Advice on RX prolapsed disc with radiation into L Foot

[physiofixme]

Hi

Do you have McKenzie courses in the UK??? If so I think you'd really benefit from doing a McKenzie course. Basically it's a whole philosophy of treating disc problems. Very very effective. For this patient I would focus on lumbar extension. Get her in prone (pillow under belly) and do some manual therapy techniques to mobilise her lumbar spine in to extension....stick to gd 3 mobilisations for now. I would then get the patient doing self extension exercises - lying prone, and pushing up with arms (hips stay in contact with floor) Like a cobra in yoga. She should just keep repeating this in sets of 10...ie. 2-3 repititions of 10 EVERY HOUR. This should help reduce pain. What is likely to happen is that the pain will start to move up her leg...this is a good thing. The further down the leg the pain is, the more irriated the disc and nerve are. I'd STOP doing any flexion or stretches until she has no leg pain. Also educate her on sitting posture...to avoid sitting when possible and opt for lying prone on the floor if relaxing at home. Also she needs to avoid lifing and avoid bending too much ie: making beds, vacuuming, cleaning bath etc until she has no leg pain. See if you can find a copy of "Treat your own back" by Robin McKenzie at your local bookstore and have a read and lend it to your patient. Also look around your libraries or other physio resources and look for " The lumbar spine - mechanical diagnosis and therapy" by R.A McKenzie. Hope this all helps.

[physio.smith]

I have often found McKenzie principle useful with these type of patients. The techniques are very useful to manage and help the patient self manage the problem. The book mentioned is a definitely worth a read.

There are courses available in the UK, see your Frontline magazine or The McKenzie Institute (UK) Trust Website for courses.

[physio48]

Many thanks for your advice have both books on order and trying to find a place on a local course.

Pt now doing better following the Mckenzie extension exercise as recommend, pain has now moved from foot to upper shin. Pt is mobilising better and in less pain.

Hopefully books will arrive soon

Many thanks