A spinal disc is the cushion between two vertebrae. It has a tough outer ring and a softer center. When the outer ring tears or weakens, the inner material bulges out — that's a herniation. If the bulge presses on a nerve, you get pain, numbness, or weakness wherever that nerve goes: down the leg in lumbar herniations, down the arm in cervical herniations.
Symptoms
Lumbar (low back) herniation: low back pain that radiates into the buttock, thigh, or down the leg. Often worse with sitting, bending, or coughing. May include numbness, tingling, or weakness in the leg or foot.
Cervical (neck) herniation: neck pain that radiates into the shoulder, arm, or hand. Numbness or tingling in specific fingers depending on which nerve is involved. Sometimes weakness in arm or grip.
Thoracic (mid-back) herniations are rare but cause band-like pain wrapping around the chest or upper back.
What causes herniations
Most disc herniations don't come from a single dramatic injury. They develop over years of repetitive stress — bad posture, poor lifting mechanics, sedentary work, weak core. A specific event might be the trigger ('I bent down to pick up a sock and my back went out'), but the disc was already weakened.
Trauma — car accidents, falls, sports injuries — can cause acute herniations. These behave differently and need different treatment timelines.
Genetics matter too. Some people have stronger disc tissue than others, and that's mostly out of your control.
How Dr. Ngo treats herniated discs
First, we confirm the diagnosis. Most disc problems can be identified clinically through symptoms and physical exam, but MRI is the gold standard when needed. We don't treat what we haven't diagnosed.
Treatment combines several approaches: spinal decompression therapy (mechanical traction that creates negative pressure inside the disc, allowing the herniated material to retract), specific chiropractic adjustments to surrounding segments to restore mobility without aggravating the injured disc, soft tissue therapy to release the muscle spasm that develops as your body tries to splint the injury, and rehabilitation exercises to strengthen the muscles that protect the spine.
Most patients with herniated discs are seen 2-3 times a week initially. Treatment plans run 8-16 weeks depending on severity. About 75% of patients avoid surgery entirely with proper conservative care.
When surgery is actually needed
Some disc herniations need surgery. The clear indications: progressive neurological deficit (weakness getting worse), loss of bowel or bladder control (cauda equina syndrome — surgical emergency), or failure of conservative care after a fair trial.
If we identify any red flags during your evaluation, we refer you to a spine surgeon immediately. Same goes if your pain is severe and unresponsive to conservative care after several weeks of proper treatment.
What we don't do: pressure you to keep coming if you're not improving. If you're not getting better, you need a different approach.
Frequently asked questions
Can a herniated disc heal without surgery?
Yes — and it usually does. Studies show the herniated material itself often shrinks over 3-6 months as the body reabsorbs it. Conservative care (chiropractic, decompression, physical therapy) helps manage symptoms and create the conditions for healing. About 75-80% of disc patients avoid surgery with proper conservative treatment.
What's the difference between a bulging disc and a herniated disc?
A bulging disc is when the outer ring extends past where it should but hasn't torn. A herniated disc is when the outer ring has torn and the inner material has pushed out. Bulging discs are common, often painless, and frequently age-related. Herniated discs are more likely to cause symptoms, particularly if they press on a nerve.
Is spinal decompression the same as traction?
Decompression is a specific form of computer-controlled traction designed to create negative pressure inside the disc. Traditional traction just pulls — decompression uses precisely calibrated cycles to allow the disc to actively pump in nutrients and release pressure on nerves. Both can help, but decompression is more targeted for disc problems.
Will a chiropractic adjustment make my herniated disc worse?
Done correctly, no. Done wrong, yes. The adjustment shouldn't be applied directly to the herniated segment. Dr. Ngo uses techniques specifically appropriate for disc patients — often gentler approaches like flexion-distraction or instrument-assisted adjusting rather than traditional manual adjustments. We don't force anything.
How long until I feel better?
Most patients notice improvement within 2-3 weeks. Significant relief usually comes by week 6-8. Full healing of the disc tissue itself takes 3-6 months. The point of treatment is to manage symptoms, restore function, and create the conditions for the disc to heal — not to magically make a herniation disappear overnight.
Can I exercise with a herniated disc?
Yes, but the right exercises. Wrong exercises make it worse. As part of treatment we teach you specifically what to do and what to avoid for your specific herniation. In general: McKenzie-style extension exercises help most lumbar herniations; flexion exercises often make them worse. Cervical herniations are different. We'll guide you.