Herniated disc in Fribourg: symptoms, treatment and support

What is a herniated disc?

Between the vertebrae, soft discs cushion the movements of the spine. According to the UK's NHS, a herniated (slipped or prolapsed) disc is when part of this disc bulges outwards; it becomes painful when it presses on a nerve.

In the lower back, a lumbar herniated disc can irritate a root of the sciatic nerve: it is one of the causes of sciatica. Doctors name the herniation after the vertebrae on either side of the disc: an L5-S1 herniation, for example, affects the disc between the last lumbar vertebra and the sacrum (the triangular bone at the base of the spine). The part of the leg affected depends on which nerve is irritated. In the neck, a cervical herniated disc can cause pain that travels down the arm.

The NHS points out that not all herniated discs cause symptoms, and the Swiss League against Rheumatism notes that a herniation seen on imaging is not necessarily linked to the pain you feel. To understand the terms in a report, read Lumbar MRI: disc problems explained.

Herniated disc: what are the symptoms?

The NHS describes in particular:

• low back or neck pain;
• pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve;
• tingling or numbness in the leg or foot (lumbar herniation), or in the arm or hand (cervical herniation);
• difficulty bending or straightening your back.

The pain can also disturb sleep and long periods of sitting. These difficulties weigh on daily life: journeys avoided, work adapted, activities put aside. They deserve attention, just as the pain does.

Lumbar or cervical herniated disc: the differences

A lumbar herniation, in the lower back, mainly causes pain in the buttock and leg. A cervical herniation, in the neck, can cause neck pain that travels into the shoulder and arm, sometimes with tingling or numbness in the hand. Arm weakness that is getting worse needs prompt medical advice. For neck pain, see also our Neck pain page.

Causes and risk factors

Often no obvious cause is found. The NHS lists possible factors such as lifting heavy objects the wrong way, sitting or driving for long periods, inactivity and being overweight. It also notes that nicotine weakens disc tissue.

Back or leg pain is not automatically due to a herniated disc, though. After 50, a narrowing of the spinal canal can cause similar symptoms: read Lumbar spinal stenosis: symptoms and daily life. Before choosing a form of support, the cause of the pain should have been assessed by your doctor.

How Centre Algos supports you

Understanding your situation as a whole

The first consultation lasts 1.5 to 2 hours (CHF 182). Bring your medical file, your test results (MRI, reports) and the list of your medications. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals who care for you, in particular your physiotherapist.

Movement: the recommended foundation

The NHS advises keeping active. If the pain is very bad, a short rest can help at first; it is then better to gradually return to gentle activity such as walking, swimming or yoga, as long as it does not make the pain worse. The UK NICE guideline (NG59) puts information and exercise at the centre of care and recommends manual therapy only as part of a package that includes exercise. Medication is discussed with your doctor or pharmacist.

Approaches at Centre Algos

Depending on your situation, several approaches can be combined, alongside medical care and physiotherapy:

• Naturopathy: sleep, diet, weight and daily rhythm, to work on habits that can influence pain.
• Cupping: applied to the back and buttock, it can help release muscle tension.
• Percutaneous hydrotomy: micro-injections under the skin. After assessment, when no warning signs are present and in agreement with your medical care, it can be discussed as a complementary option. We explain how it works, its limits and its contraindications; results vary from person to person. If hydrotomy is part of your plan, price on quotation, set at the first consultation according to your situation.

The aim is to live your days better and return to your activities, without promising a result. For an overview of non-surgical options, read Back pain without surgery.

Herniated disc: when is surgery discussed?

According to the NHS, surgery is not usually needed. Your doctor may refer you to a specialist if symptoms have not improved with other treatments or if muscle weakness or numbness is getting worse. NICE suggests considering spinal decompression (an operation that frees the nerve) when non-surgical treatment has not improved pain or function and imaging is consistent with the symptoms. The Swiss League against Rheumatism points out that surgery does not always remove the pain completely and that a new herniation remains possible.

If surgery has been proposed to you, our support must not delay a necessary decision: the options are for you to discuss with your medical team.

When to see your doctor first

Go to the emergency department immediately if you have:

• numbness around your bottom or genitals;
• loss of feeling in one or both legs;
• no control over when you pee or poo;
• pain that started after a serious accident, such as a car accident.

Do not drive: ask someone to take you.

See your doctor soon if:

• weakness in your leg or foot is getting worse;
• you have a fever, chills or feel hot and shivery;
• the pain is worse at night;
• you are losing weight for no reason or have a history of cancer;
• the pain is not improving after a few weeks or painkillers are not helping.

If none of these signs is present, there is no need for alarm: according to the NHS, a herniated disc usually gets better slowly with rest, gentle exercise and painkillers.

Let's look at your situation

This text gives general guidance. What keeps your pain going, in your particular daily life, deserves a real conversation rather than a generic answer. A question before you decide? Book a free 10-minute call to see whether our approach suits you.

Book my free 10-minute call