Pisa sign and sciatica with disc protusions at levels L4-L5 and L5-S1

by Alexandre
(Sydney, Australia)

Antalgic posture

Antalgic posture

Pisa sign and sciatica with disc protusions at levels L4-L5 and L5-S1 is going to be difficult and my book needs intermittent bed rest.

Hi there,

Reading through your website, I understand I have postero lateral disk herniation. I am the Pisa leaning to the right, away from the pain.
I have been carrying this for now 1 year or even more.

The pain has now become very bad, and it is very hard to stand and walk. Sitting is okay for some reason.

I am pretty desperate of finding a solution, but hate the idea of going under the knife.

Was wondering if as part of my rehab, I should try to lean toward the pain or lean right away from the pain in order to fix it, a bit like a side McKenzie. I notice that neither influence it somewhat. It doesn't quite make sense to me.

I have seen countless chiropractors and osteopaths in Sydney without any success. Can you recommend anyone?

I was also wondering if you were to recommend ozone injections as a potential solution. I know it is very controversial but apparently some people are having the greatest success.

Many thanks,


Hello Alex,
You're in a tough place and frankly there are no easy solutions. Surgery isn't one either but if you are developing paresis in your leg it has to be considered.

If you've seen "countless" chiropractors and osteopaths then something is going wrong. Have you given someone a chance, or are you expecting a "one treatment" miracle?

My advice for what it's worth is as follows:
1. Start doing our lower back exercises every single morning before getting out of bed, and several times a day. They take one minute.

2. Use alternating ice and heat on your back daily.

3. If you really are in an antalgic posture, looking like the tower of Pisa, go to bed and follow our slipped disc rules. This is controversial as there's lot of research discouraging bedrest. You'll notice ours is different though, with exercises every half an hour, getting up every hour and going for a short walk around the house.

4. Put a small lift in your right shoe.

5. If there's a swimming pool nearby, then get in several times a week, lying on your back and kicking up and down the pool. Not if it means travelling some distance.

6. Don't bend and absolutely no vacuum cleaning, sweeping, lifting.

7. Decide which you feel was the best of the chiropractors or osteopaths, and stick with him or her for at least a month, and follow their instructions to the letter.

I know this is all tough, it means taking a month off work, opting out of housework and quite a lot of money. The alternative is gathering momentum on the slippery slope where you find yourself.

Good luck, I hope this contributes. Let me know how you get on.

Dr B

» Pisa sign and sciatica with disc protusions at levels L4-L5 and L5-S1

» Pisa sign and sciatica with disc protusions at levels L4-L5 and L5-S1

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Jan 12, 2016
by: Alexandre Reyter

Hi B,

Thanks for your quick answer.
I'm pretty aware it is a serious problem and that lying down for a long period of time is probably effective.
Any recommendation about the Mckenzie Side-glide I talked about?

Many thanks.

I don't know much about it; if it's not working then there's probably no point in continuing.

Dr B

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