Bulged Disc Exercises (Lower back)

This blog post will cover the best bulged disc exercises for the lower back. (especially if the L4, L5 and/or S1) is involved!)

(These exercises may also be used for a disc herniation, protrusion, prolapse, extrusion and/or sequestration.)

The best bulged disc exercises for the lower back

The following exercises are to be performed completely PAIN-FREE. If any doubts, please consult a health professional to assess whether the exercises are appropriate for you.

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Step 1: Understand this

It is important to note that just because your imaging scan results show that you have a disc bulge (or Herniated Disc) in your spine, does not necessarily mean that you will have lower back pain and/or Sciatica for the rest of your life.

… Disc bulges can heal!

Note:  Interestingly enough – it is possible to have a bulged disc present and have absolutely no pain at all!

Step 2: Stop All Activities That Cause Pain

Stop, Modify or Reduce exposure to any movement/position/activity that makes your symptoms significantly worse.

The continual exposure to aggravating activities may increase the inflammation (and irritability) of your disc bulge.

The aim is to remain as active as possible without exceeding the capacity of what the lower back can comfortably tolerate.

For example: Sitting

• Stop: If your pain worsens as soon as you adopt the sitting position, try to completely avoid sitting altogether for now.
• Modify: Try sitting with a different posture, use a different chair, use a lumbar support etc.
• Reduce Exposure: Minimize the amount of sitting that you are doing.

Step 3: Reduce Inflammation

A significant amount of inflammation (… and pain!) in the lumbar spine can make it difficult to perform the suggested Bulged Disc Exercises effectively.

(Note: Please consult your medical doctor before starting any of the following:)

a) Anti-inflammatory gel

Apply an anti-inflammatory gel to the area of pain for 2-3 times per day.

b) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs help reduce inflammation in the whole body.

There are different strengths/dosages of NSAIDs and is best used if the prescribed medication is appropriate to the amount of inflammation present.

c) Cold therapy

Apply an ice pack to your lower back for at least 10-15 minutes, 3-5/day.

d) Natural products

Natural foods such as turmeric, curcumin, ginger, chia seeds and fish oil capsules are thought to help reduce inflammation.

e) Cortisone injection

The cortisone injection consists of a strong anti-inflammatory steroid (cortisone) and an analgesic substance.

It is designed to reduce local inflammation around the bulged disc.

Step 4: Gentle movement exercises

The aim with these initial exercises is to move the lower back as much as you can comfortably tolerate.

a) Is walking good for Bulging Disc?

100% yes!

Aim to stay active and mobile as much as possible.

If you are unable to walk long distances, consider walking in a heated pool (Hydrotherapy) or walk shorter distances more frequently.

(Avoid excessive bed rest as this has the potential to make your symptoms worse!)

b) Lumbar Roll

Instructions:

• Lie on your back with your knees in the bent position.
• Let your knees drop all the way down to one side.
• Alternate sides.
• Repeat 20 times.

c) Knees to chest

Instructions:

• Lie down on the floor.
• Hug both knees towards your chest.
• Completely relax your legs and allow the arms to take the full weight of the legs.
• Perform gentle oscillations in this position.
• Continue for 20 seconds.
• Note: If desired, you can perform this exercise using one knee at a time.

d) Standing Extension

Instructions:

• Stand up right..
• Place your hands on your hips.
• Start to slowly arch your lower back backwards.
• Aim to feel a gentle tension across your lower back. No pain should be experienced.
• Repeat 20 times.

e) Standing side bends

Instructions:

• Stand up right.
• Slowly bend towards one side.
• Make sure that you only go far as you are comfortable.
• Repeat on the other side.
• Repeat 20 times.

Step 5: Exercise to help reduce the disc bulge

These exercises are designed to reduce the size of a posterior disc bulge (L4/5 and L5/S1 being the most common). As the movement becomes more comfortable, try to move further into range.

a) Lumbar Extension (static hold)

Instructions:

• Whilst lying on your stomach, use your forearms to slowly arch backwards.
• Only go as high as you can comfortably tolerate.
• You should feel a gentle tension across your lower back. No pain should be experienced.
• Hold for 30 seconds.

b) McKenzie Extension (repeated movements)

Instructions:

• Whilst lying on your stomach, use your forearms to slowly arch backwards as high as you can comfortably tolerate.
• You should feel a gentle tension across your lower back. No pain should be experienced.
• Keep your lower back relaxed. All the power should be coming from your arms.
• Repeat 20 times.

c) Pelvic tilts

Instructions:

• Lie on your back with your knees bent.
• Slowly tilt your pelvis forwards.
  • “Create an arch in your lower back.”
• Aim to feel a contraction in your lower back.
• Relax back to the starting position.
• Repeat 20 times.

d) Pelvic tilt (4 point kneel)

Instructions:

• Assume the 4 point kneel position. (see above)
• Gently tilt your pelvis forwards.
• As you perform this, you should feel the lower back contract.
• Relax back to the starting position.
• Repeat 20 times.

Step 6: Spinal Decompression (Traction)

The aim of the following exercises is to reduce pressure/compression on the bulged disc.

a) Manual traction

Instructions:

• Lie down on the floor.
• Instruct someone to hold onto your ankles and apply a gentle pulling action on both of your legs.
• Keep your legs completely relaxed.
• Hold for 30 seconds.
• Note: If you find that you are sliding, perform the exercise on a tiled floor and have the skin on the lower back in contact with the floor. (This will help stick you to the floor!)

b) Chair Hover

Instructions:

• You will need 2 chairs for this exercise.
• Hold onto the top of the chairs. (See above)
• Slowly apply more pressure into your hands as to take pressure off your feet.
• Keep your legs and lower torso completely relaxed.
• You do not have to lift your feet off the floor.
• Hold for 30 seconds.

c) Decompression over ball

(Note: This position may not be suitable for those who are sensitive when bending the lower back.)

Instructions:

• Lie on top of a large exercise ball. (Facing downwards)
• Position your body so that your lower back is in line with the top of the ball.
• Completely relax your legs and allow them to dangle.
  • Let the weight of your legs pull on the lower back.
• Support your body using your hands only.
• Allow the toes to gently rest on the floor.
• Aim to feel a stretch in the lower back.
• Hold for 30 seconds.

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Step 7: Core Exercises

Strengthening your core muscles will help control your lower back and reduce pressure on the discs.

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Muscles targeted:

• Transversus Abdominis
• Multifidus
• Diaphragm (Breathing muscle!)

It is important to FEEL the contraction of these muscles so that you can effectively apply it to your strengthening exercises in Step 8.

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a) Dead bug exercise

(Transversus Abdominis)

Instructions:

• Lie on your back with both of your knees bent in the air.
• Engage the Transversus Abdominis and abdominal group by performing the following:
  • “Breathe in and blow out ALL of the air out of your lungs. As you can not exhale any more air out, take notice of how your stomach muscles have engaged. Maintain this contraction throughout this exercise.”
  • Aim to feel a slight tension in the abdominal region.
  • Do not hold your breathe.
• Rotate your pelvis backwards.
  • This is to flatten your lower back.
  • Keep your lower back elongated.
• Maintain this lower back position throughout this exercise.
• Slowly lower the opposite arm/leg.
  • Lower the better! (… but only if you can keep the lower back FLAT!)
• Alternate sides.
• Repeat 20 times.

b) 4 point kneel

(Multifidus)

Instructions:

• Assume the 4 point kneel position. (see above)
• Engage the Multifidus muscle:
  • “Imagine a string from the lower back to the back of your pubic bone. Shorten this string towards the pubic bone.”
  • Aim to feel a slight tension in your lower back.
• Slowly lift your opposite arm/leg without letting your pelvis tilt.
  • Imagine that there is a glass of water on your back. Don’t spill it!
• Alternate legs.
• Do not hold your breathe during this exercise.
• Repeat 20 times on each side.

Step 8: strengthening exercises for Herniated Disc

Strengthening the muscles that control and/or influence the lower back will help reduce pressure on the disc bulge.

a) Bridge

(This exercise will strengthen the Gluteal muscles)

Instructions:

• Lie on your back with knees bent.
• Engage your glutes to tilt your pelvis backwards.
  • This should flatten your lower back onto the ground.
• Engage your core muscles.
• Push through your heels and drive your hips upwards.
• Aim to feel the contraction in your gluteal muscles.
• Only go as high as you can go without arching your lower back.
• Hold the end position for 5 seconds.
• Repeat 10 times.

b) Arm/Leg lift

(This exercise will strengthen the Erector Spinae muscles.)

Instructions:

• Lie on your stomach.
• Stretch out both arms in front of you.
• Engage the core muscles.
• Lift up the opposite arm/leg as high as possible.
• Aim to feel a contraction in the muscles of the lower back.
• Hold for 5-10 seconds.
• Repeat on other side.
• Repeat 20 times.
• Progression: Lift both legs and arms at the same time.

c) Seated rotation with resistance

(This exercise will strengthen the muscles that rotate the torso.)

Instructions:

• Sit up right on a chair.
• Engage the core muscles.
• Using both hands, hold onto a resistance band that is anchored towards the side. (see above)
• Rotate your torso away from the anchor point.
  • Breathe out as you do this.
• Hold for 5 seconds.
• Repeat 20 times.
• Repeat for opposite direction.

d) Side bends

(This exercise will strengthen your Obliques.)

Instructions:

• Stand up right.
• Hold onto weights in your hands.
  • Use a suitable amount of weight.
• Engage the core muscles.
• Proceed to bend all the way to the side.
• Make sure that you do not twist your body.
• Alternate sides.
• Repeat 20 times.

e) Crunches

(This exercise will strengthen the Abdominal muscles.)

Instructions:

• Lie down on the floor with the knees bent.
• Gently support the back of your head with your hands.
• Engage the core muscles.
• Crunch forwards.
  • Only lift high enough so that your shoulder blades are off the floor.
• Hold for 3-5 seconds.
• Repeat 20 times.

f) Plank

Instructions:

• Get into the plank position. (see above)
• Position your pelvis in a neutral position.
• Engage the core and glute muscles to stabilize the pelvis.
• Make sure your lower back does NOT sink in.
• Hold for 30 seconds.

g) Side Plank

Instructions:

• Get into the side plank position. (see above)
• Engage the core muscles.
• Hold for 30 seconds.
• Note: Be aware that this exercises also places more stress to the shoulder.

Step 9: Prevention

Once symptoms have subsided following the bulged disc exercises, it is essential that an effort is made to reduce the risk of any re-aggravations in the future.

By now, you should have a good idea of what positions, movements and/or activities your lower back is more sensitive in.

These are the positions/movements that you will need to exercise more care with in the future.

Common positions that will aggravate the lower back:

a) Bending forwards

Engage the core muscles (see above) if you need to bend your lower back.

This will help control the lower back more effectively and potentially reduce the risk of a re-aggravation.

Remember – activate the core muscles just enough to allow you to do the movement confidently and safely. (Do NOT over-contract them!)

b) Lifting from the floor

If you need to pick up a heavy object from a lower height, aim to use the Hinge pattern (see below).

Instructions:

• Keep your lower back in a neutral position throughout this movement.
• Engage the core muscles.
• Slowly lower your torso by hinging at the hips.
  • Only go as low as you can maintain the neutral lower back position.
  • Aim to feel a pulling sensation in the upper hamstring region before returning to the starting position.
  • Keep the hands close to your body.
  • The knees should be slightly bent.
• Do not allow your lower back to round forwards.
• Progression: Hold onto a weight.

c) Sitting posture

When sitting – make sure that your pelvis is in the neutral position.

Instructions:

• Locate the “Sit bones”:
  • Whilst sitting down, slide both hands underneath your hips.
  • Feel for a bony prominence.
• Tilt your pelvis forwards and backwards.
  • As you are doing this, feel for when the pointiest part of the bone protrudes into your hand.
  • This corresponds to when your pelvis is in the neutral position.
• Visualize these bones as upside down triangles.
  • The aim is to sit directly on top of the point of the triangle.

Note: Most people tend to sit in a position of a posterior pelvic tilt which is where the tail bone is tucked underneath.

This leads to the lower back rounding forwards which can potentially place more pressure on the discs in the lumbar spine.

d) Prolonged positions

It is important to take a break from any positions (such as sitting, standing and being bent over) that is sustained over a long period of time.

Aim to take a break at least every 30 minutes.

e) How do you sleep with a bulging disc?

Aim to keep your lower back in a neutral position as you sleep.

I recommend the following:

• Sleep on the back: Place a small rolled up towel underneath the arch of your lower back.
• Sleep on the side: Tilt your pelvis in a slightly forwards position.

A prolonged amount of time in a twisted, bent, over extended or tilted position may aggravate your symptoms.

Also – make sure that your mattress is providing adequate support.

f) Exercises to avoid with Bulging Disc

Exercises that require flexion of the lower back should be avoided in the short term.

Please be careful with:

• Squats
• Deadlift
• Kettlebell swings
• Bent over rows
• Jumping
• Quick change in direction
• High impact sports

Step 10: Surgery for bulged disc

If you have persisted with these bulged disc exercises for at least 6 months and your symptoms are still quite significant, then the next option may be a surgical review with the Orthopedic surgeon.

I’ll be very honest with you and say that I am not the biggest fan of surgical intervention.

However – in some severe cases where all other conservative management has failed, it may be the next appropriate action to take.

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Closing words

Remember – The presence of a disc bulge found on imaging scans DOES NOT necessarily mean that you’ll have pain for the rest of your life!

I believe that the bulged disc exercises mentioned in this blog post will help fast-track the healing process.

Keep active and moving, get your lower back as strong as possible and exercise caution when doing the more riskier movements.

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Disclaimer: The content presented on this blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before starting any exercise. For more information: Medical disclaimer.