If your treatment regimen for a lower back (lumbar) herniated disc isn’t providing enough pain relief, try these lesser-known self-care strategies for managing your symptoms and promoting healing. 

1. The McKenzie method shifts sciatica pain.

The McKenzie method is a specialized and proven therapy for leg pain (sciatica) caused by a lumbar herniated disc

  • This therapy consists of a set of therapeutic exercises that are designed to relieve pressure on the sciatic nerve and shift the symptoms from the leg to the lower back, where it becomes much more tolerable. 1 Mann SJ, Lam JC, Singh P. McKenzie Back Exercises. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539720/ , 2 Namnaqani FI, Mashabi AS, Yaseen KM, Alshehri MA. The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: a systematic review. J Musculoskelet Neuronal Interact. 2019;19(4):492-499.  This phenomenon is called centralization of pain.

  • After the pain centralizes, the next step is to treat the low back symptoms through lumbar stabilization exercises, which strengthen the spine and its supporting muscle groups.

A physical therapist with specialized training in the McKenzie method provides this treatment.

After a few in-person exercise sessions, patients are taught to continue the exercise regimen at home for long-term benefits. 

Read more: McKenzie Method for Back Pain and Neck Pain

2. Over-the-counter (OTC) topical pain relievers provide targeted relief.

Topical medications provide quick and targeted relief from low back pain and sciatica as the medication is delivered right to the source of pain. 

The quick, targeted effects of topical medications are beneficial for self-treating acute flare-ups of pain.

Topical non-steroidal anti-inflammatory drugs (NSAIDs)

Medicated creams such as diclofenac (Voltaren) applied to the lower back treat herniated disc pain by reducing inflammation and swelling at its source, the affected spinal nerve. 3 Voltaren Arthritis Pain. Package Insert. GlaxoSmithKline Consumer Healthcare Holdings (US) LLC; 2023

Counterirritants

Gels and balms, such as Icy Hot and Tiger Balm, contain ingredients that produce a mild cool or warm sensation. When applied to the painful areas of your lower back, these products “distract” your brain from feeling the intense pain caused by the herniated disc. 4 Barkin RL. The pharmacology of topical analgesics. Postgrad Med. 2013;125(4 Suppl 1):7-18. doi:10.1080/00325481.2013.1110566911

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3. Certain sleep positions reduce pressure on a herniated disc.

Pain from a lumbar herniated disc worsens at night for some people, but adopting a sleep posture that promotes better spinal alignment alleviates discomfort.

Using pillows under the knees or between the legs relieves pressure on the spinal nerves and improves pain and sleep quality. 5 Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook: 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.

Here are 2 ways to use pillows to relieve disc pain:

  • If you sleep on your back, use a pillow under your knees to maintain the natural curve of your spine and reduce pressure on the herniated disc.
  • If you sleep on your side, place a pillow between your knees to keep your spine straight and hips balanced, and to prevent the lower back from twisting during sleep.

See Best Pillows for Different Sleeping Positions

As a general rule, avoid sleeping on your stomach as this position disturbs the normal alignment of the spine. 5 Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook: 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.

Learn more about Mattresses and Sleep Positions for Each Back Pain Diagnosis

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4. Myofascial release or massage alleviates muscle tension.

When nerve pain from a lumbar herniated disc causes you to tense up or alter your posture, these protective measures sometimes create additional problems and pain in your muscles and connective tissues (myofascial pain). 6 Bordoni B, Sugumar K, Varacallo M. Myofascial Pain. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535344/

Myofascial release is a form of manual therapy that releases tension in the muscle and tissue through the application of gentle, sustained pressure to the trigger point areas. 7 McKenney K, Elder AS, Elder C, Hutchins A. Myofascial release as a treatment for orthopaedic conditions: a systematic review. J Athl Train. 2013;48(4):522-527. doi:10.4085/1062-6050-48.3.17

This technique is usually performed by a physical therapist, but variations can be performed at home using the following steps.

  • Use a lacrosse ball or massage cane to gently apply pressure to the tender/trigger points in the lumbar area.
  • Once a tender/trigger point is identified, maintain a constant pressure for 1 to 2 minutes to allow the muscle to loosen or “release.”

While you might feel immediate relief, myofascial release could worsen pain temporarily as pressure is being applied to tight muscle knots. If your pain increases following a session, use an ice pack to calm the inflammation and pain.

Learn more about Myofascial Release Therapy

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5. Hydrotherapy calms inflammation and eases pain.

One of the main causes of pain from a herniated disc is inflammation, and a mineral-rich thermal bath is a natural and relaxing way to reduce this inflammation and relieve pain. 8 Haji Y, Taddesse F, Serka S, Gebretsadik A. Effect of Balneotherapy on Chronic Low Back Pain at Hot Springs in Southern Ethiopia: Perceived Improvements from Pain. J Pain Res. 2021;14:2491-2500. Published 2021 Aug 17. doi:10.2147/JPR.S322603 , 9 Angioni MM, Denotti A, Pinna S, et al. Spa therapy induces clinical improvement and protein changes in patients with chronic back pain. Reumatismo. 2019;71(3):119-131. Published 2019 Oct 24. doi:10.4081/reumatismo.2019.1200 A thermal bath might sound exotic and expensive, but the at-home version is simply an Epsom salt bath.

Magnesium – the main ingredient in Epsom salts – has anti-inflammatory and calming properties. When used in a hot tub, the healing properties of the salt and the water’s buoyancy ease stress on the joints and relax tight muscles. 10 Gröber U, Werner T, Vormann J, Kisters K. Myth or Reality-Transdermal Magnesium?. Nutrients. 2017;9(8):813. Published 2017 Jul 28. doi:10.3390/nu9080813 , 11 Dilekçi E, Özkuk K, Kaki B. The short-term effects of balneotherapy on pain, disability and fatigue in patients with chronic low back pain treated with physical therapy: A randomized controlled trial. Complement Ther Med. 2020;54:102550. doi: 10.1016/j.ctim.2020.102550

The benefits of hydrotherapy are even greater when used after physical therapy or exercise.

Common home remedies for pain from a herniated disc

In addition to the lesser-known therapies in this blog, the self-treatment strategies for a herniated disc that you might be more familiar with include:

Combining multiple treatment methods maximizes the pain relief. 

These tips may not work for everyone, and it usually takes time before finding what works best to help relieve your lumbar herniated disc pain. If the pain persists or worsens, it is advisable to consult with a healthcare professional.

  • 1 Mann SJ, Lam JC, Singh P. McKenzie Back Exercises. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539720/
  • 2 Namnaqani FI, Mashabi AS, Yaseen KM, Alshehri MA. The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: a systematic review. J Musculoskelet Neuronal Interact. 2019;19(4):492-499.
  • 3 Voltaren Arthritis Pain. Package Insert. GlaxoSmithKline Consumer Healthcare Holdings (US) LLC; 2023
  • 4 Barkin RL. The pharmacology of topical analgesics. Postgrad Med. 2013;125(4 Suppl 1):7-18. doi:10.1080/00325481.2013.1110566911
  • 5 Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook: 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.
  • 6 Bordoni B, Sugumar K, Varacallo M. Myofascial Pain. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535344/
  • 7 McKenney K, Elder AS, Elder C, Hutchins A. Myofascial release as a treatment for orthopaedic conditions: a systematic review. J Athl Train. 2013;48(4):522-527. doi:10.4085/1062-6050-48.3.17
  • 8 Haji Y, Taddesse F, Serka S, Gebretsadik A. Effect of Balneotherapy on Chronic Low Back Pain at Hot Springs in Southern Ethiopia: Perceived Improvements from Pain. J Pain Res. 2021;14:2491-2500. Published 2021 Aug 17. doi:10.2147/JPR.S322603
  • 9 Angioni MM, Denotti A, Pinna S, et al. Spa therapy induces clinical improvement and protein changes in patients with chronic back pain. Reumatismo. 2019;71(3):119-131. Published 2019 Oct 24. doi:10.4081/reumatismo.2019.1200
  • 10 Gröber U, Werner T, Vormann J, Kisters K. Myth or Reality-Transdermal Magnesium?. Nutrients. 2017;9(8):813. Published 2017 Jul 28. doi:10.3390/nu9080813
  • 11 Dilekçi E, Özkuk K, Kaki B. The short-term effects of balneotherapy on pain, disability and fatigue in patients with chronic low back pain treated with physical therapy: A randomized controlled trial. Complement Ther Med. 2020;54:102550. doi: 10.1016/j.ctim.2020.102550

Dr. William Kemp is a board-eligible, fellowship-trained neurosurgeon at the Virginia Spine Institute, VA. Dr. Kemp specializes in the surgical management of musculoskeletal and nerve pain. With extensive education and training at world-class medical institutions, Dr. Kemp is skilled in performing complex and minimally invasive spinal surgical procedures.

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