POSTERO MEDIAL DISK HERNIATION

Leaning TOWARDS the side of pain

POSTERO MEDIAL DISK HERNIATION (PM) is an enigma - it's easier to treat
chiropractically but it still takes 6-8 weeks to heal. More PM discs end up in surgery because
the pain often goes away after a few treatments, so the patient resumes normal living,
bending, sitting etc, before the disc has healed, and perhaps ignoring the rehab program. So, it
happens again. And again. And then ultimately s/he goes under the knife.

Notice here that our friend is leaning TOWARDS the side of pain. Easy come, easy go. Or,
more to the point, easy go, easy come right back with a vengeance.

The pain may be gone in a few days, but it still takes at least 6 weeks with Chiropractic
treatment, and perhaps longer if you have had pain for some time, for the disc to heal.
Notice how the bulge (in the picture on the right, below) is in the 'armpit', MEDIAL to the
nerve. Now our friend gets relief by leaning TOWARDS the painful side. To the RIGHT.
(I'm sorry, but this is a little confusing. In the top picture, the lesion is one the right, he gets
relief by leaning to the right. In the lower picture, the lesion is on the left. In the pic on the
right, he gets relief leaning to the left.

In short, with a Postero medial disk herniation you get relief by leaning TOWARDS the side
of pain.

Sitting, in an ordinary chair, straighten your leg on the painful side parallel to the ground. It
probably hurts, in the back, and perhaps in the same leg.

Now straighten the opposite leg. With the Postero Medial Disk Herniation, straightening the
opposite leg often, though not always, hurts even more - on the opposite side. Usually in the
back on the opposite side of the back. If it hurts in your opposite leg, then it is considerably
more complicated. You will need to go to bed, and be patient. This isn't going to get better
quickly.

Bizarre
One of the characteristics of the Postero medial disk herniation is that it tends to flip-flop.
One day you are leaning towards the painful side. The next day away from the painful side.
It's what makes this type more difficult to manage. Your chiropractor will have to be on
his/her toes. And so will you.

Home treatment
Different doctors will have different opinions, but my advice with regard to the Postero
medial Disk herniation is:
1. Go to bed until you can stand up straight. It's usually a few days, depending on how
long you've been looking like Pisa. Not continous bed rest, that's a NO-NO.
2. Do some specific exercises that your chiropractor will prescribe for you. Do them
every hour, more often if you want.
3. Ice your back twice a day (or more, it's the best painkiller too), followed by a little
warm, moist heat. A shower, a hot water bottle.
4. Every hour (roughly, there's nothing magical about 60 mins- shall we say regularly?)
get up and walk around. Go to the loo ... perch on the edge of a desk for a bit, but
don't sit. When your back starts talking to you, go and lie down again.
5. Please don't cough or sneeze. Blowing your nose will often stop a sneeze. Quickly!
don't delay.
6. Follow your chiropractor's instructions to the T. This is a serious condition. Research
shows that a higher percentage of patients with PM discs end up in surgery. I believe
that is simply because they aren't prepared to, or don't understand that they must wait
out the six weeks before playing silly buggers again.
7. Follow your chiropractor's rehab program ernestly. Please, take it seriously, then
everyone ends up happy.
8. Don't sit for several days, and then as little as possible until you are much better.
Sitting dramatically increases the pressure in the disc. DON'T SIT initially, and then
for graded periods only!
9. Do not bend over if you have to pick something up off the floor. Go down on ONE
knee. Don't squat. Absolutely don't bend and twist simultaneously.
10. Some new research shows that Lumbar belts (corset) help patients with LBP in
regards to pain and function. Wear a belt for a week or two, especially if you simply
have to go back to work. Try not to wear it all day. Lie down periodically during the
day for five minutes and do the exercises.
11. Say your prayers and take your Postero Medial Disk Herniation seriously. The pain
will probably go away quite quickly, but ... it comes back quickly too, if you aren't
sensible. Believe me, I've been a chiropractor for thirty years.