Your MRI Says Herniated Disc. Here's What That Actually Means.
Few words sound worse than "herniated disc." It sounds permanent, and it sounds like the end of heavy lifting. For most active adults it is neither. Discs heal, many herniations shrink on their own, and most people with a disc injury return to the training they love without surgery.
Free ConsultationSound Familiar?
If any of these resonate, you're not imagining it, and you're not stuck.
In the low back
- Back pain that is worse when you bend forward, sit, or lift
- Pain that is worse in the morning or after a long sit
- Coughing or sneezing that sends a jolt through the back or the leg
- Pain, tingling, or numbness that runs down one leg
- A back that locked up after a lift, a twist, or a bend
- A shift to one side when you stand after a flare
In the neck
- Neck pain with pain, tingling, or numbness into one arm
- A grip or an arm that feels weaker than the other side
- Pain that changes when you look down or turn your head
- Pain at the shoulder blade that won't let go
- Symptoms that are worse after a day at a desk
- Trouble getting comfortable to sleep
These aren't signs of weakness. They're signs that your body needs a smarter approach, built around how you actually move and train.
What a Disc Injury Is, and What It Isn't
A spinal disc is a tough outer ring with a softer center. A bulge is a broad spread of the disc past its normal edge. A herniation is when part of the center pushes through the outer ring. Either one can irritate a nearby nerve and cause pain, numbness, or weakness in the leg or the arm.
Disc changes are also very common in people with no pain at all. Many adults with no symptoms have a bulge on an MRI, and the rate goes up with age. So the scan is one piece of the picture, not the whole answer. How you move, what eases the pain, and how the nerve tests on exam tell you just as much.
At Fortitude & Freedom Performance Therapy in Waukee, Iowa, Jake Pawol, PT, DPT, OCS treats disc injuries one on one: settle the pain, protect the nerve, then rebuild the back's tolerance to load so you can lift again. In Iowa you can start physical therapy without a physician referral.
Discs are living tissue, and they respond to load like other tissue does. They don't do well with long periods of the same position, and they don't do well with total rest. They do well with regular movement and with load that goes up at a pace they can handle.
Many herniations get smaller over time, and the larger ones are often the most likely to shrink. That's one reason most people with a disc injury do not need surgery. The body has a real process for cleaning it up, and your job is to stay active while it happens.
The hard part is the fear. After a disc diagnosis, it's normal to brace every time you bend. Some of the treatment is rebuilding trust that your back can bend, lift, and twist again, because it can.
Fear of bending
Avoiding every bend makes the back stiffer and more protective, and that guarding adds to the pain. Bending is not the enemy. Bending more than you're ready for is the problem, and the plan fixes that gradually.
Read what is safe to lift with a herniated discToo much, too soon after a flare
A heavy deadlift session in the first good week after a flare is a common way to restart it. The plan builds load back in steps so the good week turns into a good month.
Your week-by-week recovery after a deadlift injuryLong sitting
Sitting for hours puts steady pressure on the low back discs. Breaking up the day often helps more than any single exercise.
A nerve that is involved
When the disc irritates a nerve root, the leg or arm pain is often the main problem. That pain needs its own plan.
Read about sciatica and nerve painHow I Treat This
I treat disc injuries by settling the pain first, then building the back back up with load. Every visit is one on one with me in my gym in Waukee, and the plan keeps as much of your training as the back allows. Individual results may vary.
A full exam of the spine, the nerves, and the strength and sensation in the limb, with a screen for red flags
Directional movements that ease the pain and pull the symptoms back toward the spine
Hands-on work and dry needling for the guarded muscles, where it fits the case
A progressive plan back to bending, hinging, and lifting from the floor
Changes to your training and your workday so the back can heal while you stay active
A plan for the first sign of a flare, so you know exactly what to do
How This Usually Goes
Disc injuries improve in steps, not in a straight line. Knowing the steps makes a bad day easier to handle.
- 1
Visit one
A full exam and a red flag screen. We find the movements that ease the pain and the ones that make it worse, and you leave knowing what to do that day and that night.
- 2
The first few weeks
The pain settles and the leg or arm symptoms pull back toward the spine. Walking, light training, and the movements that ease it fill the days.
- 3
The middle
Load comes back in steps: hinges, carries, squats, and pulls from the floor. Bending stops being scary because you have proof it's fine.
- 4
The end
Back to your full training, with a back that has the strength to handle it and a short plan for what to do if it complains again.
Who This Is For
Waukee, Iowa, and the Des Moines metro around it. People with a disc diagnosis who want to get back to a full, strong life.
- Lifters who were told to stop deadlifting after an MRI
- People who brace every time they bend to pick something up
- Anyone with a disc in the neck and pain or tingling into the arm
- People who want to try active care before an injection or surgery
- Desk workers whose back gets worse through the day
- Parents who want to lift the kids without thinking twice
Read More
Herniated Disc and Lifting
What is safe, what is not, and how PT helps.
Read MoreSciatica & Nerve Pain
When the pain runs down the leg or the arm.
Read MoreBack Pain
Episodes, tightness, and pain that limits training.
Read MoreNeck Pain
Stiffness and pain that runs into the arm.
Read MoreHurt Your Back Deadlifting?
Your week-by-week recovery.
Read MoreLower Back Pain After Deadlifts
And how to keep lifting.
Read MorePowerlifting Physical Therapy
Rehab built around the barbell.
Read MoreCommon Questions
Will I need surgery for a herniated disc?
Most people don't. Many herniations get smaller over time, and most disc-related pain improves with active care. Surgery makes sense for a small group: people with severe or worsening weakness, the emergency signs below, or pain that does not improve after a fair trial of care. I'll refer you to a surgeon when that's the right call.
When is a disc injury an emergency?
Go to the emergency room now if you have new numbness in the groin, the genitals, or the inner thighs, new trouble with bladder or bowel control, or leg weakness that gets worse quickly. These are signs of a rare but serious nerve compression.
Can I lift again after a herniated disc?
Yes. Most lifters return to deadlifts, squats, and heavy training after a disc injury. The path back is gradual, and the order matters, but a disc injury is not a lifetime ban from the barbell.
Is a bulging disc the same as a herniated disc?
No. A bulge is a broad spread of the disc past its edge, and it is very common on scans of people with no pain. A herniation is when the center pushes through the outer ring. Either one can cause symptoms, and either one can be on a scan with no symptoms at all.
Do I need a referral to see a physical therapist in Iowa?
No. In Iowa you can start physical therapy without a physician referral, so you can book directly and be seen. Some insurance plans ask for one before they pay, which is a separate question from whether you're allowed to be treated. Check with your plan.
Do you take insurance?
This is a hybrid practice. We accept Blue Cross Blue Shield and TRICARE alongside cash pay. Coverage details differ by plan, so check with your plan, and our team can walk you through the options when you get in touch.
Where can I get herniated disc treatment near me in Waukee?
Fortitude & Freedom Performance Therapy is in Waukee, Iowa, and treats people from Waukee, West Des Moines, Clive, Urbandale, Ankeny, and the wider Des Moines metro. Visits are one on one in a fully equipped gym, and Iowa does not require a physician referral to start.
Medical Disclaimer
This content is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician, and reading it does not create a patient relationship. Talk to a qualified health professional about your own symptoms before you act on anything here. If you have severe, sudden, or worsening symptoms, seek medical care right away.
Let's get you bending and lifting again.
Tell us what your back or neck is doing and what you want to get back to, and our team will set you up with Jake.
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