Surgery isn't usually considered unless you develop severe pain or nerve damage that gets steadily worse.  If you have loss of bladder or bowel control, you may need surgery right away. Surgery to remove a ruptured disc is done through a very small incision under a general anesthetic. Traction and a supportive neck collar can help a herniated disk in the cervical spine. During traction, a machine gently pulls the spine to relieve the pressure on it. For traction therapy, your doctor may send you to physical therapy so that the therapist can show you how to safely use the traction equipment and even take the equipment for use at home.

Prior to any of the above occurring, there are some basic actions you could perform right away that will help reduce pain, manage symptoms, and provide you with some comfort. You should avoid sitting for long periods of time, consider taking breaks every 15 to 20 minutes, and pay close attention to your posture. We suggest that while sitting you should:

• Keep your feet flat on the floor
• Adjust your seat so your knees and hips are at 90 degrees, and
• Hold your head directly above your pelvis

This posture will promote the proper curvature of your spine and allow 75% of your body weight to be supported by your hips and your thighs instead of your tailbone (sacrum) or the bones of your spine. Posture is not only important in the sitting and standing position but also critical during all phases of your exercise program. Exercises for people with herniated disc(s) are meant to strengthen the musculature surrounding the spine and hence reduce the load on the discs. In order to strengthen the musculature surrounding the spine, all aspects of the trunk must be exercised. Exercises that strengthen the trunk extensors (Quadratus Lumborum, Erector Spinae, Lumbar Multifidus, etc) help control and support the spine in movements that involve trunk extension from a flexed trunk position. Exercises that strengthen the trunk flexors and rotators (Rectus Abdominis, Transversus Abdominis and Internal and External Obliques) help support and stabilize the spine in all other directions (Trunk Flexion, Lateral Flexion, and Axial Rotation). A “neutral” spine is the optimal sitting and standing posture. Avoid daily activities that would require the following:

• Flexing the trunk (Lumbar Spine) while weight bearing
• Sitting with your hips pushed out in front of the spine and head
• Standing with your hips tucked excessively under you
• Standing while pushing your hips back excessively (creating hyperextension of the lower back)

Additionally, a flexible pelvic region is required to guard against muscle tightness. The Hamstrings, Hip Flexors, and Gluteals must all be stretched to allow the pelvis to remain in a comfortable neutral position. If your doctor suggests physical therapy to reduce the risk of injury to the disc and spinal nerves, you will be shown exercises that are suitable for you.

In general, the following may help prevent a recurrence or aggravation of a herniated disc:

• exercises that strengthen the abdominal and back muscles
• good posture (standing up straight, sitting straight, lifting things with the back straight)
• bending the knees and hips when lifting something and keeping the back straight
• holding an object close to the body when carrying it
• avoiding wearing high-heeled shoes
• keeping at a healthy weight
• reducing or avoiding smoking