Non-Surgical Assessment and Management of Disc & Nerve Pain
Perth Chiro Centre focuses on the assessment and conservative management of spinal disc and nerve related conditions including sciatica, disc bulges and herniated discs.
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Our assessment is not a general spinal check. The purpose of the consultation is to review your MRI or CT scan findings and determine whether your symptoms correlate with a disc and nerve condition that may respond to conservative care.
Our consultations involve clinical testing and imaging correlation to determine whether non surgical care is appropriate.
Signs of a Herniated Disc
• Leg pain (sciatica) below the knee
• Pain worse sitting
• Pins and needles in the foot
• Numbness in the leg
• Weakness in the ankle or toes
• Pain when coughing or sneezing
When a Disc Herniates, Symptoms Can Escalate Quickly
A herniated disc can cause significant discomfort and, in some cases, severe nerve pain that disrupts sleep, mobility, and daily function. Many patients initially believe they have a muscle strain when symptoms first begin. In reality, a lumbar disc bulge may already be present before a herniation develops.For many patients, symptoms appear suddenly and may feel far more intense than typical lower back pain.
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Pain may travel into the buttock or leg, and simple movements such as sitting, bending, or getting out of bed can become difficult.
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If you have been diagnosed with a herniated disc — or suspect one based on your symptoms — early assessment is important to help determine the most appropriate pathway forward.
At Perth Chiro Centre, our clinical focus is the non surgical assessment and management of spinal conditions involving discs and nerve structures.
What Is a Herniated Disc?
Spinal discs act as cushions between the vertebrae. Each disc contains a softer inner material surrounded by a tougher outer wall.
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A herniated disc occurs when part of the inner material pushes through a weakened area of the outer wall. This can place pressure on nearby nerves and trigger inflammation.
Herniations are sometimes referred to as:
• slipped discs
• ruptured discs
• prolapsed discs
• disc extrusions
They most commonly occur in the lower back.
Understanding the Different Types of Disc Herniation
Not all herniated discs are the same. The size, position, and structural behaviour of the disc can influence both symptoms and management decisions.
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Common classifications include:
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Disc Protrusion
A protrusion occurs when the disc extends outward but the outer wall remains largely intact. These presentations may respond well to appropriately guided conservative care when clinically suitable.
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Disc Extrusion
An extrusion involves the inner disc material extending through the outer wall while remaining connected to the disc. Symptoms are often more pronounced when nerve structures are affected, and careful assessment is important when determining the most appropriate treatment pathway.
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Disc Sequestration
This occurs when a fragment of disc material separates from the main disc. Management varies depending on neurological findings, symptom severity, and individual circumstances.
Imaging findings alone do not determine the best course of action. Clinical assessment plays a central role in understanding whether conservative care may be appropriate or whether medical or surgical opinion is recommended.
Does the Size of a Herniation Matter?
Larger herniations do not always produce more severe symptoms, and smaller disc injuries can sometimes cause significant nerve irritation.
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Treatment decisions are guided by the overall clinical picture rather than imaging alone, including neurological findings, symptom behaviour, and functional limitation.
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Some patients respond well to conservative care, while others may require medical or surgical evaluation. Clear assessment helps determine the most appropriate pathway.
How Diagnosis Is Confirmed
A disc herniation seen on imaging does not always explain a patient’s symptoms.
Many people have MRI findings without significant pain, while others may have severe nerve irritation with relatively small structural changes.
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Assessment therefore involves more than identifying a disc abnormality.
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The consultation includes neurological testing, movement assessment, and comparison of clinical findings with CT or MRI imaging. The goal is to determine whether the disc finding is clinically relevant and whether conservative care is appropriate.
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Where symptoms and imaging do not correlate, alternative causes of pain or referral may be considered.
Common Symptoms of a Herniated Disc
Symptoms depend on the size and position of the herniation and whether nerve tissue is affected.
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Patients commonly report:
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• Sharp or intense lower back pain
• Pain travelling into the buttock or leg
• Burning or electric shock sensations
• Tingling or pins and needles
• Numbness
• Muscle weakness
• Difficulty sitting
• Pain when coughing or sneezing
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Some herniations cause severe symptoms, while others may produce surprisingly little pain.
Accurate assessment helps determine clinical significance.
Why Do Herniated Discs Occur?
Herniations may develop suddenly or progressively.
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Contributing factors can include:
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• Repetitive spinal loading
• Lifting injuries
• Twisting movements under load
• Degenerative disc changes
• Previous disc bulging
• Reduced spinal stability
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In many cases, patients cannot identify a single event that caused the injury.
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When Should a Herniated Disc Be Assessed?
Assessment is recommended if symptoms are:
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• Severe
• Persistent
• Worsening
• Travelling into the leg
• Associated with numbness
• Affecting strength
• Limiting normal activity
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Early evaluation allows appropriate care pathways to be identified and helps reduce the risk of prolonged nerve irritation.
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This clinic assesses disc and nerve conditions using both clinical examination and imaging correlation.
A recent CT or MRI scan is required before booking.
The purpose of your consultation is to review your scan findings, evaluate neurological function, and determine whether non surgical care — including spinal decompression — is clinically appropriate.
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If you have not yet had imaging, please speak with your GP regarding referral. CT scans are often bulk billed when requested by your doctor.
Symptoms That Require Urgent Medical Attention
Seek immediate medical care if you experience:
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• Progressive muscle weakness
• Loss of bowel or bladder control
• Numbness in the saddle region
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These symptoms require emergency evaluation.
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How We Assess Herniated Disc Presentations
Assessment focuses on understanding both the structural finding and the clinical picture.
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Evaluation aims to determine:
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• Whether symptoms match the imaging
• The degree of nerve involvement
• Whether conservative care is appropriate
• Whether spinal decompression therapy may be considered
• Whether referral is required
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A recent CT or MRI scan of the affected spinal region is required prior to booking. Imaging is reviewed as part of the clinical assessment to determine diagnosis and suitability for care.
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Not all herniated discs require invasive treatment, but not all are suitable for conservative care either. Clear clinical evaluation supports informed decision making.
Non Surgical Treatment Pathways
Management depends on symptom severity, neurological findings, and individual presentation.
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Where clinically appropriate, conservative care may include:
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• Structured spinal decompression therapy
• Guidance on movement and spinal loading
• Activity modification
• Rehabilitation planning
• Monitoring neurological status
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Spinal decompression therapy aims to reduce mechanical pressure within the affected spinal segment and may assist in reducing nerve irritation in suitable patients.
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Care is individualised and adjusted based on response.
Who May Not Be Suitable for Spinal Decompression
Spinal decompression is not appropriate for every herniated disc.
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Alternative pathways may be necessary in cases involving:
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Significant neurological deficit
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Progressive weakness
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Certain large disc extrusions
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Spinal instability
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Conditions requiring surgical opinion
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Body Weight Exceeding 140kg
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Pregnancy
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Severe Vascular Disease
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Advanced Osteoporosis
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Spinal Fractures
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Bone Cancer
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Aortic Aneurysms
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Hyper-mobility of Joints
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Rheumatoid and Other Inflammatory Arthritis
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Where this is identified, referral is discussed promptly.
Our Clinical Focus
Perth Chiro Centre is structured around the conservative management of disc and nerve related spinal conditions rather than routine spinal care.
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We are equipped with four spinal decompression tables, allowing structured and progressive care for patients where decompression is considered clinically appropriate.
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Our approach prioritises:
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clear assessment
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appropriate patient selection
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conservative pathways where suitable
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honest clinical guidance
When To Book an Assessment
Consider arranging an assessment if you:
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Have been diagnosed with a herniated disc
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Had had a CT or MRI of the area within the last 4 years
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Experience leg pain associated with back symptoms
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Notice numbness or weakness
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Have symptoms that are not improving
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Want to explore non surgical options
Frequently Asked Questions About Herniated Discs
Can a herniated disc heal?
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In many cases, yes.
A herniated disc does not always remain permanently irritated. The body can gradually reduce inflammation around the affected nerve and, over time, may partially resorb the protruded disc material. Symptoms often improve as nerve irritation settles, although the timeframe varies significantly between patients.
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The important factor is not simply the appearance of the disc on imaging, but whether the nerve is continuing to be irritated.
Some patients improve steadily, while others require guided conservative management to assist recovery.
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Is surgery always necessary?
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No.
Most herniated discs are managed without surgery. Surgical referral is typically considered only when there is progressive neurological weakness, loss of bowel or bladder control, or persistent severe nerve pain that does not respond to conservative care.
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Many patients improve with appropriate monitoring, activity modification, and structured conservative management. The purpose of assessment is to identify which cases are suitable for non surgical care and which require specialist referral.
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Is walking good for a herniated disc?
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Usually, yes.
Gentle walking is often one of the safest and most beneficial activities because it promotes circulation, reduces stiffness, and helps prevent the spine from becoming overly guarded. Short, frequent walks are generally better tolerated than prolonged sitting or complete rest.
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However, walking tolerance varies. If leg pain rapidly worsens while walking, the walking distance may need to be temporarily reduced and progressed gradually.
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Is sitting bad for a herniated disc?
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Sitting commonly aggravates symptoms.
Sitting increases pressure within the lumbar discs and can place additional mechanical stress on an already irritated nerve. Many patients notice leg pain, numbness, or tingling increase during prolonged sitting, driving, or desk work.
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Frequent posture changes, standing breaks, and avoiding long uninterrupted sitting periods are usually helpful while the nerve is sensitive.
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How long does recovery take?
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Recovery time varies widely.
Some patients improve within several weeks, while others — particularly when significant nerve irritation is present — may take 3-4 months. Nerve tissue heals more slowly than muscle, and symptoms often fluctuate during recovery rather than improving in a straight line.
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The aim of management is to gradually reduce nerve irritation, maintain safe movement, and monitor neurological function while the disc and surrounding tissues settle.
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