5 Best L4 L5 Disc Herniation Exercises to Avoid Surgery

Last updated on May 25th, 2024 at 05:32 pm

When your MRI report says that you have a mild disc hernia in L4 L5, you get worried about it. You get tensed of questions to arise in your mind about whether it can be cured on its own. Do I need surgery for this?

But you do not need to worry because mild L4 L5 disc herniation can be completely cured with some simple home exercises. Exercise not only improves the patient’s daily activities but also reduces the pain and significantly increases the sufferer’s strength and endurance. Also, these patients have the chance of being safe from surgery or recurrence of low back pain².

In this article, we will discuss these exercises and we will go into every detail, so let’s start.

L4 L5 Disc Herniation Exercises

Often, people get nervous seeing their MRI report and wonder if it can ever be cured. But if your MRI report says that you have a mild L4 L5 disc bulge, then you need not panic. It is clearly mentioned that it is mild and can be managed by exercise. We are about to learn the best home exercises for lumbar disc herniation that anyone can easily do at home and cure it.

But let’s first understand briefly what this disc bulge is. Friends, our spine has a number of bones arranged one over the other, called vertebral bones. Between each vertebral bone, there is a soft gel-type material called the intervertebral disc. This disc acts as a shock absorber. Whenever we jump, twist, or bend, this soft disc absorbs all the shock that comes into the body.

But due to some reason, if there develops a slight crack on the outer cover of the disc, the gel inside it comes out and compresses the surrounding nerves. This results in back pain and sometimes radiating pain with a tingling sensation on the leg. According to an Indian study, it is frequently seen in middle-aged females. Obese and overweight are more at risk of developing lumbar disc hernia, which are common at L4L5 and L5S1 levels ¹.

We can divide the severity of disc herniation into four stages. The first three stages can be corrected with exercises without any surgery, but the fourth stage is a serious stage that usually requires surgery. However, we can divide the first two stages into mild disc herniation categories that we can easily cure with some simple home treatment or exercise.

The exercises we will learn are core stabilization exercises, which are strengthening and stretching exercises aimed at strengthening the muscles and stretching the tight structures around the lumbar region.

Research proves the efficacy of these exercises in chronic low back pain caused by lumbar disc herniation². These exercises can be done by all individuals. They are assumed to activate the main muscles, improve posture, and significantly reduce the pressure on the spinal cord³.

#1 Bridging exercise for L4 L5 disc herniation

It is the most common L4 L5 disc herniation exercise and is useful for almost every kind of back pain. The purpose of this exercise is to strengthen the muscles of the lower back.

Because of pain and inactivity, the muscles around the lower back become weak, due to which the weight of the upper trunk falls on the lumbar area, resulting in overstress on the disc. If we strengthen the muscles of the low back then we can control this condition. 

• To perform the L4 L5 disc herniation exercise, start by lying flat on your back with your hands by your sides.
• Bend your knees and slowly lift your waist off the ground, raising it to a comfortable height.
• Hold this position for at least 5 seconds, then slowly lower your waist back down.
• Aim to repeat this motion 15 to 20 times in one session.

#2 Lumbar extension disc herniation exercises

To help alleviate a slip disc issue, it’s recommended to avoid bending forward and instead focus on backward bending exercises, as they can be beneficial. When we bend backwards, it helps to push the bulging disc inwards, encouraging it to realign to its original position.

One important exercise for this is the lumbar extension exercise. To perform this exercise:

1. Start by lying flat on your stomach.
2. Then, slowly lift your chest using your elbows for support and place your chin in your palm, as shown in the figure.
3. Hold this position for at least 3 to 5 minutes; if you can maintain it longer, that’s even better.
4. Repeat this for 10 to 15 times in a session.
5. You can do this exercise any time, whether sitting or watching TV, lying down and performing the exercise.

#3 Upper back strengthening exercises

To perform the upper back strengthening exercise:

1. Start by lying on your stomach with your hands resting at your sides.
2. Next, gently lift your chest and head off the ground, going as high as is comfortable.
3. Hold this lifted position for at least 5 seconds before slowly lowering back down.
4. Aim to repeat this movement 10 to 15 times in one session to strengthen your upper back muscles effectively.

#4 Prone lying lifting leg straight

To strengthen your lower back muscles:

1. Start by lying on your stomach.
2. Lift one leg straight up, keeping your knee as straight as possible without bending.
3. Hold this position for 5 seconds, then lower your foot back down.
4. Repeat this movement with the other leg. Alternate lifting each leg, keeping it straight, and aim to complete at least 20 repetitions for each leg.
5. This exercise effectively engages and strengthens the lower back muscles.

#5 Lifting arms legs straight in quadruped

To begin this exercise:

1. Start by getting down on all fours in a quadruped position; make sure your hands are directly under your shoulders, and your knees are under your hips. Your back should be neutral, neither arched up nor sagging down.
2. Next, extend your right arm straight out in front of you, parallel to the floor, while simultaneously extending your left leg straight out behind you, also parallel to the floor. Keep your extended arm and leg in line with your body.
3. Ensure that your extended arm and leg are straight, with your fingers and toes pointing forward.
4. Hold this position for 5 seconds, keeping your body stable and avoiding twisting or tilting.
5. Then, slowly lower your right arm and left leg back to the starting position.
6. Now, repeat the same process on the opposite side. Extend your left arm straight out in front of you while extending your right leg straight out behind you.
7. Again, hold this position for 5 seconds before returning to the starting position.
8. Continue alternating sides, completing at least 20 repetitions in a session.

#6 Cat & dog exercise for herniated disc

1. Start by getting on your hands and knees in a quadruped position.
2. To begin the cat exercise, gently arch your back upward, tucking your chin to your chest.
3. Then, transition into the dog exercise by lowering your back and lifting your head up, creating a curve in your lower back.
4. Alternate between the cat and dog positions, moving smoothly from one to the other. This exercise is excellent for relieving any stiffness in your lower back.
5. Aim to do 15 to 20 repetitions in one session, and try to do it twice daily for optimal benefits.

Other Remedies

Apart from this, you can also do many different types of effective exercises with the help of the therapy ball, which I have already discussed in another article that you can read. Besides these exercises, you can also use a TENS machine to get pain relief almost immediately. If you are experiencing too much pain, you can also learn to warm with an infrared lamp or electric heating pad, which will give a lot of comfort in your severe pen.

Keep Reading: 3 Best sleeping position for sciatica for quick relief

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Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.