Question
Lower back & left leg pain. MRI shows herniation @L5 S1 same as in 11/05. Epidural steroidal injection on 01/18 - moderate relief of left leg. Scheduled for another shot on 02/08. Purchased inversion table have been doing 3x/daily for about a week - seems helpful.Heard about Active Release Therapy. Familiar? Who performs in Cinti? Very active 54 year old male tired of this nuisance

Answer
Sir,

With regard to your MRI findings, in the absence of compression of a spinal nerve root by a herniated disc, it is difficult to correlate the findings of an L5-S1 herniation with left leg pain. Therefore, it would be more likely that the leg pain is being caused by chemical irritation of the nerve root due to inflammation.

Corticosteroid injections can be helpful in reducing inflammation, but they are not generally curative for chronic spinal pain. Current research and clinical evidence show that most patients with spinal pain do better in the long run when they perform appropriate rehabilitative exercises. Such exercises may include McKenzie extension exercises (back-bending maneuvers), or Williams flexion exercises (forward-bending maneuvers). Chiropractors with training in rehabilitation and physical therapists are generally conversant with these techniques. Some patients also benefit from flexion-distraction manipulation, a form of intermittent spinal traction combined with manual spinal therapy, which is performed by chiropractors. Some patients with lumbar spinal pain and disc-related pain may benefit from a short-term course of spinal manipulation. The patient's long-term status may also be influenced by a variety of other factors, including (but not limited to) their overall health, a history of long-term spinal pain, their occupation, and their response to prior interventions.

Active Release Technique is a proprietary soft tissue therapy technique, and I am not certain that it offers significant benefit to individuals with disc-related problems, as disc syndromes are mechanical, rather than soft-tissue, in nature. Unfortunately, I cannot provide you with referrals to practitioners who utilize this technique.

I can certainly sympathize with your frustration, and I recommend that you speak to your physician about the possibility of incorporating an active treatment program into your therapeutic regimen.

I hope that this has answered your question.