L5-S1 Disc Herniation Treatment Without Surgery – Poway, CA

When an MRI says L5-S1 disc herniation, one of the first concerns patients have is whether they are headed toward surgery.

Often, they are not.

Many L5-S1 disc problems can be treated conservatively, but the MRI is only part of the story. Dr. Cassidy James Boelk, DC wants to know what the patient actually feels. Is the pain staying in the lower back, or is it shooting through the buttock and down the leg? Is there numbness or tingling in the foot? Is the calf cramping at night? Has sitting or driving become miserable? More importantly, is there any loss of strength or other neurological change?

Dr. Boelk has spent more than 22 years working with herniated discs, bulging discs, sciatica and other difficult spinal conditions. Patients from Poway regularly visit The Spinal Decompression & Chiropractic Center of San Diego in nearby Kearny Mesa for an opinion on whether Non-Surgical Spinal Decompression may be an option.

The decision is not made simply because a radiologist used the word “herniation.” Some patients have ugly-looking MRIs and relatively manageable symptoms. Others have a smaller herniation positioned against a nerve and can barely sit, sleep, or walk comfortably.

The MRI needs to match the patient.

Abel Couldn't Sleep and Had Sciatica Running Down His Leg

Abel T. came to the office after an accident. His back pain had become severe enough to interfere with sleep, and he was experiencing pain along the sciatic nerve down one leg.

⭐⭐⭐⭐⭐ Abel T. — San Diego, CA

“I had really bad back problems to the point I couldn’t sleep, also had pain radiating along the sciatic nerve which ran down one leg from the lower back—caused by an accident.

I came in and talked to Dr. Cassidy about my back problems. He evaluated me and mentioned I was a good candidate for this treatment. After the first 2 decompression sessions my sciatic pain was gone and we were able to work on the root of the problem. I did a total of 24 sessions, after which I was able to start rehabilitation training to strengthen my core.

The office is super nice and the staff’s customer service is above and beyond.

Back and neck issues are horrible to live with—trust me, I know firsthand. I gained weight, took pain killers, went into depression, and had major anxiety. I’m over it now—feeling better, walking, sleeping well, and starting to have a better social life as well.

The experience for me has been nothing but excellent. Dr. Cassidy Boelk is hands down amazing—super glad I came here.”

— Abel T., San Diego, CA

Abel's experience also shows why rehabilitation should not be forgotten. Once the severe leg pain settles enough to allow it, rebuilding strength and gradually returning the spine to normal activity becomes an important part of recovery.

Have an L5-S1 MRI? Bring It With You

Patients from Poway can schedule a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC.

If an MRI has already been performed, bring the actual images if possible, not only the written report. Dr. Boelk personally reviews available imaging and compares it with the patient's symptoms.

He will want to know things such as:

• Where the pain begins

• Whether it travels into the buttock or leg

• How far down the leg it goes

• Whether there is numbness, tingling, or burning

• Whether the calf cramps or feels unusually tight

• Whether either leg or foot feels weaker

• How long the patient can sit comfortably

• What happens during driving

• Whether walking or standing helps or aggravates the problem

• Whether the symptoms interfere with sleep

• How the injury began

• What treatment has already been tried

• Whether there has been previous spinal surgery

• Whether the condition is improving or progressively worsening

Patients do not need an MRI just to schedule a consultation. If more information or additional imaging appears necessary, that can be discussed.

There is no obligation to start treatment.

Call 619-298-0800 to schedule a No-Charge, No-Obligation Consultation.

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123
Phone: 619-298-0800
www.SanDiegoBackCare.com
Live 24/7 Answering Service • Hablamos Español

Why Is L5-S1 Such a Common Disc to Injure?

L5-S1 is the lowest disc in the lumbar spine, located between the fifth lumbar vertebra and the sacrum. It is involved in almost everything people do with the lower back, from sitting and bending to lifting, twisting, exercise, and sports.

Over time, a disc can lose hydration and become less resilient. The outer fibers can weaken or tear, allowing disc material to push outward. An injury can also occur more suddenly during lifting, an accident, sports, or another significant load on the spine.

An MRI may call the resulting problem a bulge, protrusion, herniation, or extrusion.

Those terms describe the disc, but they do not tell Dr. Boelk everything he needs to know.

Where is the disc material located? Is it close to a nerve? Is there enough room around that nerve? Does the patient's symptom pattern make sense with what appears on the scan?

Those questions matter because the same MRI diagnosis can produce dramatically different symptoms from one person to another.

What Does an L5-S1 Herniation Feel Like?

Lower-back pain is common, but an L5-S1 problem can also cause symptoms well away from the spine.

Patients may describe:

• Lower-back pain or stiffness

• Pain concentrated on one side

• Buttock pain

• Sciatica down one leg

• Burning or electrical sensations

• Numbness or tingling

• Calf discomfort or cramping

• Symptoms into the ankle or foot

• Changes in sensation in the foot

• Leg or foot weakness

• Difficulty sitting

• Pain during longer drives

• Interrupted sleep

Sometimes the leg hurts far more than the back.

A patient may even come in saying, “My back really isn't the problem. It's my calf,” or “My foot keeps going numb.”

That is one reason the entire symptom pattern needs to be considered rather than treating only the area where the patient happens to feel pain.

If Sitting Makes Your Sciatica Worse, Pay Attention to That

One of the more useful clues with lumbar disc problems is what happens when the patient sits.

Some people feel considerably better standing or walking than sitting. They may be comfortable moving around Poway but develop significant sciatica 15 or 20 minutes after getting into the car.

That pattern is worth paying attention to.

Long periods of sitting can aggravate certain disc problems, and driving adds vibration while keeping the spine in essentially the same position.

The way someone sits can contribute too. If the driver's seat is extremely low and the knees are well above the hips, the lower back can remain rounded for a long period of time.

For someone who drives an hour or more every day, that is a lot of repeated stress.

Adjusting the seat, supporting the lower back, and breaking up long periods of sitting with short walks may help some patients avoid continually irritating the same area.

Be Careful With the “My Hamstrings Are Tight” Trap

Sciatica can make the back of the leg feel incredibly tight.

Patients stretch the hamstring because that seems logical. Sometimes they stretch several times a day and wonder why the leg keeps getting worse.

An irritated sciatic nerve can create sensations that feel a lot like muscle tightness. Pulling aggressively on that nerve may increase symptoms rather than relieve them.

If stretching causes the pain to travel farther down the leg, increases numbness or tingling, or repeatedly causes a flare-up afterward, continuing to stretch harder may not make sense.

The leg may need something different than more flexibility.

What Can Be Tried Before Surgery?

There are several nonsurgical approaches to an L5-S1 herniation.

A recent injury that is clearly improving may simply need time, reasonable activity modification, and gradual rehabilitation. Medication may help control pain and inflammation during an acute episode.

Physical therapy can be useful for restoring movement, strength, and spinal stability. Some patients receive epidural steroid injections when inflammation around a nerve is contributing to significant pain.

For selected patients, Dr. Boelk may also consider Non-Surgical Spinal Decompression.

There is no rule that every patient needs the same sequence of treatment. Someone who injured the disc three weeks ago and is already improving is different from a patient who has been dealing with sciatica for nine months and has already gone through medication, therapy, injections, and multiple other treatments.

How the DRX9000 Is Used

The Spinal Decompression & Chiropractic Center of San Diego exclusively uses the DRX9000 for lumbar Non-Surgical Spinal Decompression.

The system applies controlled decompression and relaxation cycles to the lumbar spine. Treatment is adjusted to the individual rather than using one standard L5-S1 setting for everybody.

Dr. Boelk considers factors that can include:

• The disc level

• MRI findings

• Where the symptoms are traveling

• Patient positioning

• Treatment angle

• Body size

• Starting force

• Treatment cycles

• Patient comfort and tolerance

• Response to previous sessions

Those parameters can be changed as treatment progresses.

Having sophisticated equipment matters, but the equipment is only one part of the process. Someone still has to determine whether the patient is a candidate, decide how treatment should begin, monitor the response, and recognize when something does not look right.

Lisa Travels From the United Kingdom for Her Disc Problems

Patients seeking Dr. Boelk's care have traveled from well beyond San Diego County. Lisa S. travels from the United Kingdom and has three bulging discs, including one involving a nerve.

⭐⭐⭐⭐⭐ Lisa S. — United Kingdom

“I travel from the UK to see Dr Boelk and his wonderful team . I have 3 bulging disc and one is touching the nerve. I have the spinal decompression treatment and it really helps keep me in my active life . I will not go to anyone else for back treatment, this place is number one and they genuinely care about their patients.”

— Lisa S., United Kingdom

Getting Back to Activity Matters

Pain relief is important, but it is usually not the only thing the patient wants.

Someone wants to sleep through the night again. Another patient needs to make the commute to work. Someone else wants to pick up a child, get back into the gym, play golf, surf, hike, or simply walk without constantly wondering when the sciatica will start.

As the disc and nerve symptoms allow, rehabilitation can be used to restore strength, improve movement, and prepare the spine for more normal activity.

Dr. Boelk understands that process personally. He suffered an L5 compression fracture at age 16 and later dealt with additional disc injuries and sciatica. Over the years, he has spent thousands of hours working through spinal rehabilitation, exercise, and return to activity in addition to treating patients with similar problems.

Why Patients Seek Out Dr. Cassidy James Boelk, DC

Dr. Boelk has focused much of his clinical career on herniated discs, bulging discs, sciatica, degenerative disc conditions, and Non-Surgical Spinal Decompression.

His experience and credentials include:

• Doctor of Chiropractic

• Certified Spinal Decompression Doctor

• Certified Pain-Free Performance Specialist

• More than 22 years of clinical experience

• More than 100,000 spinal decompression treatments performed

• Founder of the Non-Surgical Spinal Decompression Training Academy

• Trains other doctors in spinal decompression protocols and techniques

• Founding Member of the American Spinal Decompression Society

• Member of the International Disc Education Association

• California X-Ray Radiation Supervisor & Operator

• Seven DRX9000 spinal decompression systems

• Exclusively uses DRX9000 technology for Non-Surgical Spinal Decompression

The Kearny Mesa office has four lumbar DRX9000 systems and three cervical DRX9000C systems.

Non-Surgical Spinal Decompression is a major focus of the practice, but that does not mean every patient who walks through the door is placed on a decompression table.

Sometimes the Most Important Decision Is Not to Treat

An L5-S1 herniation can be extremely painful and still be appropriate for conservative care. There are other situations where decompression should not be performed.

Dr. Boelk screens patients for problems such as an unhealed spinal fracture, unstable spondylolisthesis, significant osteoporosis, abdominal aortic aneurysm, pregnancy for lumbar treatment, certain malignancies, certain surgical hardware at the treatment level, progressive neurological weakness, cauda equina syndrome, and other conditions that could make treatment unsafe.

Previous spinal surgery also needs to be evaluated individually. The fact that someone has had surgery does not automatically answer the question. The type of surgery, level involved, hardware, stability, current imaging, and current symptoms all matter.

If Dr. Boelk believes another opinion is more appropriate, he tells the patient.

That is part of determining candidacy, not a failure of treatment.

Know the Warning Signs

Most L5-S1 herniations do not require emergency surgery, even when the pain is severe. But pain and neurological loss are not the same thing.

Seek prompt medical attention for symptoms such as:

• New loss of bowel or bladder control

• New difficulty beginning urination

• Numbness around the groin, inner thighs, or saddle region

• Rapidly progressing leg weakness

• Sudden difficulty controlling a leg or foot

• Other rapidly worsening neurological changes

Those symptoms should not wait for a routine spinal decompression consultation.

Does an L5-S1 Herniation Automatically Mean Surgery?

No.

Many patients with L5-S1 disc herniations can be managed without surgery. Some improve with time and appropriate rehabilitation. Others respond to medication, injections, or another conservative approach. Selected patients may be candidates for Non-Surgical Spinal Decompression.

There are also patients whose neurological findings, spinal instability, previous surgery, or other circumstances make a surgical opinion necessary.

The MRI diagnosis alone does not make that decision.

Dr. Boelk looks at the imaging when available, symptoms, neurological findings, spinal stability, previous treatment, previous injuries or surgery, and how the condition is changing over time.

That gives the patient a much better starting point than simply assuming the next step based on one sentence in an MRI report.

Schedule a No-Charge, No-Obligation Consultation Near Poway

Patients from Poway dealing with an L5-S1 disc herniation, bulging disc, disc protrusion, extrusion, sciatica, or another lower lumbar disc condition can schedule a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC.

Bring MRI images, X-rays, and reports if available. Patients without imaging are still welcome to schedule.

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

Phone: 619-298-0800
www.SanDiegoBackCare.com

Live 24/7 Answering Service • Hablamos Español

Call 619-298-0800 to schedule a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC.