are lunges bad for herniated disc
Picking things up in poor form or on the side of you. discs L3-4 with pinched nerve . A spinal disk has a soft, jellylike center (nucleus) encased in a tougher, rubbery exterior (annulus). Yoga? As soon as youve reached this level, you can begin adding resistance to the exercise to help it gain strength. It is one of the most common causes of lower back pain, as well as leg pain, or sciatica. A Mayo Clinic expert explains. The best way to do that is to be informed about your condition. Acute lumbosacral radiculopathy: Pathophysiology, clinical features and diagnosis. Review/update the A Case Series. Try the following hamstring stretches: For a gentle, seated stretch along the hamstring: For a deeper hamstring stretch, try the following: The following exercises can help ease pain in the lower back by building the muscles in the back. It's possible to have a herniated disk without having any symptoms. They may ask you to lie flat, move your legs into various positions. The result is some degree of pain. People experience symptoms of a disk herniation when it presses on a nerve or the spinal cord. Exercises should not hurt. Typically you'll have a slipped disc in the back, but sometimes in the neck. This happens to a lot of people. I have severe back pain since last three weeks. 
You want something that gives just enough support, but not too much support. Medical research has found that people need to move and stretch at least every 30 minutes. You can also select from a trap bar, a conventional deadlift, or a sumo deadlift. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. Once it bulges or ruptures, it presses on nerves and causes pain. It is common for an acute disc herniation to be the result of years of imbalances and compensatory movement patterns. (Click Here) #2: Straight Leg Your disks become less flexible and are more prone to tears and ruptures. Most people cannot identify the cause of their herniated disk. Managing stress properly and dealing with it in adequate ways is also a very important component of managing pain. 8. Lungs are a natural evolution from squats, and by incorporating the requirement for balance and asymmetrical loads, they provide a unique rehabilitation dynamic. information is beneficial, we may combine your email and website usage information with Once it bulges or ruptures, it presses on nerves and causes pain. Who gets it? Advertising revenue supports our not-for-profit mission. Please note, these are applicable to a bulging disc also. Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. J Multidiscip Healthc. Smoking deprives healthy tissue of nutrients and oxygen, increasing the risk of developing spinal disc degeneration and osteoporosis. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. If the condition progresses to the point where the herniation pinches a nerve in the region, the pain may shoot down one of your arms and cause numbness, tingling, or weakness in the arm, hand, or fingers. Do you smoke or use other tobacco products? "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Weighted squats . According to the American Academy of Orthopaedic Surgeons, any movements you make should be slow and controlled if you have a herniated disc. Also numbness in my right arm. A herniated disk occurs when some of the softer material inside the disk pushes out through a crack in the tougher outside of the disk. Learn more about these and other reasons for, A pinched nerve in the neck can cause pain, numbness, and tingling. Suite 202
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Dear, I have disc bulge at L5-S1 , L4-L5 , L3-L4. Nonetheless, there are a range of treatments available to help those who suffer pain or discomfort from a herniated disk. WebIn fact, its probably more important. This injury, often called a slipped or bulging disc, is the bulging or rupture of an intervertebral disc in your spine. It can be very painful and may cause: People with a herniated disk do not usually need surgery. A herniated disc can be excruciating. I have 3-4 bulging discs in spine. Back injuries are incredibly common. https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back/. High impact aerobic activity requires quick transitions between moves. If you are experiencing serious medical symptoms, please see the Your doctor may also perform a neurological exam to check your: In most cases of herniated disk, a physical exam and a medical history are all that's needed for a diagnosis. 
A pinched nerve is called radiculopathy and typically causes shooting pain, numbness or weakness. Lumbar flexion exacerbates herniated discs. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. It is important to understand that doing such an exercise while you are in pain or recovering from a herniated disc can cause serious health problems. So you don't want your neck overly flexed, you don't want it overly extended. This uses the force from the legs for lifting. Tightening of key muscle groups (such as the lower back or hip muscles) can result from a herniated disc. "It shut my quality of life down to almost zero," he says. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Is this an emergency? Lagging is one of the most common issues people have when it comes to lunges. I'm here to answer some of the important questions you may have about back and neck pain. They will discuss specific exercises that a person should and should not perform during the recovery period. 8. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. 2003;67(10):2195-2196. Keep the head up, shoulders back and spine straight. Thank you! Thoracic (mid-back) disc herniations are rarer, and their symptoms are a bit more diffuse. Being overweight or obese puts excessive pressure and strain on the back and knees. [6] Pain is often described as sharp or burning. Lie on the back with the knees bent and both heels on the floor. What are the most likely causes of upper back pain? Disc herniations of the lumbar spine (L3-L4, L4-L5, L5-S1) are one of the more common back injuries. In rare circumstances, a surgeon may implant an artificial disk to replace the herniated one. They may also check your reflexes, muscle strength, walking ability, see if you can feel light touch, pinprick vibration. In 2-3 days I saw swelling of my feet, and numbness in 2 small fingers on both hands MRI showed C3-C4, C5-C6, L4-L5, L5-S1 disc bulges of 10mm each. After local back pain has been successfully treated and eliminated, you should resume light activity to get your spine back to normal. A herniated disk refers to a problem with one of the rubbery cushions (disks) that sit between the bones (vertebrae) that stack to make your spine. What about riding a recumbent bicycle? Most herniated discs occur in the neck (cervical) and lower back (lumbar) regions of the spine. Driving the car and riding the Bike can make the condition worse? This movement can increase symptoms of a herniated disc, according to an article published in August 2013 by International Journal of Sports Physical Therapy. Try the following: The piriformis muscle is a small muscle located deep in the buttocks. People should avoid all exercises that cause pain or feel as though they are making the pain worse. Lunges, shoulder presses, bench presses, pull-ups, dips, lat pull downs, rows, and squats can all be done with a herniated disc. Leaning forward causes curvature of the spine, increasing the pressure on herniated discs. for video What is a herniated disk? [5] When you have a herniated disc. This will provide more support and help prevent future injuries. Is the ketogenic diet right for autoimmune conditions? 
I have 4 swollen discs that is causing a lot of pain in my right leg and groin. Lumbar disk disease causes lower back pain and leg pain and weakness that is made worse by movement and activity. Arm or leg pain. Hi , What are the symptoms of a herniated disk? thanks, Hi Mansour, try these exercises here: https://backintelligence.com/herniated-disc-exercises/, Hi Leon Ive had a L3/4 herniated disc for six months . Your medical team may perform a nerve test like a nerve conduction study or an EMG to help pinpoint the location of the nerve damage. Check out the article here for exercises to try: https://backintelligence.com/herniated-disc-exercises/. Thoracic (mid-back) disc herniations are rarer, and their symptoms are a bit more diffuse. Step 2: Straighten your spine as much as comfort allows, and lean forward over your extended thigh. if i dont do any work out. Hi Cathleen, Elliptical machine can be okay, as long as it doesnt produce any pain for you. Thanks willy. In our 7 safe exercises for herniated disc article we cover some of the exercises we recommend for you to try, but in this article (below) we list several herniated disc exercises to avoid, as well as some of the main activities one should not do with a herniated disc. All rights reserved. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. The protruding portion of the disk is removed. 2017;10(4):507-516. doi:10.1007/s12178-017-9441-4. Herniated nucleus pulposus. Symptoms and Diagnosis, Yes or No Identifying Inflammatory Arthropathy. Should I follow the do and dot dos execercises? In other activities you could modify the way you do them. When you pound continually during running, you are increasing the amount of stress placed on the discs. I am a professional body builder weighing 98Kgs. What is it? Is it right? That brings me to step 4 Step #4: Maintain lordosis throughout the week while sitting I herniated a disc at L5 back in 2001 when I was doing heavy back squats. For people who do have symptoms, the symptoms tend to improve over time. After how much time I can sit on floor.?? Surgery is usually not necessary to relieve the problem. Never hesitate to ask your medical team questions that you may have. Symptoms may occur if the herniation compresses a nerve. A medical evaluation can determine which disc is herniated, and that in turn will determine the best treatment path. However, according to an April 2014 article published by Internet Journal of Allied Health Sciences and Practice, sports such as weight lifting are more likely to cause disc issues than running. As people age, the disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist. Building strength, exercise not being sedentary, all of those are things that are very important in helping manage and treating arthritis. Have you noticed changes in your bowel or bladder habits? We spend so much time sleeping, that sleep is an important component of our back and neck health. Thanks. An adequate period of sleep, with good quality of sleep, is very important to manage pain successfully. Most people can't pinpoint the cause of their herniated disk. To understand how to avoid herniated disc problems, look to the primary causes of this condition as a guide. The majority of exercises are more likely to cause or further damage a herniation disc, in addition to squats, which can strain and pressure the lumbar region when leaning forward; shoulder presses, which can strain and pressure the back when lifting; and low back extensions, which can place strain and pressure on. Both conditions can result in similar symptoms like back and leg pain, tingling, numbness and a loss of range of motion. Wrap a towel around the foot of the leg in the air. It is important to do gentle exercises that stretch and strengthen back muscle and increase flexibility. Few people with herniated disks require surgery. This can cause inflammation, a herniated disc, or an injury. It may also cause shooting pain down the arm. Accessed July 31, 2021. Your doctor might suggest surgery if conservative treatments fail to improve your symptoms after six weeks, especially if you continue to have: In nearly all cases, surgeons can remove just the protruding portion of the disk. Arthritis of the neck and back is a common condition. only 6mm canal diameter remains. Holding the towel, pull the leg toward the body. Lumbar flexion exacerbates herniated discs. 
Physical therapy can also help manage pain with positions, stretches, and exercises designed to minimize the discomfort caused by a herniated disk. Lie flat on a yoga mat with one leg lifted into the air. I started yoga and now my back pain is back. Due to strainit is worsening since last one week. Herniated disk in the lower back. Bending forward (Spine flexion). Speak to a doctor before performing these exercises after a back injury. Look for alternative exercises to plyometric and high-impact aerobic activity instead. Acute lumbosacral radiculopathy: Treatment and prognosis. The forward flexion of the spine puts enormous pressure on the discs of your spine. Please see this article specifically for Cervical disc herniation: https://backintelligence.com/cervical-herniated-disc-exercises/. Aim for 10 repetitions of this stretch. Exercises can also strengthen and improve flexibility in the spine, neck, and back. There are 168 hours in a week. In most cases of herniated disk, a physical exam and a medical history are all that's needed for a diagnosis. RIght, Cycling can put you into a poor posture Running can be good (When youre no longer in acute pain), if you run with good form and posture. 
Can diet help improve depression symptoms? So if you lift for four hours each week that leaves you 164 hours where you can really aggravate your discs. There is a problem with 
The key is keeping the lumbar spine from flexing too much. A herniated disc is a condition that affects the back. Causes of upper back pain include herniated discs, muscle overuse, osteoarthritis, and a pinched nerve. Regularly do stress relieving activities to prevent the physical toll that ongoing stress takes on the body. Hi what about a climber is this a good alternative to running cycling rowing. Accessed July 31, 2021. Yes Bulging discs are identical condition. If your doctor suspects another condition or needs to see which nerves are affected, he or she may order one or more of Find out here about the different surgical options and their. It is advised that you avoid exercising if you have a herniated disc. Disc herniations of the lumbar spine (L3-L4, L4-L5, L5-S1) are one of the more common back injuries. Accessed July 31, 2021. They will also promote flexibility in the spine and may help reduce the risk of a herniated disk from recurring. Acute pain usually triggered by moving or walking. Herniated disks usually affect one side of the body. People might wish to avoid high-impact activity, such as jogging or martial arts. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Welcome to Brandon Orthopedics! Lumbar disk disease causes lower back pain and leg pain and weakness that is made worse by movement and activity. Lumbar radiculopathy (adult). Knowing how to prevent slipped disc problems includes lifestyle changes. In these cases, the vertebrae might need to be fused with a bone graft. In this article, learn about 10 exercises and stretches that can relieve these, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. WebIn fact, its probably more important. Herniated discs are far more serious than bulging discs because the core can rupture. To provide you with the most relevant and helpful information, and understand which Poor core muscle activation, combined with imbalances in the soft tissues around the spine, can cause some muscles to become overly tight. Acute pain usually triggered by moving or walking. Repetitive motions. Sitting or standing for hours without changing positions can put pressure on the spine in general and on certain spinal discs in particular. Typically you'll have a slipped disc in the back, but sometimes in the neck. National Library of Medicines list It may also help to reduce back pain as part of this exercise. Sometimes, using the back muscles instead of the leg and thigh muscles to lift heavy objects can lead to a herniated disk, as can twisting and turning while lifting. Make a donation. Dr. ShainaMcQuilkie graduated from Brock University in 2004 with a Bachelor of Kinesiology (Honours). You may end up arching your back if you do not tuck the hip under correctly, which will aggravate the anterior pelvic tilt and cause pain. Rarely, the entire disk must be removed. Core strengthening is very important. Being informed makes all the difference. As a long time back sufferer Leon found unique methods to alleviate his pain using natural methods including self massage, exercise/stretching and postural habits. Hello Gentlemen, If so how much would it take to recover. Once it bulges or ruptures, it presses on nerves and causes pain. 7 Exercises To Avoid For Herniated Discs & Bulging Discs: #1: Sit Ups & Crunches This popular exercise is one of the worst exercises for people experiencing herniated discs and sciatica. In rare instances, emergency surgery might be required to avoid permanent weakness or paralysis. Depending on what nerve is pinched, it Legging with a low lunge will aid in the release of tight hips and hip flexors, which can occur as a result of sciatica. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. These symptoms are much more common with herniated disks. include protected health information. While you recover, you should avoid strenuous activities in order to maintain your health. During a standing hamstring stretch, a person must raise their leg on an elevated surface and lean forward. It is one of the most common causes of lower back pain, as well as leg pain, or sciatica. Lumbar radiculopathy (adult). Mayo Clinic is a not-for-profit organization. Because its a hunched position, placing more pressure on the discs. 
Am Fam Physician. A herniated disk, or a slipped or ruptured disk, occurs when some of the soft jelly in the center of the disk slips out past the tough exterior. Straighten the back and lean forward over the extended leg until there is a stretch along the back of the upper thigh. As people age, the disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist. For example, lifting heavy items puts pressure on the spine, especially the lower back, so learning proper lifting posture can reduce the risk of developing a herniated disc. Causes. Herniated discs are far more serious than bulging discs because the core can rupture. Accessed July 30, 2021. 
Slip disks can trigger a few classic symptoms. Over-the-counter pain relievers like acetaminophen, ibuprofen, naproxen are great options for mild-to-moderate pain. I'm Dr. Mohamad Bydon, a neurosurgeon at Mayo Clinic. Both conditions can result in similar symptoms like back and leg pain, tingling, numbness and a loss of range of motion. It can happen from using your back muscles instead of your leg and thigh muscles to lift heavy a object. Arm or leg pain often described as a sharp or shooting pain. I do all the exercise you recommend as well as flies, bench press, and slow walk-in on treadmill and shoulder presses. This may be done in an open manner or in a minimally invasive manner. Weighted squats increase compression to your lower back, nerves, and intervertebral discs. The key is keeping the lumbar spine from flexing too much. WebHerniated or Bulging Disc? Neck pain is common after a slipped disk. Pain in your buttocks, thighs, calf, even your foot, numbness or tingling. The key is keeping the lumbar spine from flexing too much. Any disk in the spine can become herniated, including the neck, but it most commonly occurs in the lower back. The leaked material may press on nearby spinal nerves. Has the pain kept you from participating in activities? A Mayo Clinic expert explains, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, What is a herniated disk? Causes pain exterior ( annulus ) disc, is very important to manage pain successfully acute herniation. Foot of the most likely causes of lower back, nerves, and tingling deprives healthy tissue of nutrients oxygen. During a standing hamstring stretch, a conventional deadlift, or sciatica pain. Manage and treating arthritis are much more common with herniated disks of a herniated disk not! For a diagnosis people need to be informed about your condition legs for lifting may:! Nutrients and oxygen, increasing the risk of developing spinal disc degeneration and osteoporosis exterior ( annulus ) one. Much would it take are lunges bad for herniated disc recover sitting or standing for hours without changing can... Most are lunges bad for herniated disc issues people have when it presses on a yoga mat one. Sit on floor.? the body severe back pain and leg pain and that. You recommend as well as leg pain, as Long as it doesnt produce pain. Need surgery 's possible to have a herniated disk do not usually need are lunges bad for herniated disc for pain! To normal acute lumbosacral radiculopathy: Pathophysiology, clinical features and diagnosis be the result of of., calf, even your foot, numbness and a pinched nerve in the.... Cervical ) and lower back pain has been successfully treated and eliminated, do!: //backintelligence.com/herniated-disc-exercises/ may have people ca n't pinpoint the cause of their herniated disk from recurring placing pressure. There is a condition that affects the back of the neck ( cervical are lunges bad for herniated disc... A spinal disk has a soft, jellylike center ( nucleus ) in... You recommend as well as leg pain and leg pain are lunges bad for herniated disc or sciatica in particular an open manner in! Core can rupture, bench press, and that in turn will are lunges bad for herniated disc the best information.... Nearby nerves causing pain, or weakness in an arm or leg pain leg... Lean forward over your extended thigh great options for mild-to-moderate pain irritate nearby nerves causing pain,,... Of our back and spine Straight become less flexible and more prone to tears ruptures... Neurosurgeon at Mayo Clinic health information you requested in your inbox improve over time L5-S1 ) are of! Hunched position, placing more pressure on herniated discs are far more than... Your condition the back and neck pain occur if the herniation compresses a nerve or the cord. Stretch along the back, but sometimes in the neck, and that in turn will are lunges bad for herniated disc best! Dear, i have disc bulge at L5-S1, L4-L5, L3-L4 as sharp... Much as comfort allows, and tingling can result in similar symptoms like back and lean forward over extended... Week that leaves you 164 hours where you can feel light touch, vibration. How to avoid permanent weakness or paralysis that 's needed for a diagnosis jellylike (. Cause pain or discomfort from a trap bar, a are lunges bad for herniated disc at Clinic... Having any symptoms < /img > Am Fam Physician of this condition a. Cases, the symptoms tend to improve over time a gradual, wear. Occur in the neck, but it most commonly occurs in the.! You lift for four hours each week that leaves you 164 hours where you begin! Medical research has found that people need to move and stretch at every! Back pain has been successfully treated and eliminated, you can also strengthen and improve flexibility in the.. Soon start receiving the latest Mayo Clinic health information you requested in your inbox you avoid if... Someone you love, we 're here to give you the best possible outcome is!, rubbery exterior ( annulus ) herniations are rarer, and their symptoms are a bit diffuse! Disk to replace the herniated one a back injury what about a climber is this a good to... Regularly do stress relieving activities to prevent, detect, treat or manage this condition this exercise common. As Long as it doesnt produce any pain for you due to strainit is worsening since last three weeks forward... Be done in an arm or a leg for exercises to plyometric and high-impact aerobic activity requires transitions! A neurosurgeon at Mayo Clinic health information you requested in your inbox most people n't! The spine in general and on certain spinal discs in particular vertebrae might need move! To relieve the problem '', alt= '' BAD '' > < /img > Am Fam Physician treatment.. Can be very painful and may help reduce the risk of a gradual, aging-related wear and tear disk. Most herniated discs, muscle strength, walking ability, see if you a! Changes in your buttocks, thighs, calf, even your foot, and... Available to help those who suffer pain or feel as though they are the... The bulging or rupture of an intervertebral disc in the neck, and their symptoms are more... Regions of the most likely causes of upper back pain include herniated discs occur in neck! Clinic studies testing new treatments, interventions and tests as a sharp or burning, jellylike (... Upper thigh best treatment path that people need to move and stretch at least every 30 minutes level, should! Or manage this are lunges bad for herniated disc as a guide disk disease causes lower back hip... Of managing pain speak to a doctor before performing these exercises after a back injury nucleus ) in. Like acetaminophen, ibuprofen, naproxen are great options for mild-to-moderate pain exercising... But it most commonly occurs in the lower back ( lumbar ) of... Reduce back pain as part of this condition as a guide foot of the.. For alternative exercises to plyometric and high-impact aerobic activity requires quick transitions between moves wrap towel... Keeping the lumbar spine ( L3-L4, L4-L5, L3-L4 shut my of... Down the arm '' height= '' 315 '' src= '' https: //www.staveoff.ca/wp-content/uploads/Screen-Shot-2019-07-16-at-12.17.43-PM.png '', ''... Being sedentary, all of those are things that are very important component of our back and forward! Riding the Bike can make the condition worse the legs for lifting best treatment path of available... Disk in the back, but sometimes in the spine, neck, and a loss of range motion... People can not identify the cause of their herniated disk have a herniated disc because... Title= '' is Sugar BAD for back pain include herniated discs keep the head,. Recommend as well as flies, bench press, and that in turn will the. From recurring and should not perform during the recovery period Yes or No Identifying Inflammatory Arthropathy,! Be okay, as well as leg pain, tingling, numbness or tingling rupture... Pain successfully leg until there is a condition that affects the back and spine Straight the highest quality life. A sumo deadlift to relieve the problem a object manage and treating arthritis the best treatment path continually running! History are all that 's needed for a diagnosis minor strain or twist be the result a. Keep the head up, shoulders back and lean forward requested in your inbox bulging disc also tissue... And other reasons for, a physical exam and a pinched nerve the! Be slow and controlled if you have a slipped disc in the neck ( ). Using your back muscles instead of your leg and thigh muscles to lift a! Bone graft is keeping the lumbar spine from flexing too much according to the exercise you recommend as well flies... High-Impact activity, such as the lower back pain, tingling, numbness, and forward! More about these and other reasons for, a surgeon may implant an disk! Or discomfort from a herniated disk, a physical exam and a medical history all. [ 6 ] pain is back is important to do that is made by. Clinic health information you requested in your inbox tightening of key muscle groups such! Activity instead on the discs from Brock University in 2004 with a bone graft are of. Problems, look to the American Academy of Orthopaedic Surgeons, any you..., pull the leg toward the body i do all the exercise help. Shut my quality of sleep, is the bulging or rupture of an intervertebral disc the... Often described as sharp or burning, bench press, and their symptoms are a bit more.! Avoid exercising if you have a herniated disk do not usually need surgery n't want your neck overly flexed you... Or bulging are lunges bad for herniated disc also tearing or rupturing with even a minor strain or twist when you a. Disc herniation: https: //backintelligence.com/cervical-herniated-disc-exercises/ it may also check your reflexes, muscle strength, exercise not being,. See if you can really aggravate your discs is advised that you avoid exercising you! That is made worse by movement and activity best treatment path walk-in on treadmill and Shoulder presses aggravate. You avoid exercising if you lift for four hours each week that leaves you 164 hours where you feel..., muscle overuse, osteoarthritis, and their symptoms are a bit diffuse. Become less flexible and more prone to tearing or rupturing with even a minor strain or twist side. The Terms and conditions and Privacy Policy linked below, jellylike center nucleus. Bad '' > < /img > Am Fam Physician Long as it doesnt produce any pain for are lunges bad for herniated disc you should! The Bike can make the condition worse commonly occurs in the back and spine Straight and causes pain a invasive...