches, PIlates and Other Flexion Exercise:
Isometric Abs. Most people exercise their abdominal muscles by bending forward. Bending forward is a main way you pressure your discs outward, eventually degenerating them. The following exercise teaches how to use your abdominal muscles without forward bending. It is a better workout than abdominal crunches. It is also a myth that strengthening abs will fix back pain. That may sound strange. But stronger abs does not make you stop bending and standing wrong in the ways that injures discs. In fact, most of the abdominal exercises taught are the very forward bending exercises that injure discs and pressure the back more. It is another myth that tightening abs and pressing navel to spine helps in fact, it can make more pain. You certainly can’t breathe in or move easily if you tense your abdomen in the way commonly taught. So what do abs do to help prevent pain?.
A major purpose of your abdominal muscles is to hold your back from arching backward when you are standing up. Many people don’t know this and don’t use their abs, and allow their lower back to sway inward or arch inward too much. This is called lordosis or swayback. Arching is not the kind of force that injures discs. It does make another kind of lower back pain in the soft tissue and joints called facets. People with this problem get pain after long standing and running. This is different from the usual disc pain that comes on from long sitting. They may do “ab exercises” for this by lying on the floor or standing against the wall and pressing the low back (pelvic tilt) to reduce the curve. But that does not change your positioning the rest of the time, and so, does not heal the back pain that is common from overarching. You are supposed to use the tilt when standing to keep your back in position to preventing arching. This exercise strengthens your abs and back at the same time you retrain how to hold your back without arching:
The “isometric Ab” retraining drill shows you how to keep your lower back from overarching
under loads that you lift overhead, as if you are standing. It is a more effective and functional way to train your core muscles, and better for your discs, than exercise that bend and curl you forward.
The “isometric Ab” retraining drill shows you how to keep your lower back from overarching
under loads that you lift overhead, as if you are standing. It is a more effective and functional way to train your core muscles, and better for your discs, than exercise that bend and curl you forward.
* Lie face up, arms overhead on floor, biceps by your ears.
* Press your low back toward the floor to remove the arch. You will feel your abdominal muscles working to prevent your back from arching.
* Hold hand weights an inch above the floor, without arching your back. Keep your low back against the floor by using abdominal muscles to straighten your spine.
* Straighten your legs so that you can practice the way you need to hold your spine when standing – spine in healthy position without bending knees.
This is how your abs should work all the time, when standing up, to prevent too much arching. Use this exercise to practice using your abs to control the posture of your back, even against moving resistance, simulating real life activity when standing up. Notice that you don’t need to tighten your abs to do this. Just use your abdominal muscles, like any other muscles, to move your body to healthy position.
Retrain the Push-up Position: This is another exercise to work your abdominal muscles without forward bending. It is a far better workout than abdominal crunches, and has the advantage of retraining you how to use your abdominal muscles to put your spine in healthy position when you stand up.
In a push-up position (hands and toes, not on knees) tuck your hips under so that your back doesn’t arch. You will immediately feel your abs working when you do this. You will also immediately feel the pressure in your back disappear, that was caused by arching. The purpose of this exercise is to train your abs at the same time you relearn how to hold your back when you are standing up. Keep your back straight, not letting it sag into an arch like a hammock. Tuck hips as if you were starting a crunch, but don’t hike your behind up in the air or drop your head. Make your posture as straight as if you were standing up. Use a mirror, if available, to see yourself and learn what healthy position feels like. Use this new healthy position all the time, particularly when you stand and reach overhead. Don’t let your back arch to reach overhead. Use the principle of this tuck exercise. For more about ab exercise and preventing the pain from arching, see the abs article The Ab Revolution No More Crunches No More Back Pain.
Common source of pain.
Sagging weight onto lower spine pinches discs, spine joints called facets, and soft tissue. It is not useful exercise.
Straighten lower spine.
Leverage shifts off lower spine into ab muscles
When you tilt your hip under to reduce a too-large inward lower back curve, you will immediately feel your abs working and pressure gone from your back.
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Common source of pain.
Sagging weight onto lower spine pinches discs, spine joints called facets, and soft tissue. It is not useful exercise.
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Straighten lower spine.
Leverage shifts off lower spine into ab muscles
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When you tilt your hip under to reduce a too-large inward lower back curve, you will immediately feel your abs working and pressure gone from your back.
2. How to Stretch Your Hamstrings Without Ruining Your Discs
Tight hamstrings are commonly thought to contribute to back pain. This is turning out not to be completely true. Worse, hamstring stretches are often done in ways that round and strain the back and degenerate discs.
Leaning over at the waist, both standing and sitting, for toe-touches does stretch your back and hamstrings, and may feel good, but it is terrible for your back. This is true even for yoga stretches where you bend over forward sitting or standing touch toes. You know never to bend over like that to pick things up or sit like that at your desk. It doesn’t magically become good for you by calling it a stretch.
* Stand no more than arms length from a wall. Stand straight. Both feet pointing forward, not out.
* Lift one leg to press the foot and heel toward the wall, directly in front of you.
* Stand upright. Don’t round your back, or let your hip curl under you. This is a functional hamstring stretch – you need to stand, lift legs, and balance without being so tight you are pulled into unhealthful rounding.
* If your hip curls under, it may be because the front muscles of your hip are too tight. Use this retraining drill to stretch and straighten, not further round the back. See the stretching article.
This hamstring stretch is different and more functional than putting one foot up on a bench.
3. When Walking and Exercising
* Walk with feet parallel, not turned in or out. Weight on entire sole, not pressing inward flattening the arches.
* Walk, move, exercise and sit down with shock absorption, not stomping.
* Notice your upper back position – prevent rounding the spine and shoulders.
* Notice lower spine position. Check if you are allowing a slouch that tilts the pelvis forward which overarches the lower spine, pinching the vertebral joints called facets, and the discs. Use your muscles to move to neutral spine – important for disc health – see Neutral spine article.
How Long Does It Take To Fix Disc Pain, Pinched Nerve, and Sciatica?
You should begin to feel the difference the same day as you try everything presented above.
If you’re not feeling better right away, check what you are doing compared to what you have learned above and in the other free articles.
It takes years to hurt a disc, but only days for it to start healing once you no longer are bending badly and pushing it out. Make sure there is not something else contributing to your pain. It is is almost always quick and easy to start getting your life back and start feeling better right now. Don’t wait.
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