A herniated disk is a painful and sometimes debilitating condition that can affect the low back, legs and buttocks. One form of treatment that has proven successful in reducing symptoms is the McKenzie Method exercise program for a herniated disk.
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Treating a Herniated Disk
According to the American Academy of Orthopaedic Surgeons (AAOS), a herniated disk most often occurs in the lower back, but it can happen anywhere along the spine. Most back pain is triggered by a herniated disk.
While anyone can experience a herniated disk, the AAOS says they're typically a result of age-related wear and tear, which is most commonly seen in adults as they age.
The McKenzie Method exercise program for a herniated disk begins with a trained physical therapist taking a thorough history and having the patient perform a series of repeated movements, certified McKenzie Method expert Todd Edelson, PT, DPT, owner of Montclair Physical Therapy, tells LIVESTRONG.com.
"The skilled McKenzie clinician can accurately and efficiently determine a specific exercise to treat the symptoms that may result from the herniation," he says. What makes this method so effective, says Edelson, is if the patient is given only one exercise, and they improve, the McKenzie practitioner and the patient will know exactly why because there is only one variable — that is, one exercise — in play.
However, if the patient gets worse, the clinician will also know exactly why. "In both cases, the clinician has gained valuable information that allows him or her to adjust the exercise prescription appropriately," says Edelson.
McKenzie Treatment for Herniated Disk
Treatment for a herniated disk with the McKenzie Method starts with a qualified physical therapist. They will have you follow a muscle-building strength program for the lower back that also improves abdomen and back flexibility, according to Harvard Health Publishing.
If the pain is worse when bending forward, the Cleveland Clinic recommends McKenzie exercises for bending backward, which may minimize the pressure on the nerve.
"In a large majority of cases, patients with a lumbar disk herniation will respond to extension-based exercises such as back-bends or press-ups," says Edelson. However, there are cases when extension exercises are not appropriate.
"The McKenzie Method allows the clinician to identify these cases and adjust the exercise program accordingly," he says. The exercise must be specific to the individual case. In other words, "one size does not fit all," says Edelson.
Certified McKenzie Method expert Mark Miller, PT, Dip. MDT, chief clinical officer at Integrated Musculoskeletal Care, agrees. "The specific movement or exercise that best resolves lumbar disk herniations when they are they are the source of lower back generated pain and dysfunction is dependent on the patient's McKenzie assessment results — they are all different," he tells LIVESTRONG.com.
Read more: Vitamins for a Herniated Disc
Limitations to the Method
If you're seeking McKenzie treatment for a herniated disk, make sure you work with a qualified physical therapist who is trained and certified in this method. In addition to treating a current herniated disk, a physical therapist can work with you to help prevent a herniated disk from happening again.
"Some people will not respond to the McKenzie Method," says Edelson. However, he does say it's easy to identify these people within a few visits, which allows for the timely referral to the appropriate health care provider and prevents long, fruitless courses of treatment.
There are certain contraindications to any form of mechanical intervention. According to Edelson, these include, but are not limited to, fracture of the vertebrae, active infections, cauda equina syndrome (loss of bladder and/or bowel function, numbness in the groin) and apparent neurological signs (e.g., drop foot).
Since the McKenzie Method requires active engagement by the patient, Edelson says some patients are unable to actively participate in their healing and might be better suited for different interventions.
- Academy of Orthopaedic Surgeons: "Herniated Disk in the Lower Back"
- Harvard Health Publishing: "Herniated Disc"
- Integrated Musculoskeletal Care: "J. Mark Miller, PT, Dip. MDT, Personal Interview"
- Montclair Physical Therapy: "Todd Edelson, PT, DPT, Dip. MDT, Personal Interview"
- Cleveland Clinic: "When (and How) Physical Therapy Can Provide Relief for Your Low Back Pain"