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Back and Neck Injury/Sciatica pain in both legs from L5-S1 disc herniation


QUESTION: Dear Lawrence Gold.

I have suffered lumbar disc L5-S1 herniation 3 years back as confirmed by MRI.
i have bilateral symptoms in both legs like numbness, pain upto feet in both legs accompanied by back pain.
i have been doing McKenzie exercises for relieving symptoms from sciatica and received myofascial release treatment from physiotherapist.

but the episodes of sciatica pain and back pain comes back again after 2 months or so.

i want to have complete relief from sciatica pain without any flare ups.



ANSWER: Dear Anupam,

If the McKenzie exercises were successful, they would have caused the disc material extruded from the disc to be drawn back into the disc.

Herniation is not the correct term; a herniation is a bulge. If you were instructed to do McKenzie exercises, it was because the disc ruptured. Please see this page | | for explanation of its nature and causes.

When a disc ruptures, its vertebra  collapses down and squeezes out its pulpy material, which presses on the nerve exiting at that level. That causes sciatica.  Please see this entry  | | for explanation of sciatica.

The purpose of myofascial release, in your case, would be to end the muscular contractions that led to the rupture (or herniation); however, myofascial release is only somewhat effective in ending chronic muscular contractions; however, somatic education exercises, when added to McKenzie exercises, would much more effectively end those contractions. I point you to the following page |; herniation is a relatively delicate condition and if you do those exercises, you should do them very gently and often until the contractions relax and your back lengthens and flattens, in which case the disc may heal. Healing of discs takes months.

If you do have a rupture, you may need surgery to correct the problem.

That's the information I can offer.

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QUESTION: Dear Lawrence Gold.

Thanks for you reply.

Please find my MRI report findings 2 years back.
Diffuse Disc bulge with posterocentral and bilateral postero paracentral herniation at L5-S1 level (protrusion) producing thecal sac indentation and narrowing of bilateral neural foramina.
At that time symptoms were much severe than now present episodes in 3 months or so.
These symptoms sometimes resolves on their own within 5 days or with Mckenzie exercises.
As it is not extrusion, kindly provide your expert opinion to avoid reoccurances.
Also my weight have increased by 4 kgs.



Hello, Anupam,

As it is not extrusion, you may follow the links I have provided and do the exercises shown in the video tutorials on those pages. As I wrote, be gentle and observe the effects.

The pain may or may not come from the narrowing of the exit points of the sciatic nerves from the spine. The tutorials provided will get you started and show you how somatic education exercises work and if they help.

More complete programs are available | |.  

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Lawrence Gold


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In practice since 1990. Two years on staff at a hospital Wellness and Rehabilitation Center. Success rate: approx. 95%+

Townsend Letter for Doctors and Patients, American Journal of Pain Management, Somatics: Magazine-Journal of the Mind-Body Arts and Sciences.

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Certifications (partial list): Hanna Somatic Education Dr. Ida P. Rolf method of Structural Integration

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