Herniated disc without intervention

Herniated disc without surgery but with a special physiotherapy in Rome

Disc Herniation: how we treat it in the FisioClinic Physiotherapy Center in Rome




Keywords: L5 S1 hernia expelled treatment, low back pain, sciatica, isometry, sacroiliac joint, witch’s stroke, lumbar block, lumbosciatalgia, cervical, cervicobrachialgia.

the herniated disc, which affects the lumbar spine most frequently (in the L4 L5 S1 sections) and, with a lower incidence, the cervical area, is the result of the lacerative or degenerative lesion of the “pad” interposed between one vertebra .

This cushion is the intervertebral disc, formed by an innermost and gelatinous portion, the core and an outermost and fibrous portion which ensures that the core remains inside the disc itself, guaranteeing its mechanical function as a shock absorber.

Following incorrect mechanical stresses, most of the time maintained over time through postures, postures, repeated gestures, athletic gestures, this bearing is put to the test! Just think that by lifting a weight of only 10 kg incorrectly you get to put a load of about 340kg on the last lumbar disc !!! Even just sitting, the loads on the column are huge! (LINK ergonomics).

A disk that undergoes such stresses can deform, generally thinning and creating protrusions

lumbar hernia L4 L5 S1

This cushion is the intervertebral disc, formed by an innermost and gelatinous portion, the core and an outermost and fibrous portion which ensures that the core remains inside the disc itself, guaranteeing its mechanical function as a shock absorber.

Depending on the anatomical structures that this protrusion is going to stimulate, you can have a symptom of different types. In the same way, but in a more severe clinical picture, when following the fissure of the fibrous portion of the disc, the material coming from the nucleus creeps up to arrive directly outside its seat, we speak of an expelled hernia.

herniated lumbar or cervical disc

In general, the symptomatology for which a herniated disc may be responsible is radiated (sciatica or “sciatica” at the level of the lower limbs, cervicobrachialgia for the upper limbs) in a topographically consistent manner with the nerve root that the material is going to stimulate.

So if I don’t have irradiation along the limb, does that mean I don’t have a herniated disc?

NO, no it is said! It takes a careful diagnosis.

Local lumbar pain, even very acute, associated or not with the blockage of the area (the so-called “witch’s blow”) but not irradiated, must be studied with the same attention. In these cases, the articular component of the vertebrae itself, the articular facets, rich in receptors and which can justify, if altered symptoms such as the famous “lumbar block”, must be investigated.

In addition to this there are other structures that can send very strong painful stimuli to the brain at this level, such as ligaments, tendons and joint capsules. The disc itself, even in the absence of appreciable anatomical alterations in magnetic resonance imaging, can send painful stimuli through the nerve roots discovered more recently, present in the most external fibers of the fibrous ring.

But if instead I have an irradiation, a sciatica, then I definitely have a hernia?

Here too the answer is NO !!

We could be faced with many other peripheral compression forms such as direct compression of the sciatic nerve by the m. Piriformis and in that case in our Rome Physiotherapy Center we know how to deal with it (See “Piriformis Syndrome”)

Going back to herniated discs, now I understand what they are … but then how do you treat them?

Doing the opposite of the pathological process that led to the appearance of the hernia itself!

Disc herniation without intervention, Bringing the vertebrae back to the situation where there is no more pathological compression of the intervertebral disc and / or facet joints!

So, in the Rome Physiotherapy center we do not treat the symptom … therefore we try to treat the biomechanical and motor control causes (neuromuscular) that produced its deterioration of the disc or the expulsion of the hernia itself!

we decompress in a precise and controlled way the disc which is excessively compressed to give the possibility to all compromised structures (nerve root, capsule, ligaments) to carry out those physiological healing processes that otherwise could not take place (a structure that continues to be compressed it will be continuously inflamed, swollen … the more it swells, the more compressed and compressive!).

At the same time, not at a later stage, we can rebalance the tensions of all the structures that keep these vertebrae in the wrong position, in the sense of rigidity, blockage, compression, functional and biomechanical alteration.

So you don’t use machinery?

NO, we use much more sophisticated tools: our hands with a special manual therapy! the hands of physiotherapist specialists who have dedicated their studies to a specific training and specialization course. Disc herniation without intervention

But I have already done a lot of treatments, including manual, osteopathic, chiropractic, sometimes manipulative, pharmacological, but I can not solve definitively!

This is perhaps because, although the treatments already carried out have probably been positive and well carried out (and above all correctly proposed by the only legally qualified figures such as the Physiotherapist or the doctor), they have not managed to restore a sufficient balance.

This is perhaps because, although the treatments already carried out have probably been positive and well carried out (and above all correctly proposed by the only legally qualified figures such as the Physiotherapist or the doctor), they have not managed to restore a sufficient balance.

In practice they did not arrive at the causes of the problem.

Reducing a compression of a hernia on a root and consequently pain, can be a matter of a few sessions or a few days (manual therapies, manipulations, osteopathy, even anti-inflammatory drugs, cortisone etc.), but Re-educate a body towards a mechanic that works well, physiological, it is completely different!

And it is precisely a RE-EDUCATION that takes! … and only in this way can we trace the cause of that hernia, of that compression, sometimes very subjective, distant in time, the result of personal adjustments and compensation. Disc herniation without intervention.

To cure we must re-educate the body and this means Respect; respect the “biological” times of the body we are facing, of the human being, of the person.

For this type of treatment, exclusively exercised by the specialized physiotherapist (the only one who is legally allowed), we have become a reference not only in Rome but also in Bergamo.

We do not use standardized exercises or gymnastics, with more than ten years of success on our side here in the Center of Physiotherapy Rome, we do not rely on “fashions” that last a few years and carry risks and potential damages; but we use a unique methodological approach, taught and recognized in most of the world, with 30 years of “career” of worldwide success, (in Italy, not surprisingly, historically the first University Master for Physiotherapists):

Global Postural Rehabilitation Souchard RPG (LINK).

Some examples of treatment result:
Case 1:

Lumbar hernia treatment result

Patient with large L5-S1 lumbar hernia, expelled and partially migrated, highly symptomatic, diagnosed in Rmn and Emg. Very impaired walking.

Curated with coherent cortisone pattern without effect. Complete classic lumbosciatalgico (sensory) symptom, no motor deficit. Global Postural Rehabilitation (RPG Souchard) begins in our center after evaluation and planning.

One session per week, except for the first two made after three days. Symptom responds positively already after the first session. After the third session, the radiated symptoms are almost resolved. At the sixth session there was a session every 15 days. The patient repeats a control Rmn at 5 months. H5-S1 hernia almost completely reabsorbed.

Case 2:

Lumbar hernia treatment result

Hernia expelled and cranially migrated L5-S1. Patient starts therapy two months after the first rmn with increased symptoms and inability to walk without two Canadian sticks.

Lower back pain, radiating to the limb in a territory consistent with the metamer affected by the large hernial formation. Treated exclusively with the Souchard RPG method, one session per week. Back in the second session without Canadian sticks and with a clear reduction in the radiated symptoms.

Interesting fact is the evident sclerosis of the subchondral in the anterior portion of the vertebral bodies L5 and S1 which denounces the long time in which the column worked in anterior hyperpressure (due to the clear lumbar rectification seen in the first rmn), with consequent posterior opening and herniation of the nucleus.

Therefore, and to avoid recurrence, much work has been done on the recovery of a physiological curve (in the second rmn, in addition to the reduction of the hernia, it is noted that the l5-s1 disc is much less compressed. In the upper metamers they are noted at the first rmn numerous bulging, also reduced in the new rmn and added expression of a column with reduced joint crushing component.

Note: the clinical cases are real patients treated in our centers, inserted only as easily understandable examples. However, each clinical case must be studied individually and the results may be different.