How do herniated discs occur and what are the best treatment options?

“Ouch….I’ve slipped a disc!” 

Low back pain affects over 80% of the population at some point in their lives and it’s the second most popular reason for visiting the GP after the common cold. It comes in many guises but a herniated or ‘slipped’ disc is one of the easiest things to succumb to and is one of the most difficult types of back pain to relieve. 

This article examines the ways in which herniated discs can occur and explains the treatment options available to help patients get back to their usual daily activities.

Contrary to popular belief, slipped discs are not just common to people who do manual work involving heavy lifting: many office-based workers succumb to disc problems as a result of sitting in one position for too long, putting pressure on the disc walls so that they weaken over time.

The spine is made up of 24 individual bones called vertebrae which are stacked on top of each Herniated Disc MRI scan - Pre IDD Therapy. Discs are the protective circular pads of connective tissue in between – the ‘padding’ which acts as shock absorbers, protecting the spine when we run or jump.

We cause small weaknesses in our spine all day long with prolonged sitting or standing in certain positions, for example at workstations or hunched over the ironing board.

The intervertebral discs are unlike other parts of the body in the sense that they have a limited nerve supply.

Very often we are not aware of the discs being under strain until the accumulation of months or years of stress has reached a point where small tears form in the outer disc wall. These tears can result in several months of nagging discomfort.

As a defence-mechanism against further damage, the body will often react to this situation with muscle spasm or at the very least, ‘muscle guarding’ which is when the long muscles of the spine tighten up. This causes compression of the discs and a lack of mobility in the spine. 

If this situation prevails, the tears can very often become worse and allow the inner jelly like part of the disc – the nucleus – to herniate outwards. This is referred to as a herniated, bulging or ‘slipped’ disc.

Disc problems can also cause pain in other areas of the body, the most common of which is sciatica, a grinding pain which travels down the length of the leg.  Sciatica can be caused by the bulging part of the disc squashes the nerve root next to the disc or when chemicals from a prolapsed disc irritate the nerve endings.  

Neck pain, headaches or numbness in the foot can also be a sign of a damaged disc. So, what are your options for treatment?

Your first port of call should always be a good osteopath, physiotherapist or chiropractor who will have experience in treating disc-related problems. With this type of manual therapy in most cases you should see a marked improvement in your condition in 6-8 weeks.

At the same time, if you are in so much pain that you can’t sleep then your GP can prescribe you painkillers and/or anti-inflammatory medicines which can be taken alongside physical treatment.

If you see no real sign of improvement after eight weeks of manual therapy, it would be advisable to get an MRI scan of your spine to confirm the possible causes of your pain and the location (level) of the spine affected.

If a disc problem is identified, a programme of treatment including IDD Therapy non-surgical spinal decompression may be recommended.

IDD Therapy is a computer-controlled mechanical treatment used by clinicians to gently and safely relieve pressure on specific discs, alleviate muscle spasm and increase mobility in the spine.
decompression[1]As part of the IDD Therapy programme, patients undergo a course of core-strengthening exercise to help them maintain their healthy spine.

In a small number of cases, patients with severe disc damage/degeneration may require invasive treatments including injections and/or surgery. Also, in rare circumstances, the patient may require immediate surgery, for example, when the bowel and bladder function is affected.

There are different types of surgery for a herniated disc, the most common is the microdiscectomy where fragments of the disc may be cut away.

Another common type of spinal surgery is the lumbar fusion where the vertebrae surrounding a disc are fused together.

Thus, there are now several treatment options available to patients with herniated discs and indeed, a wider array of effective non-surgical options allowing more patients to avoid invasive procedures.

For information about treatment options at Spine Plus or any other IDD Therapy providers, please use the form below.

Robert Shanks BSc (Hons) Ost
Clinical Director
Spine Plus
Spine Plus is a group of multidisciplinary clinics in London and Essex.

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Spine Plus Clinics – At the Forefront of Herniated Disc Treatment with IDD Therapy Spinal Decompression

Spine Plus Clinics in Essex and London are well established providers of IDD Therapy treatment for unresolved herniated discs, sciatica and chronic low back and neck pain.

In this video co-clinic director Robert Shanks discusses the role of IDD Therapy treatment, how it works and what it can do for patients needing more for their pain, without resorting to invasive procedures.

Also includes patients discussing their experiences of treatment, some of whom have avoided the need for surgery.


For more details about IDD Therapy at Spine Plus clinics, please visit their website

If you are a clinician and would like more information about IDD Therapy please use the form below or visit

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IDD Therapy Spinal Decompression for the Herniated Disc: A Clinician’s View

Osteopath Robert Shanks is the co-founding Clinical Director of Spine Plus, a group of multi-disciplinary back pain clinics based in London and Essex. He trained with The British Medical Acupuncture Society and is also a qualified electrotherapist.

Robert’s area of special interest is chronic low back pain and neck pain associated with bulging or herniated discs.  He is an advocate of innovation and technological advances in spinal care and uses IDD Therapy non-surgical spinal decompression to treat his chronic disc patients.

I first became interested in mechanical spinal distraction in 2002 and I started using a home-made cervical traction device based on pioneering osteopath, Alan Stoddard’s model featured in a book from the 1950’s!  Yes, it sounds a bit Wallace & Gromit but it did the job more effectively than using my hands alone.  I then started using portable traction beds which featured a manual pump allowing for intermittent sustained traction.

The object of these devices was of course, to distract the spine in order to take some pressure off the disc(s) and any pinched nerves.  We used it as part of a standard 30 minute treatment session.  

Developments in spinal decompression have come a long way since those primitive traction devices.  Indeed, traction per se created a divide amongst clinicians in its heyday: there were those like myself who found the tool a useful addition to manual therapy and there were others who saw too many shortcomings for it to be fully effective.  

One of the key shortcomings of traditional traction was the imprecise nature in which the treatment was applied, for example, the traction force was aimed non-specifically at the entire vertebrae and not at the particular segment we were trying to treat.  Moreover, as the linear ‘pull’ was unnatural to the body, it could actually cause muscles to spasm, leading to an increase in pressure and pain!  This meant that in order to ensure relative comfort for a patient, the treatment tended to be administered in short bursts of 10 to 15 minutes with a low traction force – which proved ineffective for many chronic conditions.

Around 2008 I began hearing about Intervertebral Differential Dynamics (IDD) Therapy, a non-surgical spinal decompression treatment which appeared to address the failings of traction quite systematically.  These sophisticated IDD treatment machines were developed in the US in the late Nineties by a team of engineers and clinicians whose aim was to mechanically decompress the disc by improving upon traditional traction methods.Patient having IDD Therapy spinal decompression treatment

With modifications and revisions along the way and advances in computer technology, the team finally produced an FDA cleared class II decompression machine which, with computer-controlled forces directed at precise angles, was shown to distract targeted segments of the spine, e.g. L4/L5 from between 5 and 7mm – which had significant therapeutic implications. 

The decompression unit also included a unique oscillation feature capable of mobilising the joint at the point of maximum distraction – in much the same way as manual therapists mobilise other joints – but which given the strength of the spine, is difficult to do with the hands alone.  Moreover, because the device used a gently progressing pulling force (sinusoidal waveform) which mimics the natural contraction mechanism of a muscle, the muscle remained relaxed and lengthened throughout the slow and consistent stretch without going into spasm.  Thus patients could enjoy the necessary higher pulling forces for longer, whilst remaining completely relaxed.

I read all of the clinical research papers on IDD Therapy but I was more interested to see the treatment in action and hear the experiences of clinicians in the UK who were already using it as part of a specialised rehabilitation programme for their herniated disc patients.

The clinicians I spoke to viewed IDD Therapy as a structured programme with patients having a series of regular hourly treatments spread over a number of weeks.  The sessions consisted of some heat therapy to warm up the target area followed by 25 minutes on the IDD machine.  After the mechanical decompression, patients would have some cold therapy to prevent any temporary soreness caused by the soft tissues being worked in a new way.   Corrective exercise was introduced gradually as the programme progressed to help achieve lasting success.

I tried the treatment for myself on the latest IDD machine (the SDS Spina); I could really feel the differences which I’d heard and read about.  I decided to introduce the treatment at one of my clinics in April 2011.

In the last year the clinic has treated over a hundred patients with IDD Therapy.  These have tended to be patients with herniated or prolapsed discs whose symptoms of chronic back pain, neck pain and sciatica had prevailed despite standard manual treatments.  The clinical outcomes have been impressive: I would say that 70% of these patients have made good to excellent improvement.

A typical patient is 63 year old Rita from Chigwell who achieved an exceptional outcome with IDD Therapy after suffering for four years with an L1/2 disc bulge which surgeons would not operate on.  She had undergone countless manual treatments, facet joint injections and epidural injections without any lasting improvement.  After a series of IDD treatments she became pain and spasm-free and was able to return to work and carry out her daily household chores again.

Another patient had a considerable L4/5 disc bulge; after a programme of IDD Therapy the bulge had shrunk to less than a third of its size.

Although I have used IDD Therapy to treat acute pain, most IDD candidates have been in pain for several months, even years and have tried one or more manual treatments and/or injections without success.  For these patients, a programme of treatments spread over a number of weeks is necessary to achieve long lasting therapeutic changes to chronic conditions which have built up over time.

When patients first come to me, some are in so much pain that they are physically and emotionally exhausted and fearful of making the slightest movement.  Over the course of the IDD programme, we can help to change their outlook and expectations, setting them the realistic goal of becoming pain-free and being able to get back to their normal daily activities.  We track all patients with research tools such as the Oswestry Disability Index, Visual Analogue Scale and other objective outcomes measures.

IDD Therapy is an invaluable treatment tool to me.  It has finally enabled me to offer something meaningful for disc patients which, in my experience, is preferable to surgery and more therapeutic than epidurals, nerve root blocks and facet joint injections.  

It’s hard to find a negative side to the treatment: an IDD session takes longer than a standard 30 minute manual treatment but we cannot cut elements of the session without having a detrimental effect on our treatment goals.   By having IDD as a treatment tool to use alongside manual therapy, we are seeing more patients at the clinic and as our experience grows, we are better able to predict how to progress patients who of course, all have individual needs.

Since introducing IDD we have been able to treat several lumbar-surgery candidates; I know of patients who have been booked in for an operation and have tried IDD as a last resort and are now pain-free and active again.

Naturally, there are some patients who do not respond to treatment but generally speaking, my patients have had very good outcomes and from a personal perspective, it’s hugely satisfying to know that I have been able to do more for them.

Robert Shanks BSc (Hons) Ost

For information about IDD Therapy, call Steadfast Clinics on 01279 602030 or visit