Can Spinal Decompression Help an L4-L5 Disc Herniation? | San Diego, CA

If your MRI says you have an L4-L5 disc herniation, Non-Surgical Spinal Decompression may be an option.

But Dr. Cassidy James Boelk, DC doesn't decide that just because the words “L4-L5 disc herniation” appear on an MRI report.

After more than 22 years working with spinal decompression patients, he's seen plenty of people with similar MRI findings who have completely different problems. One person may have mostly lower back pain. Another has pain running into the leg. Someone else is dealing with numbness or weakness and can barely walk around the grocery store.

The MRI matters. What is happening to you matters just as much.

Dr. Boelk has performed more than 100,000 spinal decompression treatments and his San Diego clinic has seven DRX9000 systems. He also trains other doctors in spinal decompression protocols and techniques.

L4-L5 is one of the most common levels he evaluates.

⭐⭐⭐⭐⭐ “I Lost Mobility and Had Difficulty Even Putting Shoes On”

“I can walk, run and exercise without any pain.”

“I have been seeing Dr. Boelk since November for my back pain due to disc herniation. I lost mobility and had difficulty even putting shoes on. The pain was interfering with my everyday lifestyle. After reviewing the X-ray results, we agreed upon a treatment plan. Agreeing to this treatment plan was the best choice I've made for my back pain. The spinal decompression has relieved all the pain I felt in my lower back. I can walk, run and exercise without any pain and I'm able to get back in the gym and continue my daily routines. The office staff are very friendly and caring as well. I highly recommend Dr. Boelk's office to anyone seeking exceptional care.”

— Paul C.

Paul's problem had gotten to the point where something as simple as putting on his shoes was difficult.

That's the type of information Dr. Boelk wants from a patient. Not only “my back hurts,” but what has the problem actually stopped you from doing?

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Have an MRI Showing an L4-L5 Herniation? Bring It In.

If you already have an MRI, bring the actual images if possible.

The consultation is no charge.

Dr. Boelk will personally review your case and compare what he sees on the MRI with what you're experiencing.

He'll want to know:

• Where your pain starts and where it travels.

• Whether you have numbness or tingling.

• Whether you've noticed weakness in the leg or foot.

• How long you can sit, stand and walk.

• What happens when you bend, lift or exercise.

• What makes the symptoms settle down.

• What treatment you've already tried.

• Whether the L4-L5 finding actually fits your symptoms.

• Whether additional examination or imaging may be appropriate.

• Whether he believes Non-Surgical Spinal Decompression is worth considering.

No MRI yet? That's okay. Dr. Boelk can still listen to what's happening and discuss what he thinks the next step should be.

There is no charge and no obligation to start treatment.

You aren't scheduling the consultation because you've decided to do spinal decompression.

You're coming in to find out whether Dr. Boelk thinks he may be able to help you.

If he doesn't, he'll tell you.

Because Dr. Boelk personally performs these consultations while treating his existing patients, the office can only set aside a limited number during the week.

Call 619-298-0800 and ask about the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.

Live 24/7 Answering Service • Hablamos Español

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What Can an L4-L5 Disc Herniation Feel Like?

There isn't one symptom pattern that every L4-L5 patient follows.

That's important.

Some people have a lot of lower back pain. Others are much more concerned about what they're feeling in the leg.

Depending on exactly where the disc is herniated and which nerve is affected, patients may describe pain, burning, tingling or numbness traveling away from the lower back.

Sometimes they'll tell Dr. Boelk the back isn't really the problem anymore.

It's the leg.

They can't stand very long. Walking starts the symptoms. Sitting in the car is miserable. Or the leg feels strange and they don't trust it the way they used to.

That's why simply knowing the level is L4-L5 isn't enough.

Dr. Boelk Wants to See the MRI, Not Just the Report

Patients sometimes come in having memorized the worst sentence in their MRI report.

“Large disc protrusion.”

“Severe foraminal narrowing.”

“Nerve root impingement.”

Those findings deserve attention, but Dr. Boelk still wants to look at the actual images.

Where is the herniation?

How large is it?

Which direction is it going?

What does the rest of the lumbar spine look like?

Does the imaging make sense with the symptoms?

A patient can have more than one abnormal level on an MRI. The job isn't simply to find the ugliest-looking disc and assume that's the answer.

What Is Spinal Decompression Trying to Accomplish at L4-L5?

The clinic uses the DRX9000 exclusively for Non-Surgical Spinal Decompression.

Treatment applies controlled distraction to the spine. The goal is to reduce mechanical stress at the involved spinal segment and create a more favorable environment around the disc and surrounding structures.

Dr. Boelk doesn't tell patients that the DRX9000 is guaranteed to “suck an L4-L5 herniation back in.”

He'd rather look at what happens to the patient.

Can you walk farther?

Is the leg pain traveling less distance?

Can you sit longer?

Are you sleeping better?

Can you put your shoes on without struggling?

Are you beginning to exercise again?

Recent research on lumbar disc herniation continues to support conservative care for appropriately selected patients. A 2025 systematic review found improvements in pain and disability across conservative approaches including exercise, manipulation and traction, although the researchers also noted substantial variation among the studies.

Don't Just Tell Dr. Boelk Your Pain Is a 7

Tell him where it is.

That's much more interesting clinically.

Suppose your pain was originally in your back, buttock, calf and foot.

A few weeks later the foot feels normal and the symptoms stop around the buttock.

That's useful information.

Now consider the opposite.

The pain used to stay around your lower back and buttock, but lately it's traveling farther down the leg and you're beginning to notice numbness in the foot.

Dr. Boelk wants to know that too.

The number on the pain scale may not tell the whole story.

⭐⭐⭐⭐⭐ “After Treatment I Am Back to Shoveling Snow, Teaching School, Taking Walks”

“I was having pain radiating down my legs, I couldn’t sleep, I could barely walk.”

“My name is Lynn. I am from Alaska, and I just want to say it was totally worth taking a trip to go to the Spinal Decompression & Chiropractic Center of San Diego. I was having pain radiating down my legs, I couldn’t sleep, I could barely walk.

After treatment I am back to shoveling snow, teaching school, taking walks. So, I just want to thank Dr. Boelk and the clinic, you guys are wonderful, and you have created such a wonderful, friendly, kind and truly caring atmosphere. I highly encourage anybody that might be considering spinal decompression therapy, it really makes a difference.”

— Lynn C., Alaska

Lynn came all the way from Alaska.

She wasn't looking for a slightly better pain score. She wanted to walk, sleep and get her life back.

Those are the changes Dr. Boelk wants patients to pay attention to.

What If You've Already Tried Physical Therapy or an Epidural?

Bring that history with you.

Plenty of patients come to the office after they've already tried other conservative treatments.

Maybe physical therapy helped some things but the leg symptoms never went away.

Maybe an epidural gave you relief for a few months.

Maybe you've had several injections and each one helped less than the one before.

Maybe nothing has helped much at all.

None of that automatically tells Dr. Boelk whether spinal decompression will work. It does give him more information about the case.

Does an L4-L5 Herniation Mean You Need Surgery?

No. Not simply because the MRI says L4-L5 herniation.

For lumbar disc herniation without serious neurological deficits or cauda equina syndrome, conservative treatment is commonly considered first. The decision changes when there is progressive neurological loss, severe or refractory symptoms, or other findings that make surgical evaluation more appropriate.

That's why Dr. Boelk asks about strength.

Pain matters, but increasing weakness gets his attention.

If you're starting to have significant difficulty lifting your foot, your leg is clearly becoming weaker, or you're developing progressive neurological changes, that needs to be appropriately evaluated.

New bowel or bladder dysfunction, difficulty initiating or controlling urination, or numbness involving the groin, inner thighs or saddle region requires prompt medical evaluation.

Those symptoms aren't something to wait on while trying routine spinal decompression.

Not Every L4-L5 Herniation Is a Decompression Case

Dr. Boelk commonly evaluates L4-L5 disc herniations, protrusions, selected extrusions, sciatica, degenerative disc disease and foraminal narrowing.

That doesn't mean he treats every one.

He also looks at spinal stability, bone health, previous surgery, hardware, neurological findings and the rest of the patient's medical history.

Sometimes the safest answer is not spinal decompression.

★ “He Could Not Treat Me”

“He looked at my MRI images, explained what he saw and potential routes for recovery.”

“I decided to see Dr. Boelk after a pretty gnarly motocoss neck injury. At the Hospital I was at, I felt I was getting pressured into a surgery which I refused. A friend of a friend referred him after Dr. Boelk successfully treated his broken back.

Dr. Boelk is a compassionate individual who truly cares about his patients. He looked at my MRI images, explained what he saw and potential routes for recovery. He could not treat me as I have to wait until the fracture in my neck heals, but the level of professionalism, compassion, caring and knowledge displayed by him was exceptional.

He also recommended to seek an additional opinion form another neurosurgeon. My experience was that he really cares and he's not someone who would take advantage of the situation someone's in (unlike some other doctors). I will definitely be back and already recommended him to others as well! Thank you Dr. Boelk!”

— Jan H., San Marcos, CA

Jan wasn't an appropriate candidate at that time because his fracture hadn't healed.

Dr. Boelk didn't treat him anyway.

That type of decision is part of evaluating patients properly.

More Than 22 Years of Spinal Decompression Experience

Dr. Cassidy James Boelk, DC has performed more than 100,000 spinal decompression treatments. His clinic has seven DRX9000 systems and is the largest known Non-Surgical Spinal Decompression clinic in Southern California.

His professional background includes:

• Doctor of Chiropractic

• Certified Spinal Decompression Doctor

• Certified Pain-Free Performance Specialist (PPSC)

• Founder, Non-Surgical Spinal Decompression Training Academy

• Trains other doctors in spinal decompression protocols and techniques

• Founding Member, American Spinal Decompression Society

• Member, International Disc Education Association

• California X-Ray Radiation Supervisor & Operator

Dr. Boelk also understands spinal injuries personally. He suffered an L5 compression fracture at age 16 and later dealt with disc injuries and sciatica himself.

If Your MRI Says L4-L5, What Should You Do Next?

Start by figuring out whether what's on the MRI actually matches what's happening to you.

Maybe you're still doing pretty well and the symptoms are improving.

Maybe you've been stuck in the same place for months.

Or maybe six months ago you could walk for 30 minutes and now the leg starts bothering you after 10.

That's worth paying attention to.

If you're trying to avoid surgery and wondering whether Non-Surgical Spinal Decompression might be an option, you don't have to make that decision before coming in.

Bring the MRI and get an opinion.

No-Charge Consultation With Dr. Cassidy James Boelk, DC

Dr. Boelk will personally review your case, look at your MRI if you have one and compare the imaging with your symptoms.

No charge. No obligation. And not everyone is accepted for treatment.

If Dr. Boelk thinks your L4-L5 disc herniation may be appropriate for Non-Surgical Spinal Decompression, he'll explain why.

If he doesn't, he'll tell you that too.

Because these consultations are personally performed by Dr. Boelk while he continues to treat his existing patients, only a limited number can be accommodated each week.

Call 619-298-0800 and ask about the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.

Live 24/7 Answering Service • Hablamos Español

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

619-298-0800
SanDiegoBackCare.com