The effectiveness of manual therapy for hernia of the lumbar spine

In medical practice, there are many methods used to treat protrusions and hernias. One of the most popular is manual therapy, also known as osteopathy.

The use of this method of treatment has its own indications and contraindications. To achieve a qualitative result, a certain number of manual exposure procedures should be carried out. Only a chiropractor with certain skills and knowledge should conduct therapy sessions.

Is it possible to carry out manual therapy for spinal hernia

Manual therapy refers to conservative treatments used to treat the spine. A patient may contact a chiropractor for treatment if:

  • The examination was diagnosed with protrusion caused by displacement of the vertebrae and predisposed to a transition to a hernia;
  • The patient refused surgery (in such cases, manual therapy is prescribed for supportive purposes);
  • A vertebral hernia was diagnosed, the patient is concerned about the standard symptom complex for pathology.

You can use the services of a chiropractor with a hernia. At the same time, it is most important that this is not a self-taught osteopath, but a qualified specialist. It is possible to conduct therapy sessions only after a comprehensive examination. Understanding where the hernia is located and what caused it allows the therapist to choose the right massage tactics and calculate the intensity of the applied efforts.

Types of manual exposure

The main goal of manual therapy is to activate the hidden reserves of the body and stimulate it to self-healing. For treatment, one of the methods of manual exposure can be used:

  1. Arthro-vertebral. The doctor acts on certain parts of the musculoskeletal system.
  2. Corneal. Using special movements, bioactive points on the skull are influenced.
  3. Myofascial cutaneous. The main effect is produced on inflamed skin and muscles. This method of manual therapy can be used independently or in preparation for surgery.
  4. Visceral. During therapy, a vertebrologist acts on the internal organs.
  5. Dephanotherapy. Pulse and traction movements are used.

For hernias of the spine located in the lumbar region (most often they are localized there), mainly defanotherapy is used. This method of manual treatment can reduce pain, eliminate the protrusion of the discs affected by the hernia, reduce the manifestations of the inflammatory process, correct the patient’s posture and strengthen muscles.

Manual treatment technique

Before proceeding as procedures for manual exposure, doctors accurately determine the location of the hernia. For this, magnetic resonance imaging or computed tomography can be used.

If the hernia is in the acute stage of development, the doctor makes very gentle and not sharp movements. Initially, the pressures and applied forces are minimal. With each subsequent session, the chiropractor is increasingly working on the affected area. Such an avalanche-like approach gives the body time to get used to the load so that it does not react to it too painfully and the patient’s condition does not worsen. During the session, the patient should be as relaxed as possible. During this period, the load on the spine becomes uniform, and the pillar itself occupies the correct physiological position.

Specific movements allow the formation of negative pressure in the spinal column, due to which the hernia is repaired. Thus, the core of the spinal disc returns to its correct place. The pressure that it exerted on the nerves and blood vessels is eliminated. Unpleasant symptoms go away with him. It is very important that all movements of the specialist during the physical impact are smooth, soft. If the pressure is too strong, the inflammatory process inside the disk and the joint as a whole may increase. Closer to the last sessions, more force is being applied by the doctor. This is necessary in order to physically correct the hernia. After this, the patient may experience slight pain in the back, but this is exclusively temporary.

Manual therapy should always be carried out in conjunction with physical therapy and medical treatment. Training should be selected individually for each patient, the first classes are conducted under the supervision of a doctor. Of the medications, patients are prescribed muscle relaxants (relax muscles), analgesics (relieve pain) and NSAIDs (relieve inflammation).

What to expect result

Manual therapy by a vertebrologist improves the general condition of the patient. The results of treatment are:

  1. Partial or complete elimination of pain;
  2. Removal of spasm in the muscular skeleton of the back and structures supporting the spine;
  3. Elimination of inflammation at the site of hernia formation;
  4. Restoration of mobility in the spinal column;
  5. Normalization of blood circulation, due to which the supply of tissues with oxygen and nutrients is restored.

If the vertebral hernia is in a dangerous position, compresses the nerves, blood vessels and limits the motor function of the spine, surgery is performed and the hernia is removed.

How many therapy sessions are needed

Treatment of spinal hernias with manual therapy is a rather lengthy process. The doctor should select the duration of the treatment course individually.

On average, one session of manual therapy lasts half an hour. With hernias of the spine, the required number of such sessions can vary within 15-20 procedures.

Therapeutic sessions are not carried out daily. Be sure to take a break in 2-3 days so that the spinal column and the muscles that surround it can rest and recover.

Symptomatic relief usually occurs after just a few treatments. But this does not mean that treatment should be stopped. The number of sessions has a clear link to the complexity of the clinical situation in a particular patient. Long-term exposure to the affected area allows you to consolidate the result and make sure that problems with the spine no longer bother the patient.

Contraindications to treatment

A comprehensive examination of the patient is performed to identify contraindications to the therapy. There are cases when manual therapy can not only not improve the situation, but also cause severe harm to the spine. This treatment technique is prohibited with:

  • The presence of strokes, circulatory disorders in the brain and other pathologies of the cardiovascular system.
  • Vertebral artery occlusion.
  • Pregnancy If a woman is in 2 or later trimesters, manual treatment is prohibited.
  • Some pathologies of the central nervous system.
  • Infectious diseases. First you need to cure these dysfunctions, after which you can begin the procedures.
  • The presence of tumors of different localization.
  • Spinal injuries. Manual therapy differs from therapeutic massages in its more severe effect on the affected area. If the patient had injuries, during the session, the doctor may violate the integrity of the tissues, stimulate repeated trauma or pinching of the nerve.
  • A history of spinal cord and brain diseases.
  • Increased intracranial pressure.

In such cases, patients are prohibited from visiting the chiropractor’s office. Alternative methods are used to treat spinal hernias to help get rid of the neoplasm.


It is possible and even necessary to attend manual therapy sessions for spinal hernia.

Manual procedures are used in conjunction with medication and exercise therapy. On average, the duration of treatment is up to 20 sessions. Manual therapy has some contraindications, so the patient must undergo examination before treatment.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles