Herniated or Bulging Disc

Back pain can arise from many causes, including a bulging or herniated disc. The vertebrae of your spine are cushioned by round flat discs with a tough outer layer called the annulus and a jellylike center called the nucleus. The discs, located between the vertebrae, serve as shock absorbers and prevent the bones from rubbing against each other. Sometimes the outer layer of a disc tears or ruptures, causing the center to push out into the spinal canal.

A herniated disc does not always cause pain, but if the bulging disc presses against a nerve, pain can range from mild to debilitating. Herniated discs can happen anywhere along the spine, but they most often occur in either the low back or neck region.

Herniated Disc Symptoms

Symptoms of a herniated disc vary, depending on the location. In the lower back, sciatica is the most common symptom, marked by a sharp or shooting pain that may travel down one side of the low back, into the buttock and down the leg, caused by pressure on the sciatic nerve.

Other symptoms in the low back include:

  • Pain on one side of the lower spine
  • Weakness in the leg or foot
  • Numbness or tingling in the leg, foot and toes
  • Loss of bladder or bowel control

A herniated disc in the neck region can cause pain in the upper back and neck that sometimes shoots down the arm.

Other symptoms in the neck include:

  • Weakness in one arm
  • Arm tingling or numbness
  • Burning sensation in the shoulders, neck and arm

Herniated Disc Causes

Many factors can contribute to a bulging disc. While the condition can be brought on by trauma, it is more often the result of age-related disc degeneration.

Other causes include:

  • Improper lifting technique
  • Obesity
  • Excessive sitting
  • Sedentary lifestyle
  • Poor posture when sitting or standing
  • Excessive use of mobile devices or computers
  • Faulty walking or running gait mechanics
  • Repetitive overuse from sports or exercise

Smokers are at a higher risk of disc herniation due to decreased circulation that restricts the supply of nutrients and oxygen to the structures of the spine.

Herniated Disc Diagnosis

Many spinal disorders can mimic symptoms of herniated disc pain, including pain arising from the sacroiliac or facet joints. Therefore, a clinical exam is not always sufficient to accurately diagnose a herniated disc.

At NYDNR, we use real-time diagnostic ultrasound to view the spine and nerves. Ultrasound enables us to view inflammation, along with damage to soft tissues and cartilage. Once a herniated disc has been diagnosed, we are then able to devise an individualized treatment plan.

Herniated Disc Treatment

Traditional treatment for a herniated disc focuses on managing pain and reducing inflammation. Rest, NSAIDs, muscle relaxants and steroid injections are standard protocol. MRI is rarely necessary, and surgery has been shown to be of limited benefit. While pain management is important, it does not get at the underlying cause of herniated disc pain or correct it to prevent future episodes.

Treatment for Herniated Disc at NYDNR

The back pain specialists at NYDNR use a combination of innovative, clinically proven approaches to treat herniated disc pain and restore function. Our goal is to correct gait, posture and mechanical issues that contribute to disc herniation.

Our treatment approaches may include:


Physical Therapy for Herniated Disc

Improve posture, rebalance muscles and improve deep spinal stability with exercises specifically designed to promote spinal health and stability.


DNS (Dynamic Neuromuscular Stabilization)

This unique and effective treatment method restores innate developmental movement patterns that promote healthy musculoskeletal alignment and function, reducing pressure on the spinal discs.


Ultrasound Guided Dry Needling

Discs are sometimes affected by muscle tension or spasm that contributes to changes in surrounding structures. Dry needling is an increasingly popular treatment method that disrupts dysfunctional neuromuscular activity, relaxing the muscles and relieving pain.


3D Chiropractic Care

All functions of your body are controlled and coordinated by a vast neural network. Stress or impingement in any area of your nervous system can cause health problems throughout your body. 3D Chiropractic looks beyond your pain symptoms to get to the source and fix it.

Herniated disc pain should not be taken lightly, as it can lead to further spinal degeneration and reduced mobility.

Other treatments may include:


Our Rewards

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.

Bulging and Herniated Disc Disorders

A protruding or herniated disc in the lumbar spine can cause excruciating pain that sometimes radiates to relieve pressure.

Causes of Disc Herniation

Some individuals are anato disc herniation, but in most cases the problem arises from behavioral lifestyle conditions.

Causes include:

  • Excessive sitting
  • Poor muscle tone
  • Sedentary lifestyle
  • Overweight and obese
  • Faulty lifting technique
  • Poor posture
  • Repetitive overuse from work or exercise
  • Faulty gait mechanics
  • Other biomechanical factors

If you suspect you have a herniated disc, avoid prolonged sitting and lifting heavy weights. Do not seek treatment involving high velocity spinal manipulation.


Disc pain sometimes mimics other syndromes like sacroiliac joint dysfunction, pain originating from the vertebral facet joints and muscular pain. Real-time diagnostic ultrasound can help your therapist confirm disc herniation and pinpoint the exact location at which the nerve is compressed. Misdiagnosis can lead to further damage if the wrong treatment strategy is employed.


The treatment plan should be based on health histo be treated on a case-by-case basis, under the supervision of an experienced clinician.

Treatment at NYDNR

At NYDNR, we use innovative approaches based on clinical evidence of their effectiveness for treated herniated disc pain.

Some of our treatment methods include:

  • DNS (dynamic neuromuscular stabilization)
  • ISM (integrated systems model)
  • McKenzei method
  • Clinical Pilates
  • Acupuncture
  • Votja therapy

Our back pain specialists provide individualized treatment based on accurate diagnosis.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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