Told You Have a Herniated Disc? What It Means
By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published October 2026
You finally got an MRI for your back or neck pain, and the report says "herniated disc." For a lot of people, those words are scary. They picture something broken that will never be the same, or a surgery they can't avoid.
The reality is usually more hopeful. Disc herniations are common, many get smaller on their own, and many people improve with time and active care. This article explains what a herniated disc diagnosis means, what research shows about recovery, and which symptoms need a doctor right away.
This article is for people whose physician has already diagnosed a herniated disc, often with an MRI. It isn't meant to help you diagnose yourself.
The short answer
A herniated disc means some of the soft inner material of a spinal disc has pushed beyond its usual boundary. It can irritate a nearby nerve and cause pain, numbness, or tingling in the leg (or the arm, for a neck disc), but many people with disc herniations on MRI have no pain at all. Research shows that many herniations shrink over time, especially larger ones. Staying active and following a guided exercise program are core parts of non-surgical care, and your physician or spine surgeon will discuss whether other treatments, including surgery, make sense for you.
What is a herniated disc?
Between the bones of your spine are discs that act like cushions and spacers. Each disc has a tough outer ring and a softer, gel-like center. When part of that center pushes out through the outer ring, it's called a herniated disc. You may also hear "slipped," "ruptured," or "bulging" disc, though these terms don't all mean exactly the same thing.
MRI reports often use more specific words:
• Bulge: the disc extends a little beyond its normal edge, over a wide area
• Protrusion: a more focal push outward, still mostly contained
• Extrusion: disc material pushes further out
• Sequestration: a piece of disc material has separated from the disc
Herniations are most common in the lower back, where they're often linked with sciatica, and in the neck, where they can cause arm symptoms. Your physician is the right person to explain exactly what your report shows.
Does a herniated disc always cause pain?
No, and this surprises many people. A large review of spine MRIs in people with no back pain at all found that disc bulges showed up in 30% of 20-year-olds and 84% of 80-year-olds, and disc protrusions in 29% of 20-year-olds and 43% of 80-year-olds (Brinjikji et al., AJNR 2015).
In other words, disc changes on MRI are often a normal part of aging, a bit like gray hair on the inside. That doesn't mean your disc isn't involved in your symptoms. It means the MRI is one piece of the picture, and your physician will match it to your symptoms and exam.
Do herniated discs heal?
Often, yes. A 2015 review found that disc herniations frequently shrink on their own over time, and the larger types are actually the most likely to regress (Chiu et al., Clinical Rehabilitation 2015):
• Sequestration: about 96% showed regression
• Extrusion: about 70% showed regression
• Protrusion: about 41% showed regression
• Bulge: about 13% showed regression
Symptoms often improve before an MRI would show any change. Recovery is different for everyone, and some people do need further medical treatment. Questions about injections or surgery are decisions to make with your physician or spine surgeon, who can explain the options for your situation.
How can physical therapy help?
Physical therapy focuses on helping you move, stay active, and get back to the things you need and want to do while your symptoms settle. The UK's NICE guideline on low back pain and sciatica recommends considering group exercise programs and encourages people to continue normal activities as far as possible (NICE NG59). The APTA's low back pain guideline also supports exercise, education, and manual therapy as part of care (George et al., JOSPT 2021).
A physical therapy evaluation may include:
• Your diagnosis and imaging report from your physician
• How your symptoms behave with sitting, standing, walking, and bending
• Strength, sensation, and reflexes in your legs or arms
• How you move, lift, and get through your workday
• Screening for signs that need your physician's follow-up
A typical plan may include:
• Clear education about your diagnosis and what recovery usually looks like
• Movements that ease symptoms, and ways to stay active without flaring them
• Strengthening for the trunk, hips, and legs, or the neck and shoulders, progressed over time
• Hands-on treatment, when it helps you move more comfortably
• Guidance on sitting, lifting, driving, and returning to exercise
• A home program you can keep doing on your own
Physical therapy doesn't guarantee a specific result, and it isn't a substitute for a surgeon's opinion when one is needed. If your symptoms change or get worse, we coordinate with your physician.
At Nova Physical Therapy in North Hollywood, back and neck pain is one of our core services, and every plan starts with an evaluation so treatment fits what we find.
When do I need a doctor right away?
Call 911 or go to the emergency room if you have (NHS):
• Numbness around your genitals, buttocks, or inner thighs
• New trouble controlling your bladder or bowels, or trouble starting to urinate
• Pain, weakness, or numbness in both legs
• Weakness in a leg or foot that is getting worse quickly, such as your foot slapping or dragging when you walk
These can be signs of serious pressure on the nerves at the base of the spine (cauda equina syndrome), which needs immediate care.
Contact your physician promptly if you notice:
• Arm or leg weakness that's getting worse
• Clumsy hands, trouble with buttons or handwriting, or new balance problems (especially with a neck disc)
• Fever, unexplained weight loss, or a history of cancer along with back pain
• Pain that keeps getting worse despite care
We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.
Do I need a referral for physical therapy in California?
Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.
Frequently asked questions
Is a bulging disc the same as a herniated disc?
Not exactly. A bulge is a broader, milder extension of the disc, while a herniation is a more focal push of disc material. Bulges are very common in people without pain. Your physician can explain what your report means.
Will I need surgery for a herniated disc?
That depends on your symptoms, your exam, and how you respond over time. Many people improve without surgery, and for some people surgery is the right choice. That decision is made with your physician or spine surgeon.
Can a herniated disc go away on its own?
Many do get smaller over time, especially larger herniations. Research shows regression is common, though it varies from person to person.
Should I avoid bending or lifting forever?
Usually not. Most people can gradually return to normal bending and lifting with guidance. A physical therapist can help you build back up safely.
Is it safe to exercise with a herniated disc?
For most people, staying active is encouraged. The right type and amount depends on your symptoms, so get guidance from your physician or physical therapist, and stop and get checked if any of the warning signs above appear.
How long does it take to recover?
Many people notice improvement over several weeks to a few months, but it varies. Symptoms often improve before an MRI shows any change.
Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.
If your herniated disc comes with leg pain, read our posts on sciatica and lower back pain for more on what helps.
About Nova Physical Therapy
Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from back and neck pain, sports injuries, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.
Schedule an evaluation
If you've been told you have a herniated disc and want a clear plan to stay active and move forward, an evaluation can help you understand your next steps.
Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Imaging results should be interpreted by your physician. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.
References
1. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. Link
2. Chiu CC, Chuang TY, Chang KH, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015. Link
3. National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). Link
4. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1–CPG60. Link
5. NHS. Back Pain. Link