Many patients with a herniated intervertebral disc come to the doctor’s office with a similar story. They are afraid to pick up their grandchildren because of shooting pain in the leg, which can be truly paralyzing. Their social life dwindles, and relationships with loved ones suffer due to persistent discomfort that never goes away. Behind these stories, as noted by physical medicine and rehabilitation specialist Jesús López Escobar from the Moncayo clinic in Albacete, lies the same thought: “I’ve tried almost everything, but nothing helps.” Added to this is overwhelming exhaustion—both physical and emotional.
To begin with, it’s important to understand what a disc herniation is. Between our vertebrae are elastic ‘cushions’—discs that act as shock absorbers and provide mobility. As we age, they lose moisture and elasticity. Sometimes, the inner part of a disc bulges outward, compressing or irritating a nerve root. This causes the pain that radiates down the leg in a lumbar hernia, or into the arm in a cervical one. It is often accompanied by tingling or a sense of weakness. But the problem isn’t just mechanical. Fear makes us move less, our bodies become tense, and coordination is affected. This creates a vicious cycle: pain breeds fear, and fear and avoidance of movement only worsen the situation, paralyzing daily life.
Against such a backdrop, discussions about physical activity may seem risky. However, movement is an essential part of therapy. Even with a hernia, the body is capable of handling stress if it is introduced gradually and correctly. Problems arise when a person moves too abruptly, with poor technique, without proper preparation, or, on the contrary, completely avoids activity. During acute periods, it’s best to start with light and frequent exercises. As the pain subsides, you can gradually increase the intensity.
What kind of activity is beneficial? Experts highlight three simple directions. First, daily gentle movements: slow pelvic tilts, the ‘cat-camel’ exercise at a slow pace, and confident walking. For cervical hernias, chin tucks and scapular positioning control are helpful. Second, basic strength training two or three times a week: controlled standing up from a chair, glute bridges, and alternating arm and leg lifts from a hands-and-knees position. It is important to do few repetitions but with perfect technique. Third, calm breathing, which helps reduce the overall intensity of pain. Many begin regaining confidence with this simple routine. Later, the program can be expanded to include elliptical workouts, cycling, or swimming. The key is consistency.
Are there exercises that should be avoided at first? Absolutely. These include sudden torso bends with weights, rotational movements with resistance if they trigger radiating pain, as well as heavy compressive loads performed without proper technique, such as deep squats or maximal leg presses. Jumping is also off-limits during periods of exacerbation. It’s important to understand: this doesn’t mean ‘never,’ it just means ‘not yet.’ You can return to these exercises when the body is ready.
Physical activity helps in several ways. It modulates pain, lowering the ‘alarm signal’ from the nervous system. Coordination improves, and the hips and shoulder blades start functioning properly. Muscles become stronger, which allows you to distribute the load without overstraining your back. And, crucially, confidence returns. Every rep performed correctly and tolerated well sends your body a signal of safety.
How can you tell if an exercise is harmful? There are three clear signs: the pain spreads further down the limb and remains intense the following day; new numbness or tingling appears that doesn’t resolve within 24 hours; or you notice weakness that you didn’t have before. In addition, there are ‘red flags’ that require immediate medical attention: loss of control over urination or defecation, numbness in the groin area, or fever accompanied by lower back pain.
The rehabilitation approach varies depending on the location of the problem, but the core principles remain the same. For lumbar hernias, the key to success is working with the hip joints. You need to learn to bend at the hips, strengthen the glutes, and maintain core control. Walking is very beneficial. For the cervical spine, the main focus is on the shoulder blades: chin tucks, strengthening the mid-back muscles, and paying attention to the position of screens and gadgets, keeping them at eye level. The training plan is always tailored to the individual’s lifestyle. For those who spend a lot of time sitting, regular breaks and short exercises are recommended. For those whose work involves lifting heavy objects, techniques are developed to move safely using the legs rather than the back. The most important thing is to listen to your body and be honest with yourself about your condition on any given day.
