A herniated disc, also known as a slipped or ruptured disc, occurs when the soft inner material of an intervertebral disc pushes out through a weak area in the tougher exterior. This can cause pain, numbness, tingling and weakness in the area supplied by affected nerves. Herniated discs are most common in the lumbar spine and cervical spine.
Many people with a herniated disc wonder if stretching is helpful or if it could potentially make their condition worse. Stretching is commonly recommended for low back pain, but there are some conflicting opinions on whether certain stretches are advisable for a herniated disc.
This article examines whether stretching can aggravate a herniated disc. It looks at the risks and benefits of stretching and provides guidelines on safe stretches to try.
What is a herniated disc?
Spinal discs are soft, rubbery cushions located between the bony vertebrae that make up the spinal column. They act as shock absorbers and allow flexibility in the spine.
Each disc has a tough outer layer called the annulus fibrosus. This surrounds the soft inner nucleus pulposus.
A herniated disc occurs when the nucleus pulposus pushes through a weak spot in the annulus fibrosus. This forms a bulge that can put pressure on nearby spinal nerves.
Common symptoms of a herniated disc include:
- Pain in the area supplied by the compressed nerve, such as sciatica pain radiating down the leg
- Numbness or tingling in the affected nerve distribution
- Muscle weakness in the area of the compressed nerve
- Reduced range of motion of the spine
Herniated discs are most likely to occur in the lumbar spine, especially at L4-L5 and L5-S1 levels. They also frequently occur in the cervical spine at C5-C6 and C6-C7.
Can stretching aggravate a herniated disc?
Whether stretching is helpful or harmful for a herniated disc is controversial. There are potential risks associated with stretching, but also possible benefits.
Here is an overview of the pros and cons of stretching with a herniated disc:
Potential risks of stretching
- May increase pressure on the herniated portion of the disc
- Could cause the herniation to expand or release inflammatory substances
- Might compress or irritate spinal nerves
- Risk of overstretching and straining tissues around the herniation
These risks depend on the type of stretch being performed and the individual’s symptoms.
Aggressive stretching into areas of pain or weakness could be more likely to cause problems. However, cautious stretching within a comfortable range may pose little risk.
Potential benefits of stretching
- May help reduce pain and muscle tension
- Can improve mobility in the spine and surrounding tissues
- Helps restore normal range of motion
- Promotes circulation to deliver nutrients and remove waste
Gentle, controlled stretching can help limber up tight tissues. This may relieve pinched nerve symptoms from a herniated disc.
However, it is unclear if stretching can directly reduce the size of a disc herniation. The herniated portion is avascular and does not receive direct blood supply.
Guidelines for safe stretching with a herniated disc
Most experts recommend gentle stretching within a pain-free range of motion if you have a herniated disc. Here are some guidelines for safe stretching:
- Only stretch to the point of feeling mild tightness – avoid aggressive or painful stretches.
- Focus on areas above and below the level of herniation to avoid excess pressure on the disc.
- Avoid stretching into extremes of spinal flexion or extension.
- Discontinue any stretch that causes symptoms like pain, numbness or tingling to flare up.
- Apply moist heat to tight muscles before stretching.
- Avoid overstretching and bouncing motions that could strain tissues.
- Stretch regularly to maintain flexibility – little and often is best.
It is also important to strengthen the core and back muscles that support and stabilize the spine. This provides the stability required for safe stretching.
Seek advice from a physical therapist or doctor on suitable stretches. They can create a customized stretching program tailored to your condition and symptoms.
Specific stretches to try
The following gentle stretches may be beneficial if you have a herniated lumbar or cervical disc, provided they do not cause any increase in pain or neurological symptoms.
1. Knee rolls
- Lie on your back with knees bent and feet flat on the floor. Relax your shoulders and arms by your sides.
- Gently let both knees fall to one side, keeping shoulders on the floor. Hold for 10-15 seconds.
- Slowly bring knees back to center, then let them fall to the opposite side. Hold again.
- Repeat 3-5 times per side.
This provides a gentle rotational stretch in the lumbar spine.
2. Lower back rotation
- Get on your hands and knees. Make sure your shoulders are over wrists and hips over knees.
- Sit your buttocks back towards your heels, without moving the hands/knees position.
- You should feel a gentle stretch in your lower back on the side you are sitting back towards.
- Hold for 10-15 seconds then come back to center.
- Repeat 2-3 times on each side.
Go slowly and only stretch within your comfortable range of motion.
3. Child’s pose
- Kneel on the floor with toes together and sitting back on your heels.
- Keeping knees together, slowly lower your chest down to rest on your thighs.
- Reach your arms forward with palms facing down and relax your head and shoulders.
- Hold the stretch for 15-30 seconds.
Avoid this stretch if it causes pinching sensations in the low back.
4. Upper back rotation
- Sit up tall with legs crossed. Keep your chin tucked slightly and chest lifted.
- Place your right hand on the outside of your left thigh or knee.
- Gently twist your upper back to the left as you look back over your right shoulder.
- Hold for 10-15 seconds then slowly come back to center.
- Repeat on the opposite side.
Make sure you do not over-rotate the neck.
5. Chin tucks
- Sit or stand with proper upright posture.
- Draw your chin straight back, without tipping or tilting your head.
- You should feel a mild stretch along the back of your neck.
- Hold for 5-10 seconds then relax the neck.
- Repeat 5 times.
This stretch helps counter poor neck posture that can occur with cervical disc herniations.
When to avoid stretching
It is best to avoid stretching if you have:
- Acute and severe pain that limits your range of motion
- Sudden onset of intense neurological symptoms like numbness, weakness or loss of bowel/bladder function
- Signs the disc herniation is substantially worsening like progressive leg weakness
In these cases, stretching could potentially worsen the herniation or compress the nerves further. Seek prompt medical advice.
Stretching should also be discontinued if your symptoms are aggravated and do not settle quickly.
Other complementary treatments
While gentle stretching may help, it is just one part of an effective treatment plan for a herniated disc. Other recommendations include:
- Medications – Over-the-counter pain relievers or prescription medications to reduce inflammation.
- Hot/cold therapy – Heat before activity, ice after activity to control pain and swelling.
- Spinal decompression – Use of inversion tables or extension exercises to take pressure off the discs.
- Physical therapy – Spinal strengthening and stabilization exercises.
- Epidural steroid injections – Anti-inflammatory medication injected near irritated spinal nerves.
- Surgery – Removal of the herniated portion pressing on nerves, or spinal fusion if disc damage is severe.
Treatment is tailored depending on the location and severity of the herniation, as well as the individual’s symptoms.
Conclusion
Stretching could potentially aggravate a herniated disc if motions are too forceful or push into painful ranges. However, gentle stretching within a comfortable range may help ease muscle tension and improve mobility.
It is difficult to predict exactly how an individual’s herniated disc will respond to stretches. Increase intensity slowly and discontinue any stretches that worsen pain or neurological symptoms. Following guidelines for safe stretching and seeking advice from a physical therapist or doctor can help determine appropriate stretches for your condition.
Along with stretching, be sure to address the underlying causes of disc herniations like poor posture, improper lifting, lack of core strength, and excess weight. Effective management typically requires a combination of conservative treatments. In severe cases, surgery may be needed to remove pressure on the spinal nerves caused by the herniated disc material.