Lumbar Disc herniation and Sciatica

Understanding Lumbar Disc Herniation and Radicular Pain (Sciatica)

An acute disc herniation occurs when the soft inner material of a spinal disc pushes through its outer layer, often irritating nearby nerves. This causes radicular pain—sharp, shooting pain, numbness, tingling, or weakness radiating from your back into the leg (e.g., sciatica in the leg). Most cases (80-90%) improve with conservative care within 4-6 weeks without surgery.

Stay positive: Your body can often heal this naturally, but following these instructions reduces pain and prevents worsening.

If you have been told that your acute disc herniation will cause paralysis and that you need surgery, please read this - link

Pain Management Strategies

• Medications: Doctor will usually prescribe pain killers like NSAIDS (e.g. Naproxen for reducing inflammation and pain. You may be given additional acetaminophen (up to 3,000 mg/day) if needed. Your doctor may prescribe a short course (3-7 days) of muscle relaxants (e.g., cyclobenzaprine) or oral steroids (e.g. methyl predinisolone) for severe pain. Avoid long-term opioids or narcotic medications.
• Ice/Heat Therapy: Apply ice packs (wrapped in cloth) for 15-20 minutes every 2-3 hours for the first 48 hours to reduce swelling. Switch to heat after 2 days for muscle relaxation.

Activities :

How to sleep?

• Lie on your back with knees bent (pillow under knees)
• side-lying with a pillow between knees to ease nerve pressure.
• Use a firm mattress
• Avoid sleeping on the stomach

How to get of of bed?

• Roll onto your side first (log roll)
• Keep shoulders, hips, and knees in one line
• Push up using your arms while swinging legs down
• Avoid sitting up straight from lying down

How to sit?

• Sit on a firm chair with back support
• Keep feet flat on the floor
• Use a small pillow or rolled towel for lower back support
• Avoid slouching or leaning forward
• Do not sit continuously for more than 30–45 minutes

Standing

• Stand tall with weight evenly on both feet
• Avoid locking your knees
• Do not stand bent forward for long periods

✔️ Short, frequent standing breaks are better than prolonged sitting

Walking

• Walking is safe and encouraged
• Start with short walks, multiple times a day
• Walk at a comfortable pace
• Stop if leg pain increases significantly

🚶‍♂️ Walking helps disc healing and nerve recovery

Bending

• Avoid bending forward from the waist
• Always bend at the hips and knees
• Keep the back straight
• Hold objects close to your body

👉 Think “hips back, chest up”

Lifting from the Floor

• 🚫 Avoid lifting heavy objects in the acute phase
• If necessary:
• Squat using knees and hips
• Keep object close to your body
• Do not twist while lifting
• 🚫 No sudden jerks or twisting movements

Lifestyle Guidelines

Limit bed rest to 1-2 days maximum—prolonged rest weakens muscles and slows recovery. Gradually resume light activities:

• Avoid: Heavy lifting (>10 lbs), bending/twisting, prolonged sitting (>30 minutes), high-impact activities (running, jumping).
• Do: Walk short distances (5-10 minutes every few hours), perform gentle stretches (e.g., knee-to-chest), maintain good posture.
• Physical Therapy: Start PT after 1-2 weeks if pain persists—focus on McKenzie exercises, core strengthening, and nerve gliding.

Red Flags: Seek Immediate Care

Contact your doctor or go to the ER if you experience:

• Worsening weakness (e.g., foot drop, inability to walk)
• Loss of bowel/bladder control (cauda equina syndrome—emergency!)
• Severe unrelieved pain despite meds
• Fever, unexplained weight loss, or history of cancer/infection

Expected Recovery and Follow-Up

Most patients see 50% pain relief in 2-4 weeks. Schedule follow-up in 2-4 weeks for reassessment—MRI if no improvement. Surgery (microdiscectomy) is rare (<10%) but considered for persistent severe symptoms >6 weeks or red flags.

Follow these steps consistently for the best outcome.

Questions? Discuss with your surgeon.