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Postero LATERAL Disk Herniation


... leans AWAY from the pain

(Keywords: Postero LATERAL Disk Herniation, chiropractic, antalgia, 50 percent less pain rule)

This is a serious condition seen every day in the chiropractic clinic. It's bread and butter for the chiropractor, but should NEVER be taken lightly. It will take a minimum of SIX WEEKS TO HEAL. Injure your back again within the six weeks and you are asking for serious trouble, and the likelihood of radiating pain down the leg.


Antalgia - the sign of Pisa


A Lumbar disc protrusion herniation  may, but not necessarily, cause an antalgic list to starboard as you can see in the case of this young man. In the case of a postero lateral disk herniation, should you go into this antalgia, you will lean away from the side of pain.



A scoliosis is a permanent twist in the spine, but an antalgia is temporary: you wake up one morning with severe lower back pain and find yourself looking like the leaning tower of Pisa. After the disc has been reduced you will again stand up straight as normal.

A postero lateral herniation is the more common type, and is less likely to lead to surgery if one follows one thousand cases. But it is a serious condition, that must never be taken lightly. It bites!


Notice how in the picture on the left, that the disc bulge is LATERAL to the nerve root. You will get relief by leaning to the right, pulling the nerve root AWAY from the bulge.

Leaning towards? Or away from the pain? Or, just struck straight forwards, unable to straighten up?


The Rules

  • Get to your chiropractor quickly. The postero lateral disk herniation is not the time for the wait and see what happens approach, which I usually advocate with pain. One doesn't need to run to the doctor with every cough, nor to the chiropractor with every little pain. But if you have the sign of pisa, don't wait.
  • Stay at home at least until you can stand up straight again for 24 hours. It will take a few days at least, and sometimes a few weeks. Massaging bed rest may be necessary.



  • Try very hard not to sneeze or cough. A quick nose blow will usually abort a sneeze.
  • Immediately start putting an ice compress on your back for 20 to 30 mins, perhaps alternating with a little heat. At least twice a day. It's also the best painkiller.
  • Stay out of the bath. Shower only.
  • Don't sit, not at all, until you are up straight. Perching on the edge of a desk is okay.
  • Your chiropractor will advocate a rehab program. Make sure you go through with it. Otherwise you will again be all bent and twisted in a few weeks or months, with a much greater likelihood of leg pain sciatica ...

Leg pain

Postero Lateral disk herniation causes pain that may radiate down your leg. If you are in an antalgic posture, you will be leaning AWAY from the painful leg.

For details of the pain patterns in the leg, click here: Tingling in feet and legs ...

What is a herniated disc? A disc consists of two parts, an outer ring of tough fibres, and an inner bubble of gel. In the so-called slipped disc, both the Postero Lateral Disk herniation, the Postero Medial disk herniation and the (Far) Lateral disc herniation the bubble of gel herniates through the tough outer ring. At this link I have described in detail what may be happening in your back. Read more … Slipped disk ...

A herniated bubble of gel in a slipped disc? No, a photograph of the Cat's Eye nebula taken from the Hubble telescope. Beautiful, eh!


50 Percent less pain rule
Lower back exercises


The moment you come out of the antalgic posture, the pain decreases dramatically. Now comes the dangerous period: you feel 50 percent less pain but the annulus fibrosis has probably healed by less than 10%. The central gel, the bulging nucleus pulposis has been reduced, so you have much less pain and are standing upright, but now at least six weeks must pass before that tissue has completely healed. Beware!



The search this site function in the navigation bar on the left enables you to find stuff on this site.

Google has gone through an enormous shakeup in the last year, giving webmasters much grief.

Meantime, use that search function to find more information about subject material mentioned on the page where links have probably been removed.  There are over 360 pages at chiropractic help; it's become a veritable encyclopedia dedicated to better health.


I advocate doing a set of very gentle exercises even when your back is extremely painful. Movement within the joint is what prevents a huge amount of fluid - swelling - from invading the disk. But you do need to be discrete and sensible. You are not out to make the Olympic team!


Important considerations if you have pain in the leg

  • Maignes syndrome is a lumbar facet syndrome, but high in the lower back, not right at the base which is the more usual site. What's confusing is that the pain often radiates to the buttock, groin and front of the thigh.
  • Tingling in the toes may be caused by a Mortons neuroma ... which is a benign irritation of the nerves in the forefoot.
  • Pregnancy too is a time when many women complain of back pain and sometimes there is Leg pain during pregnancy too.
  • The merry devil is upper leg pain or just a numb feeling, usually on the side of the leg, caused a "double crush" syndrome: the nerve is affected in the back AND in the groin where the Lateral Femoral Cutaneous nerve emerges from the pelvis. Meralgia Paresthetica

Useful links


Have A Question about your lower back?

I receive many questions about Chiropractic. It might be help with a spinal condition, but it might also be from a person who can't walk after a hip operation, or some such thing.

I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like.

However, do understand that, in the main, I'm going to be directing you, should it be pertinent, to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give as much detail as you can.

Google has taken a very strong stand against webpages with poor grammar. Please don't use capitals, dots, hyphens and brackets. Don't write from your smartphone because I simply don't have the time to correct your grammar, and won't answer.

There is no charge for this service, however if you find my answer useful, you might like to consider purchasing my latest book, Stones in my Clog. Gems, both funny and healthful, from the life and work of a Chiropractor. It's only $2.99. http://www.bernard-preston.com/Stones-in-my-Clog.html

Pose Me A Question! Pretty please, in decent grammar and spelling.

I will never give or sell your email address to anyone.

Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.

Your problem: eg Tingling in feet and legs

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Interesting challenges of the day

1. Mr B  came initially for a painful and stiff neck and then asked whether chiropractic could help the cold numb feeling running down the side of his thigh for six months. Meralgia paresthetica is a double crush syndrome with the nerve affected in the back and groin. He's 80% improved after five treatments.

2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.

3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.

4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.

5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.

6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of her foot. It started after a long drive in the car. After six treatments she is 60 percent better, but it's slow and is going to take the full 6 weeks to heal.

And now a setback, after lifting her child she now has leg pain. It's going to the be difficult.

7. This lady is a 70 year old woman, is on maintenance care for a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection after a total shoulder replacement. After four operations he is incapacitated.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. This man is a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. I reassured him it's not hip arthritis.

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mr C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.