♪Bob and Brad, the two most famous ♪
♪ physical therapists on the internet. ♪
- Hi folks I'm Bob Schrupp physical therapist.
- Wow, Brad Heineck physical therapist.
- We're the most famous physical therapist on the internet.
- In our opinion of course, Bob.
- Herniated disc, sciatica, how often
can it heal on it's own?
I think a lot of people will want to know this, Brad.
- Right.
- If you have sciatica and it's caused
by a herniated or bluging disc, you wanna know,
can that disc actually heal.
- Or do you need surgery, the big questions.
- So we're going to go over that today.
We actually have a fine study that
provides us with the answers I think.
- There you go, but--
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This thing is solid here, this is made out of
pipes and you'll see how it works.
It actually increases your strength.
- It's a good product is what he's saying.
(laughing)
- Apparently I didn't convey that very well.
So anyway the study was called, this is a mouthful but I
want to say it so people can look it up if they want to.
- Sure.
- Incidence of spontaneous resorption of
lumbar disc herniation ametanalysis,
which means they looked at a whole bunch of studies.
- They actually looked at 11 studies.
- Wow you did your homework, Bob.
- I did.
- Cause that's a mouthful.
- Let's talk about first off,
how does a herniated disc even give you pain down the leg?
- Right so we're talking the lumbar spine,
a disc bulging or herniated, whatever you may call it.
Slipped disc some people say.
- So yeah let's say here's two vertebrae from your back.
We'll see this is L5 and this is L4.
- Sure.
- [Bob] In between you have this disc and the disc
is made out of a nucleus pulposus.
- Which is a fluid like substance.
- The center, yep, and the annulus fibrosus.
Alright, I never thought about this but
nucleus pulposus, annulus fibrosus, it kinda rhythms.
- There you go, that way you can
remember it if you go to the doctor.
- So anyway you're gonna have the disc
and it's between the two vertebrae.
It provides you with height, it provides you
shock absorption, it gives you the ability to move around.
But what happens over time is if you,
especially if you do a lot of activity
where you're bending forward repeatedly like this,
you can actually weaken the back of the disc.
- Sure.
- And all this sudden this kind of thing happens.
- Right there that's the bulging disc,
the herniated disc, and most of the time
it herniates out the back side
or the lateral back side which--
- [Bob] Right, because there's a big ligament here,
so it goes actually out to the side a little bit
generally and that's where the sciatic nerve is.
- [Brad] Right.
- [Bob] Or the nerve roots are that
lead to the sciatic nerve.
- [Brad] Sure.
- So if you wanna look on here, we got a little model here,
Brad's gonna go head and--
- So we've got L4, L5, and right there,
they're showing it in red that that's the bulging disc,
pushing into this nerve that goes down the leg
and may go to near to the foot on that one.
- So the question the study ask is can this,
you know once it goes out like this and herniates
or extrudes it, there's a lot of different words for it.
- Sure, yep.
- Can this get reabsorbed?
Can it go back in?
- Can the body heal itself, so to speak?
- Right, and the answer is, I'm going to give you the
kind of the answer right ahead of time is that yes it can.
So they looked at, like I said 11 studies
and on the average of those 11 studies,
they found out that the disc would
reabsorb in 66.66% of the cases on average.
- That's like two thirds.
- It's like two thirds, yep, seven out of ten almost.
And it usually was, you know, like two to five years
after the diagnosis it would get reabsorbed.
You know this happened to my brother in law.
- Sure.
- I was a younger therapist and he had a herniated disc
and at the time I thought, "Wow you've got to have surgery."
- Yeah.
- And he didn't have surgery and then like two years later
I said, "Well whatever happened that?"
He goes, "They said it got reabsorbed, and it went away."
- Yeah.
- So, now the thing is for a lot of you out there gonna say,
"Well this is really bad pain."
And that's why we're going to want you
to try some exercises, we have a bunch of videos,
a lot of them are called, by Mckenzie.
- Right.
- M-c-k-e-n-z-i-e.
- Or if you Google "Bob and Brad herniated disc".
- Herniated disc, yep.
- Or sciatica, and go to one of our playlists
and it will have a number of it you can get
a pot of coffee and just start
watching em, you'll get a full education.
Write up a paper and send it to us
and we'll give you your masters degree.
I'm just kidding but no we have a
nice playlist, a lot of information.
- Right, so you're gonna wanna try that and obviously,
or maybe it's not obviously, if you start
getting progressive weakness from this sciatica,
you know it's actually pressing on a nerve,
then you have to consider surgery.
- One of the classic symptoms is foot drop
or if you're unable to walk and your foot
continually slaps on the floor without control,
that's a big one there.
- Really bad numbness too would be a sign.
But if it's just, I shouldn't say if it's just pain,
if it's pain, I want you to try the exercise
to see if you can knock the pain down and live with it
because what they have found also, they've found
with some of the studies that if there's little difference
between patients who underwent surgery
and those who did not.
- So surgery isn't always the correct all.
- It's not always the answer.
It is sometimes but I really would do everything
in your power to not have the surgery to start off with.
- Sure.
- And try conservative means first.
- Right, and one big thing can be posture,
particularly seated posture using
a lumbar support of some kind.
Because when you're seated with poor posture that
really can help push that disc out where you do not want it.
- Yeah especially doing it over a long period of time it's
just going to go ahead and wear out the back of that disc.
But also understand this, the disc wears out with age.
I mean, you know this is not an uncommon thing.
It's very likely that Brad and I
probably have discs that are wore out.
- Right.
- And if they did an MRI and CT scan right now,
but yet we're not having pain, at least not from that.
- Right, as a matter of fact my brother just got an MRI
and his doctor said, "Your 60 years old
we're going to see some problems in your back
compared to when you were 20 or 30 years ago."
It's just the way the body responds.
- It's like wrinkles, I mean it shows up
wrinkles are on the outside.
- Gray hair.
- Gray hair, and on the inside you're gonna
have discs that are starting to wear out.
But again the bodys an amazing thing and it can reabsorb
and again we're looking at almost
7 out of 10 times where it does.
- Sure.
- So there's hope out there, Brad.
- Right there you go, Bob.
- Alright thanks everybody for watching.
- And once again Bob, we can fix--
- Oh we're going to do that too?
- Yeah why not Bob, let's put it in.
- We can fix just about anything.
- Except for...
- a broken heart.
- I was on vacation and I was thinking about a little bit,
so I think I got some new ideas.
- Okay, good.
- There you go.