There are other considerations as well. Did it rupture to one side? What if you have both stenosis and herniation? Throw in a bone spur, now what? By the way, it’s the norm to have more than one condition. Did you know arthritis of the spine is the most common form of arthritis? So you see how there is not a one-size-fits-all answer.

So you got an MRI, and found a bulging disc at L4-5. In your thorough research online, you found McKenzie exercises. Which is probably the right exercise for a bulging disc. Here is yet another issue. What if your sciatica symptoms are not from the disc at all? All too often I see it in my clinic. A patient has back pain, goes to their physician. Imaging reveals a bulged disc. The physician recommends surgery, patient agrees, and then a few weeks later there is no change in symptoms. All along it was just a tight muscle. This is the problem with imaging; the medical field has become reliant on it. Some studies have shown that 64% of people have a disc abnormality but have no symptoms of back pain (Jensen et al., 1994).

I always tell my patients that when you see a medical provider, think about what tools they have in their tool box. That is generally what they are going to recommend. A physician has needle, knife, or pill. That is how they know how to solve it, and that is not wrong. But it just not be right for you, right now. Get multiple opinions from different providers. Just keep in mind there is usually more than one way to solve a problem. The question is, how do you want to solve it?





References:

Jensen, M., Brant-Zawadzki, M., Obuchowski, N., Modic, M., Malkasian, D. and Ross, J. (1994). Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain. New England Journal of Medicine, 331(2), pp.69-73.