Why "Herniated Disc = Pain" Is Not the Whole Story: A Manual Therapist's Approach to Hope
Have you been struggling with back pain for years, only to visit a doctor and be told, “You have a herniated disc”?
Perhaps you heard things like: “The disc that’s bulging out is pressing on a nerve, and that’s causing the pain.” “We might need to consider surgery.”
Hearing this, it’s easy to feel anxious and wonder what the future holds.
The explanation that a herniated disc is compressing a nerve is still very common. However, it’s also true that a growing number of specialists now believe that this physical compression isn’t the whole story behind the pain.
How Has the Cause of Pain Been Understood?
For over a century, the idea that “pain and numbness in the legs are caused by a herniated disc pressing on a nerve” has been accepted as common knowledge in the medical community.
Based on this concept, countless surgeries to remove the protruding part of the disc have been performed worldwide. So, it’s completely understandable why the image of “herniated disc = nerve compression and pain” is still so strong today.
A New Perspective: It's Not Just About Compression
However, recent research has shown that there are many cases that cannot be explained by nerve compression alone.
For instance, the following questions have been raised:
A herniated disc is a very soft tissue, much like a gummy candy. Is it capable of exerting enough pressure on a much tougher nerve to cause severe pain all by itself?
A prominent theory now suggests that in addition to pressure, chemical substances released from the herniated disc can cause inflammation, which in turn triggers pain.
If a nerve were truly under intense and continuous compression, it would more likely lead to paralysis—a loss of sensation or the inability to move a leg—rather than pain.
These points have brought attention to the idea that the cause of pain and numbness is not simply a matter of physical compression.
Another Important Perspective: Muscles and Blood Flow
So, if physical compression isn’t the only factor, what else could be causing the pain?
Of course, there isn’t just one single cause; the reasons are incredibly varied, including factors like a decrease in bone durability, a decline in organ function, or the involvement of the autonomic nervous system.
And what many manual therapists are paying close attention to is poor blood flow caused by muscle tension.
Through daily habits and stress, our muscles can become tight without us even realizing it. When muscles stiffen, they constrict the blood vessels running through them, which worsens circulation.
Blood plays the vital role of delivering oxygen throughout the body while carrying away substances that cause pain. If that flow is restricted, muscles can become starved of oxygen, which we then experience as “pain” or “numbness.”
In fact, there are many cases where a patient’s pain doesn’t improve even after surgery to remove the hernia. Conversely, there are also many people who have a visible herniated disc on an MRI but have no symptoms at all. These facts support the idea that the cause of pain is not just from the herniated disc’s compression.
You might also like: Solving the Mystery of Chronic Pain: What is “Oxygen Starvation” in Your Body?
The Key Is Finding "Why" There's Strain
At my studio, I base my treatments on this very perspective of focusing on muscles and blood flow.
I don’t just mindlessly try to loosen tight muscles. That often provides only temporary relief. What’s most important is to identify the root cause of why those muscles became tight in the first place.
It could be due to how you’ve used your body over many years, a subtle habit in your daily life, or perhaps you’ve been compensating for another part of your body, putting continuous strain on specific muscles.
I take the time to listen carefully to each client’s story and thoroughly assess their condition, aiming for fundamental improvement that addresses the root of the problem.
Before you resign yourself to thinking, “It’s just my age,” or “I have to live with this,” why not take a moment to listen to what your body is truly telling you? That painful condition you’re experiencing might not be just because of the herniated disc.