Symptoms of a Herniated Disc: When Should You See a Physiotherapist?

Back pain is something eight out of ten people experience at least once in their lives. Only a small share of those pains, however, genuinely come from a herniated disc. Knowing the difference prevents both unnecessary worry and unnecessary treatment.

What is a herniated disc?

Between the vertebrae sit discs that act as cushions. When a weakness develops in the outer ring of a disc, the inner part can shift and press on a nerve root — this is what we call a herniated disc. That pressure is what makes pain travel down the leg.

Which symptoms point to a herniation?

• Pain running from the lower back into the buttock and down the back of the leg (sciatica)
• Numbness or pins and needles in the leg or foot
• Pain that increases when coughing, sneezing or straining
• Symptoms that clearly worsen when bending forward
• Pain that worsens with prolonged sitting and eases somewhat with walking

Pain that stays in the back and does not travel into the leg is usually muscular and does not mean a herniation.

When to see a doctor immediately

The following need urgent assessment and a doctor should be seen before a physiotherapist:

• Loss of bladder or bowel control
• Numbness in the groin and inner thigh
• Rapidly progressing, marked weakness in the leg
• Fever, unexplained weight loss or recent significant trauma

What does physiotherapy do?

Current clinical guidelines state that in the great majority of disc herniations the first choice is not surgery but exercise-based physiotherapy. The process runs in three stages:

1. Bringing pain under control. Positional advice, manual therapy and, where appropriate, electrotherapy.
2. Restoring movement. Nerve mobilisation and graded work on range of motion.
3. Preventing recurrence. Trunk stabilisation (core), hip strength and daily-life adjustments.

That third stage is the one most often skipped and the one that matters most. If the programme is dropped once pain settles, the complaint returns within months.

Should I have an MRI?

Imaging is not necessary for every episode of back pain. A significant proportion of people with no symptoms at all show disc bulges on MRI. The decision is therefore made on the clinical picture, not on the image. If you already have a report, bringing it to the assessment speeds things up.

How long does it take?

The number of sessions depends on how long you have had the problem, how severe it is and your general condition. At the first assessment with Fzt. Aydın Ali, measurements are taken, goals are agreed together and the process is reviewed at regular intervals.

If your back pain has lasted more than two weeks, travels into your leg or keeps coming back, you can book an assessment.