What we are talking about
Between one vertebra and the next there is a disc that works as a shock absorber. When its outer ring weakens, the core can push outward: it is called a protrusion if it stays contained, a herniation if it comes out. Degenerative disc disease is the ageing of the disc; stenosis is the narrowing of the canal the nerve roots pass through.
Here is the surprising part: in people with no pain at all, imaging studies find protrusions in a share that grows with age until it becomes the majority after fifty. A herniation seen on a scan, on its own, does not explain the pain and does not decide the plan.
What matters is how the symptom behaves: how far it travels, what makes it worse, what relieves it, whether there are neurological signs. That is what the work is built on, and that can be assessed by talking it through and watching you move.
When it makes sense to get seen
You do not have to wait until it becomes unbearable. These are the most common reasons people write to us:
- Pain running from the back down the leg, past the knee
- Tingling or numbness in a specific area of the leg or foot
- Pain that gets worse sitting for a long time or bending forward
- A report mentioning a herniation or protrusion that nobody has explained to you
- Fear of moving, which is making you move less and less
- Episodes that come back every few months and that you now take for granted
What can be done remotely, and what cannot
The format changes the tools, not the goals. Put plainly:
What can be done remotely
- Reconstructing the history of the symptom, which is the part that guides the plan most
- Reading the report together and understanding what it has and has not to do with what you feel
- Watching you move and testing the positions that aggravate and relieve
- Building and correcting an exercise programme, session after session
- Sorting out the positions of your day: how you sleep, how you sit, how you lift
What cannot
- Manual therapy: hands-on work is not there at a distance
- Equipment (tecar, laser, ultrasound) and instrument-based treatments
- Neurological tests that have to be performed physically on the patient
If signs come up during the assessment that call for a doctor or a scan, we tell you and point you in the right direction. This is not a medical visit and does not replace a diagnosis.
Frequently asked questions
Does a herniated disc reabsorb?
It can, and it happens more often than people think: the larger, extruded herniations are precisely the ones most likely to shrink over time. It is not a rule that holds for everyone and it does not depend on exercises, but it is why surgery is rarely the first road.
Should I rest?
No. Prolonged rest makes the outcome worse. In the acute days you cut back what genuinely hurts, but movement has to be kept: it is the active part of the plan, not a reward to be granted after recovery.
Should I repeat the MRI?
It rarely changes anything. Images do not follow pain: you can feel much better with the same radiological picture. It is repeated when new signs appear, not to check on progress.
When is surgery needed?
When there is a neurological deficit that is progressing, or when after a well-run conservative programme the pain remains disabling. That is a specialist's decision: we help you get there informed, and recover well if it goes ahead.
