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Herniated Disc Treatment: Physical Therapy in Brooklyn Without Rushing to Surgery

By Dr. Jack Engelberg, PT, DPT · · 4 min read

Hearing the words "herniated disc" can be scary. Many people picture a slipped piece of spine that needs surgery to fix. In reality, disc herniations are common, often improve on their own, and frequently respond well to physical therapy. Understanding what's happening in your spine is the first step toward recovering with confidence.

What Is a Herniated Disc?

Between each pair of vertebrae sits an intervertebral disc. Each disc has a tough outer ring (the annulus) and a softer, gel-like center (the nucleus). The discs act as spacers and shock absorbers and allow the spine to bend and twist.

A herniated disc happens when some of the inner material pushes through a weakened area of the outer ring. A bulging disc is a broader, more even extension of the disc beyond its usual boundary. Both can occur in the low back (lumbar spine) or the neck (cervical spine).

Here's something reassuring: disc bulges and herniations show up on MRIs of many people who have no pain at all. A finding on imaging only matters if it matches your symptoms.

Common Symptoms

In the low back:

  • Low back pain, sometimes mild compared to the leg symptoms
  • Pain, numbness or tingling down one leg (sciatica)
  • Pain that is worse with sitting, bending, coughing or sneezing
  • Leg or foot weakness in some cases

In the neck:

  • Neck pain and stiffness
  • Pain, tingling or numbness into the shoulder blade, arm or hand
  • Arm or grip weakness

What Causes a Disc Herniation?

  • Age-related changes — discs gradually lose water content and resilience over time, making the outer ring more vulnerable.
  • Repetitive or heavy loading — frequent lifting with bending and twisting.
  • Sudden strain — a single awkward lift can be the last straw for a disc that was already irritated.
  • Prolonged sitting — long periods in a flexed position add load to the discs.
  • Genetics, smoking and general fitness — all play a role in disc health.

How Physical Therapy Helps a Herniated Disc

Research shows that the body can partly reabsorb herniated disc material over time, and symptoms often improve within weeks to months. Physical therapy helps you stay active and comfortable during that window and lowers the chance of future episodes.

Evaluation

Your therapist will check your movement, nerve function (reflexes, sensation and strength), and how symptoms respond to different positions. They'll also screen for signs that need a physician's input.

Treatment Options

  • Repeated movement testing and exercise — certain directions of movement may reduce or centralize your symptoms
  • Manual therapy — mobilization and soft tissue techniques to reduce pain and stiffness
  • Nerve glides — to restore nerve mobility in the leg or arm
  • Core, hip and shoulder-girdle strengthening — to support the spine
  • Postural and ergonomic coaching — desk setup, car seat position, and how to handle long workdays
  • Graded return to lifting — practicing safe, confident lifting rather than avoiding it forever

What You Can Do at Home

  • Walk daily in short, comfortable bouts.
  • Break up sitting every 30 minutes or so.
  • Use supportive positions — a lumbar roll in your chair, or a pillow under your knees when lying on your back.
  • Avoid prolonged slouching or repeated bending in the first days of a flare.
  • Use heat or ice for comfort.
  • Follow your symptom map. If pain moves out toward your leg or arm, back off. If it moves toward the spine, that's usually a good sign.

When to See a Physical Therapist

Consider an evaluation if:

  • Pain radiates into your arm or leg
  • You've had symptoms for more than a week or two
  • You've been told you have a herniated disc and want a non-surgical plan
  • You're recovering from disc surgery and need rehab

Seek immediate medical care for loss of bladder or bowel control, numbness in the groin area, rapidly progressing weakness, or difficulty walking or using your hands.

Frequently Asked Questions

Can a herniated disc heal without surgery?

Many do. Symptoms often settle with time and conservative care, and imaging studies have shown herniated material can shrink. Surgery remains an option for people with significant nerve deficits or symptoms that don't respond to treatment.

Is it safe to exercise with a herniated disc?

Yes, with the right guidance. The type and intensity of exercise matter, which is why a tailored plan is helpful. Complete rest is rarely the answer.

What about a herniated disc in my neck?

The principles are similar. Read our guide to neck pain for more about cervical spine issues.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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