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  • locka
    Participant
    Post count: 3

    several years with chronic but not disabling back pain. MRI shows herniation in L4 L5 and some stenosis. two cortisone shots, (one in the SI joint, one epidural) and trying to exercise regularly, hoping to keep it manageable and avoid surgery. advice from my GP, a pro sports medicine guy and from occupational therapists, and with tons of reading online, still get conflicting info about best approaches to physical therapy. doing the ‘mcgill big three’ for strength and core, but, for instance, is stretching recommended? EG the McKenzie method? is there a well established protocol for exercise for therapy for herniated discs?

    thanks very much in advance for your reply!

    AL

    locka
    Participant
    Post count: 3

    And I should add, I’m 50 y.o. M in otherwise good health. Again, thanks for taking the time.

    AL

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    The keys for rehabilitation with pain generated from an HNP would be to reduce or avoid BLT (bend load twist), (generally) work on extension exercises and Pilates work. You can use non-steroidals if they work and you can tolerate them. Expect some mild flair-ups on occasion. Include cardiovascular exercise as a major part of your rehabilitation.

    There is no established exercise pattern as it depends upon where the herniation is located in the spinal canal to design a program. Some herniations aggravate the root with flexion and some with extension.

    Dr. Corenman

    locka
    Participant
    Post count: 3

    Thanks very much for your reply! Two pieces of information I’ve not heard before that I find extremely useful, are that there are flare ups (so if you have a bad day, not the end of the world, necessarily) and that flexion and extension might help or hurt depending on your specific case. This is reassuring, and also now I know to pay close attention to effects of flexion vs extension movements.

    Much appreciated, thanks again! And have a great holiday season.

    AL

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    Good luck

    Dr. Corenman

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