28/08/2026
Before & After
Conservative Physiotherapy Management
This patient initially presented with significant low back pain, radicular symptoms, lower-limb numbness and paraesthesia, disturbed sleep, and lumbar active range of motion limited to approximately 50% in all directions.
Following a neurosurgical consultation, surgical intervention was recommended; however, the patient chose to pursue conservative management.
Treatment was intentionally gentle, progressive and symptom-guided, including:
Gentle assisted stretching
TENS
Therapeutic massage
Isometric and progressive therapeutic exercises
Alongside physiotherapy, the patient remained consistent with an individualised home exercise programme and gradually incorporated swimming and cycling as tolerated.
After one year of conservative management, the patient reported complete resolution of symptoms, with no further back pain, radicular symptoms, numbness or paraesthesia, and returned to normal daily activities, including sport.
At this stage, I recommended a follow-up MRI to reassess the lumbar spine and compare the imaging findings with the initial scan.
The before-and-after MRI images demonstrate the radiological changes observed over this one-year period.
An important reminder: MRI findings should always be interpreted alongside the patient’s clinical presentation. Conservative treatment does not guarantee that a disc herniation will regress, and not every case is suitable for the same approach. Treatment decisions should be individualised, particularly when neurological symptoms are present.
Treat the patient, not just the MRI.
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