Can a L4/5 herniated disc improve with only physiotherapy and exercise?Orthopaedic Surgery Sport Medicine Spine Health
I've read that slipped disc symptoms can improve with only physical therapy, rehab and exercise. How much improvement can one expect?
Depending on the severity/size (or Stage) of your disc herniation in both your clinical signs and in your MRI, Stage 3 (large, severe) slipped disc must undergo surgery to improve no other choice !
Early Stage 1 (small, mild) and Mid Stage 2 (moderate disc bulge) can be "managed" by physical therapy whenever it "acts up" but without surgery cannot be permanently "cured".
As long as it doesn't escalate to Stage 3 or affect your quality of life/work, we can live with it with on-off treatment for relapses as long as physical therapy still helps, is non-invasive and can be repeated multiple times (unlike surgery).
In principle, low or non-impact "horizontal" exercises (swimming, yoga, etc) are safer for your lower back. You don't want high impact "vertical" exercises (running, racket games, etc) to stress your worn out L4-5 disc further !
Dr Fong Shee Yan
MBBS, FAMS, FRCS, MMed Ortho
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