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 Best L4-L5 Treatment For Disc Bulge, Herniation & Slipped Disc

 L4-L5 disc bulge, slipped disc, spondylosis, bone-spur, and joint pain is treatable without injections or surgery.  Avoid the L4-L5 surgery by opting for our corrective non-surgical treatment to fix and repair spinal discs and joints. Schedule a consultation now!

The L4-L5 Disc Bulge & Disc Herniation

location of the l3-l4, l4-l5 & l5-s1 spinal disc levels marked

Herniated and bulging disc at the lower back is most common at the L4-L5 segment or level. The L4-L5 is situated at your belt line. It is responsible for 95% of bending and twisting motions involving the waist. Moreover, it the most heavily burdened spinal segment, as they provide load-bearing functions that support the upper body. Due to the excessive stress placed on it, the L4-L5 section is a common site for spinal disc bulges, herniations, protrusions, prolapses, extrusion, and fragmentations. This article will provide in-depth information on the L4-L5 spinal segment to help you understand your condition and what you can do to recover fully without surgery or injections.

The L4-L5 spinal segment is a common cause of acute and chronic lower back pain (backaches). An L4-L5 disc bulge can impinge nerves that run down the legs, causing sciatic-like symptoms. A slipped disc is one of the most common causes of a pinched nerve.  An L4-L5 disc bulge or slip-disc (slipped disc) pinches and leads to serious health issues, including impotence, reproduction issues, infertility, loss of bowel and bladder control, or paralysis in one or both legs. A pinched nerve at the L4-L5 level can also occur from bone-spurs (spondylosis) or ligament thickened (hypertrophy of ligamentum flavum).

This article provides in-depth information on the L4-L5 segments and the common conditions that arise from them. Regardless of the cause, an L4-L5 spinal segment is treatable without surgery or injection. The key to recovery is accurate diagnosis followed by corrective treatments that focus on the problem’s root cause. Let’s start with some general information on the low back (lumbar spine) before starting on disorders and treatment options.

The Function Of The Lumbar Spine

The lumbar spine is also referred to as the lower back. It is a complex structure. There are a total of 5 vertebral bones in the lumbar spine. Each is attached to an intervertebral: working closely with surrounding muscles, joints, and nerves to provide a dynamic range of movements and weight-bearing. The L4-L5 spinal disc is the second-lowest disc space, and the lowest segment is the L5-S1. The L4-L5 spinal segment is the most critical of all the lower back segments as it accounts for 95% of bending at the waist. It is no accident that most back pain patients present with L4-L5 disc bulge disorders.

A herniated disc is the leading cause of spinal canal stenosis and disability. It also has a higher chance of undergoing degenerative changes and eventual disc herniation (slip disc or slipped disc). Let our expert clinical non-surgical teams provide you with the exceptional care you need today.

Large extruded / disc bulge at L4-L5 side view MRI

How The Spinal Disc Gets Damaged?

Intervertebral discs are composed of two essential parts, the annulus fibrosis on the outer rim and the nucleus pulposus in the inner portion. However, repetitive trauma, constant axial loading of the spine, injury, or weakness of the lower back muscles can cause the inner part (nucleus pulposus) to protrude through the outer ring. This can result in different types of slipped disc, such as disc bulge, disc herniation, prolapsed disc, or sequestrated disc, extruded disc, and fragmented disc.

A slipped disc can causes impingement on the exiting nerve root or nerve roots. An L4 disc herniation can impinge multiple traversing nerve roots in severe cases: L5 and even the S1 nerve root. In other words, one slip disc can pinch several nerve roots and even the spinal cord. Nerve root impingement and spinal cord compression are the main reasons why so many opt for L4-L5 surgery. However, before providing information on an L4-L5 operation or other forms of spine surgery or lumbar fusion, we like to go over some of the common symptoms associated with an L4-L5 nerve root impingement.

Common Problems Involving The L4-L5 Spinal Segments

To help you understand the cause of your low back pain, we have listed some of the most common disorders that involve the L4-L5 spinal segments include:

Muscle & Ligament Disorders At L4-L5

Injury, damage, or disorders of the ligamentum flavum are common muscular and ligamentous issues that cause concern. Muscular and ligamentous issues involving the L4-L5 segments are relatively common. They are present in almost all persons over the age of 40. However, having muscles or ligament issues alone will not cause significant pain. A muscular or ligamentous source of back pain occurs when they are damaged. Ligamentum flavum is a ligament with muscle characteristics. In other words, it has contractile abilities. Damage to ligamentum flavum leads to hypertrophy of ligamentum flavum that compresses the nerve and spinal cord.

Spinal Joint Disorders

As mentioned, the L4-L5 spinal segment is the most mobile and most burdened in the lower back. Moreover, the weight-bearing activities during sitting put excessive burdens on these segments’ joints. Spinal joints or facet joints of the spine are lined with cartilage that contains synovial membranes. Stress during standing or sitting can lead to inflammatory changes where fluids accumulate within the joints. Excessive accumulation of fluids is the leading factor in joint degeneration (facet hypertrophy) and bone spurs (arthritis).

L4-L5 Slip-Disc (Slipped Disc)

Bulging, herniated, protruded, and prolapsed discs are medical terms implying a slipped disc or slipped disc—an L4-L5 slip-disc results when the spinal disc at L4-L5 degenerates or wears out. The most common site for spinal disc degeneration, disc bulge, and the slipped disc is the L4-L5 segment. AN L4-L5 slip disc (herniated or bulged) can impinge (compress) the thecal sac (spinal cord fibers) and spinal nerves. The slightest amount of compression or impingement on a nerve or spinal cord fibers is significant. Nerve compression is significant because it causes nerve degeneration. The degenerative changes within a nerve are the leading reason for nerve pain, weakness, and paralysis.

A compressed nerve can result from a slipped disc, bone-spur, spinal misalignment (subluxations), spondylolisthesis, and ligamentous issues (hypertrophy of ligamentum flavum). Bone-spurs (arthritis and spondylosis) are the second most common cause of a compressed nerve. Regardless of the cause, compressed nerves need urgent attention, especially at the L4-L5 segment of the lower back.

Spondylolisthesis At L4-L5

An L4-L5 spondylolisthesis is a congenital or, at times, an acquired condition (degenerative spondylolisthesis) where one vertebra slips forward to the vertebrae below. The slippage of one vertebra on the other (spondylolisthesis) is graded based on its severity.:

  1. A grade I spondylolisthesis: forward slippage of less than 24%
  2. Grade II spondylolisthesis: Slippage of 25-49%
  3. Grade III spondylolisthesis: Slippage of 50-74%
  4. And A Grade IV spondylolisthesis: slippage of over 75%

Spondylolisthesis is always present with co-condition. The most common co-conditions associated with spondylolisthesis are:

  • Hypertrophy of ligamentum flavum: Thickening of a spinal ligament within the canal
  • Facet Hypertrophy: Bone spurs and arthritis
  • Disc Degeneration: Wear and tear of spinal discs
  • Joint Degeneration: Wear and tear of spinal joints
  • Spinal canal stenosis: Shrinkage in the spinal canal size
  • Foraminal Stenosis: Shrinkage of the holes where spinal nerves come out

As you can see, spondylolisthesis can become quite a problem. Spondylolisthesis at the L4-L5 spinal segment can cause carrying degrees of back pain, leg pain, and sciatica. It may also cause weakness in the legs, loss of bowels and bladder control, reproductive issues, and paralysis. Both degenerative and the acquired forms of spondylolisthesis are treatable without surgery.

What Is An L4-L5 Spondylosis?

Spondylosis is a relatively loose term describing spinal disc and spinal joint disorders leading to nerve root irritation. The L4-L5 segment is a common site of spondylosis. Symptoms of spondylosis at the L4-L5 vary. Symptoms depend on the severity of nerve compression resulting from spondylosis. However, having no pain does not mean that you have no spondylosis. For most, spondylosis is asymptomatic (cause o pain) until later stages. We have provided common symptoms often seen with varying degrees of spondylosis at L4-L5 below:

  • Mild L4-L5 spondylosis causes back pain.
  • Moderate L4-L5 spondylosis cause back pain, pain in the buttocks, hips, thighs, leg, or feet. It may also cause numbness, tingling, or weakness in the leg, feet, or toes.
  • Severe L4-L5 spondylosis causes intense back pain, weakness in legs, bladder and bowel disorders, erectile dysfunction in males, and female reproductive issues. If neglected, it will lead to partial or complete paralysis.

What Are The Dangers Of An Canal Stenosis At The L4-L5 Level?

Spinal stenosis is a common cause of pain and disability. The L4-L5 level is the most common site for spinal canal stenosis in the lower back. Spinal stenosis results from premature wear and tear of spinal joints, muscles, ligaments, and spinal discs. The shrinkage or stenosis of the spinal canal is a progressive disorder. What this means is once the shrinkage starts, it progresses.

The danger with progression is complete or partial impairment of nerves or spinal cord. Any reduction of the spinal canal is a cause for concern, especially if the reduction is at the L4-L5 level. They concern us because it leads to weakness or paralysis of lower limbs, impotence, infertility, and loss of bowel and bladder control— Common sites of spinal canal stenosis.

L4-L5 Foraminal Stenosis

Canal stenosis refers to shrinkage of the spinal canal (housing of the spinal cord). Foraminal stenosis refers to the narrowing of the opening between spinal segments. The opening (foramina) shrinks with spinal disc degeneration, joint degeneration (facet hypertrophy), ligamentous issues (ligamentum flavum hypertrophy), or bone spurs (arthritis). Foraminal stenosis at L4-L5 is the leading cause of back pain, sciatica, leg pain, numbness, and weakness in the legs.

Symptoms Of Lumbar Spinal Segment (L4-L5)

Most patients may experience lower back pain that radiates to one side of the lower limb or even both sides. Tingling, numbness (pins and needles), and an aching or burning sensation in the leg and on top of the foot are widespread. In severe cases, an L4-L5 slipped disc leads to weakness in the legs or feet. Some may even have an inability to walk, leading to an inability to stand. Those who cannot walk or stand may have a condition called “foot drop.”

Patients with footdrop frequently present with a high steppage gait where they exaggeratedly raise the thigh while walking as if they are climbing the stairs. They also have a slapping gate, where the foot strikes the ground as they walk. A drop foot is a severe condition resulting in damage or degenerative changes in the nerves that control leg and foot movements. The degree of injury is relative to the severity of a slipped disc. Therefore, those with a slipped disc should do their utmost best to obtain the needed non-surgical care as soon as possible. While surgeons recommend surgery for foot drop, we recommend our conservative treatment through collaborative chiropractic and physical therapy (physiotherapy).

What Are The Best Treatment Options For L4-L5?

Of course, the best option is a non-surgical route. Acute lower back pain or chronic lower back pain treatment is always better with nonsurgical treatments as provided by our comprehensive methods. The best targeted, extensive measures for lumbar discs of acute or chronic nature are integrative chiropractic, physical therapy, and physiotherapy.

Chiropractic Specialty Center® offers combined treatments from clinical and experts teams of chiropractors and physiotherapists. Our physio-zone provides focused L4-L5 physiotherapy through manual or highly specialized machines. The care you will get from our chiro-zone will include spinal adjustments and flexion-distraction therapy. Therapy devices such as spinal decompression therapy, shockwave therapy, high-intensity laser therapy are among some of what you will get at our physio-zone.

Chiropractic treatment of the L4-L5 or L5-S1 consists of the realigning of malpositioning spinal segments, stabilizing joints, and depressurizations of spinal discs. The best and most effective treatment for L4-L5 slipped disc is through a non-rotatory method of chiropractic.

Rotatory chiropractic adjustments such as Gonstead or Diversified can further damage a slipped disc. As such, our chiropractors provide treatments through an Activator. The Activator is the best and most targeted chiropractic treatment for acute lower back pain or chronic lower back pain.

L4-L5 Treatment At Our Chiro-Zone & Physio-Zone

our chiro and physio-zones provide precision treatment and therapies for the L4-L5 that are impossible at competing centers. Our methodology and technology for the L4-L5 segments enable our clinical teams to provide you efficacious non-invasive therapies that fix and repair the actual cause of an L4-L5 problem. Best of all, the care you get is holistic and natural without any side effects.

Physical therapy (physiotherapy) involves manual procedures provided by physical therapists or physiotherapists. Manual methods such as joint mobilizations, soft tissue mobilizations, and strengthening programs are integral to physical therapy treatment at our physio-zone. Physiotherapy is the process of providing treatments through therapeutic devices specific to the spine. In our centers, our patients receive both physical therapy and physiotherapy. We provide targeted spinal rehabilitation at our physio and chiro-zones in addition to physiotherapy and physical therapy treatments.

Our combined collective and collaborative nonsurgical treatments incorporate the best principles of lumbar disc treatments as provided through chiropractic, physical therapy (physiotherapy), and breakthrough devices (the RxDecom®) through the NSD Therapy® To summarize, NSD Therapy® is the gold standard in conservative treatments for acute or chronic lower back pain.

Can Pressure On The Nerves From A Slipped Disc Be Relieved Through Non-Surgical Treatments?

The L4-L5 Lumbar disc often places varying degrees of pressure on the nerves when they bulge, herniate or protrude. In other words, a slipped disc or slip-disc can impinge or put significant amounts of pressure on the nerves that exit the spine. Spine surgeons often attempt either destroying the nerve through a Radiofrequency Ablation (RFA or RF Neurotomy) or other forms of spine surgery to alleviate the pressure on the nerves. However, surgical interventions have not proven well in the long term. Sufferers who sought surgical interventions for an L4-L5 disc often return for additional surgeries.

Pressure on the nerves from herniated, bulging, or extruded lumbar discs are best treated without surgery. In our center, our primary goal is to take away the pressure on the nerves by correcting issues that led to nerve impingements or nerve pressure (pinched nerves). Our non-surgical treatments for the L4-L5 are not patches that spine surgeons offer. They fix the damaged joints, muscles, ligaments, and lumbar discs through our nonsurgical treatments.

Should You Opt For L4-L5 Spine Surgery?

L4-L5 lumbar fusion or minimally invasive spine surgery is not as effective as some would have you believe. Spine surgery is just that: surgery! So, when they use terms such as “minimally invasive spine surgery,” they decrease your surgical fears by making it sound minimalistic. In other words, it is a play-on-words. Ye, it is not as intense as fusion surgery (lumbar fusion), bone graft, discectomy, foraminotomy, or laminectomy, but invasive. Even the most minimally invasive spine surgery carries risks and, as such, is better avoided, especially when effective conservative measures are available right here in town. It is just that simple!

We are even opposed to an l4-L5 spinal injection, such as steroidal injections at the L4-L5. Steroidal injections or any other type of injection into the spine have complications. Besides, under the best scenarios, spinal injection only provides limited improvement. But, the failure rate and risks of complications are even higher when it comes to spine surgery. Steroidal injections, facet joint injections, and spine surgery are invasive means that offer short-term gains. Our advice is to opt for nonsurgical treatments from our clinical experts.

The L4-L5 spine surgery, like the steroidal injections, is a temporary solution, often requiring additional surgical interventions. So, they are not the fix; some would have you believe. If you have a lumbar spine condition for which the surgeons recommend surgery, call our center. Visit our clinical research-based teams for effective chiropractic and physiotherapy (physical therapy) options enhanced with spine-specific technology. We have helped thousands of patients that the surgeons recommended lumbar surgical intervention. We are confident that our non-surgical treatments will provide you with better options when compared to an L4-L5 surgery.

The Best Non-Surgical Treatments For L4-L5 Spinal Discs & Joints

NSD Therapy methods showing chiropractic (kiropraktik) & physiotherapy combined

If you seek the best conservative treatment options for an L4-L5, visit our center and receive targeted nonsurgical treatments today. Our clinical teams have the most comprehensive treatment programs for mechanical spine conditions, including slipped disc, facet joints, and spinal nerve damage. Best of all, the care you get from us will help you avoid the necessary spine surgery or spinal injections.

Spine surgeons dedicate their time and energy to invasive procedures while CSC’s clinical team concentrates on non-surgical options. So, if you are looking for non-surgical fixes or repairs, we are the better options. Your surgeon is an expert in spine surgery and may not be familiar with the latest non-surgical intervention trends. That could be the reason why they are so adamant about having you go through spine surgery.

As far as we are concerned, the L4-L5 surgery is an option best avoided. We have treated many severe lower back cases, such as a slipped disc, with a higher than 90% success rate. In short, almost every patient we have treated has improved. If you or any of your friends are experiencing similar symptoms, please do not hesitate to give us a call today! Centers have provided non-invasive treatment for the L4-L5 slipped disc through the efforts of the best research-based CSC chiropractors in Kuala Lumpur, advanced clinical physiotherapists, and specific methods and technology-specific for a slipped disc.

If you have an L4-L5 slipped disc, we are your best bet for a speedy recovery. Our methods and technology have helped thousands. Visit one of our centers for the best L4-L5 treatment without surgery or injection today. Contact CSC today to learn more about your non-surgical recovery from L4-L5 disc bulge, slip disc, stenosis & spondylolisthesis; we can help!

This Post Has 30 Comments

  1. Khairul Amir

    What is the cost for L4-L5 Slip-Disc treatment?

    1. CSC Clinical Team

      First and foremost, please accept our apologies for not responding sooner. We don’t know how this comment bypassed our attention. Our L4-L5 or L5-S1 slip-disc treatment charges depend on the procedures provided. However, the type of care you can expect from us is unmatched by others in Malaysia. We offer holistic slipped disc treatment with proven results. Meaning we fix the cause and not just pain relief. Pain relief care is okay, but the pain returns time and again. Therefore, corrective care is the best option. However, restorative care takes effort and requires treatments on advanced spine technology. It will be slightly more expensive per session when compared to standard physiotherapy or chiropractic. But, you will save tons of money in the long term.

      Our center’s typical slipped disc treatment takes about 2 to 3 hours and involves up to 9 different procedures. There are no shortcuts to fixing a slipped disc. The costs and prices for treating slip discs depend on the procedure provided. At CSC, we treat slipped disk patients through the integrative methods of chiropractic and physiotherapy. By combining slipped disc chiropractic treatment with physiotherapy and rehabilitation, we leverage the benefits of chiropractic, physiotherapy, and rehabilitation in getting our patients to get better faster with lasting relief.

      We are incredibly transparent with costs of care and pricing. As such, we have published specific pages that explain costs and treatment prices for all procedures provided in our centers. Feel free to compare our costs, fees, and prices with competing centers for the same procedures. By comparing our prices to competing centers, you will see that Chiropractic SPecialty Certner® (CSC) has the lowest treatment costs in Malaysia. Please visit one of the two pages mentioned below to revive the costs of care for physiotherapy and chiropractic:

      Treatment prices for physiotherapy

      Cost of care for chiropractic and chiropractic prices in Malaysia

      We have more than fifteen years of clinical experience treating slipped discs. In short, you can expect the best when you visit us. Those that choose shortcuts are doing an injustice to their patients.

      1. Raghubir singh

        My MRI shows my intervertebral disc heights at:
        L1-L2 at 11 mm
        L2-L3 at 7.2mm
        L3-L4 at 1mm
        L4-L5 at 6.8mm
        L5-S1 at 13 mm.
        I can walk up to one minute. I have been suffering from this problem for the last 20 years. Please suggest what I should do now. I am residing in India.

        1. Dr. Yama Zafer, D.C.

          Dear Raghubir,
          I suspect you have severe spinal canal stenosis from multilevel spinal disc, spinal joint, and ligamentous issues combined. From what i understand, there are no effective non-surgical treatment options in India for patients with degenerative disc disease, bulging discs, or herniated discs that cause spinal canal stenosis. Moreover, there is nothing that I can tell you that you could do to make it feel better. It would be best to have advanced non-surgical spine care, preferably through NSD Therapy® methods combining chiropractic and physiotherapy. In India, many claim to be a chiropractor without having a chiropractic degree from an accredited Univiserty. Alternatively, you can visit our center in Kuala Lumpur, Malaysia. FOr more information, please WhatsApp us when ready.

  2. aiman

    Hi Mychiro,

    Do you need an MRI to get treatment for the l4-l5 slip disc? My case is severe; how many sessions and how long will it take to complete the treatment? I really appreciate any help you can provide.

    1. CSC Clinical Team

      Dear Aiman,
      Slipped Discs (bulging discs, herniated discs, protruding discs, prolapsed discs, extruded discs, and fragmented discs) are dangerous conditions needing targeted treatments. MRI assessments provide the best diagnostic measure of the severity. It is impossible to assess a slipped disc adequately or slipped disc without thoroughly assessing the MRI images. Corrective care must target the damaged disc. MRI enables insights that x-ray or general exams fail to provide. In short, YES; we need MRI imaging to provide corrective care.

      The length of care depends on many factors that will be too long to cover here. However, to provide a ballpark figure, it would be safe to assume one would need 30-35 sessions of NSD Therapy® for moderate or severe spinal disc cases. Please keep in mind that some may require less or more.

      I welcome you to contact our center at 03-2093 1000 for more information about our treatment plans or schedule a one-on-one consultation with our chiropractor today. I hope this helped.

      Your Relief Team

      1. Dhoni

        My problem is related to a disc issue causing sciatica pain that I believe is coming from L1-L2, L3-L4.and L5-S1.

        1. Yama Zafer, D.C.

          Dear Dhoni,
          Sciatica arises when the lower back nerve impingement or compressed. The compression can result from bone spurs, slipped discs, ligamentous or muscle issues. To recover, you will need to have the root cause identified and corrected. We have treated thousands of patients with sciatic issues without the need for medication, injections, or surgery. Our integrative methods of care combine chiropractic and physiotherapy. Moreover, the care we provide for sciatica patients is enriched with advanced therapy devices such as RxDecom, High-Intensity Laser Therapy, shockwave therapy, in addition to general physiotherapy and chiropractic therapy devices. Learn more about our sciatica treatment by calling us on 03 2093 1000.

          1. Dinakar

            Hi sir
            My name is Dinakar, and I am 48yr old. I have problems with L4 and L5 slip disks issue. My surgeon recommends another spine surgery. My last spine surgery was in 1997 for the same problem. Please suggest what I do, my financial condition is awful, I lose my job when—Covid 2nd wave. Please suggest me.

            Thanks and regards

          2. Dr. Yama Zafer, D.C.

            Dear Mr. Dinakar,
            Thanks for posting a question. Spine surgery should always be the last option, as they often fail or need further surgical interventions.f It is not uncommon for a person to have more than one surgical intervention. Some have even had two or more spine surgeries and still live with pain.

            As far as your current condition, I would encourage you to seek conservative measures before your second surgery. The first step is to thoroughly assess your spine to see how our methods can help. We will need to review your previous MRI and X-ray scan as well.

            I understand your plight with financial issues; however, patients who experience back pains after having surgery require attentive care. As such, there is little that you can do to solve the problem. In short, you need focused treatments that focus on damaged tissues for lasting relief. Should you need our help, please contact our office on 03 2093 1000.

    2. Jerusha boyani anasi

      I greatly appreciate your help with my spinal injuries I have herniated disc. How can I access you?

      1. Dr. Yama Zafer, D.C.

        Dear Jerusha< We have helped thousands recover from a herniated disc without surgery or injections. Our advanced methodology, combined with breakthrough spine technology, can help. We have an award-wing team of physiotherapists and Malaysia’s best chiropractor to help patients like you. Please feel free to contact our center via WhatsApp for additional information.
        We look forward to hearing from you soon.

  3. Sanchita Shome

    I have an L4 L5 and L5 S1 disc disease, can you help?

    1. Yama Zafer, D.C.

      Dear Sanchita,
      Thanks for posting a question. Our center is the premier non-surgical treatment center for neck pain, back pain, sciatica, and slipped disc. Our advanced mythologies and specialized therapy devices have helped thousands recover. I am confident that we can do the same for you. Watch this short video on our slipped disc treatment. It will help you understand how we treat patients with disc disorders. Should you wish to set an appointment for your initial consultation, please call our main center at 03 2093 1000. We have several centers in the Klang Valley.

      Hope this helps

  4. Sham

    I have a problem with my L4 L5. I now experience nerve pain due to spinal nerve compression in my left leg. Can this be helped?

    1. Dr. Yama Zafer, D.C.

      Dear Sham,

      Chiropractic Specialty Center® is Malaysia’s premier non-surgical spine and joint center. The most common cause of pain, numbness, tingling, and weakness in the legs is nerve compressions at L4-L5 or L5-S1. Slipped discs such as bulging, protruded, prolapsed, herniated, and extruded discs are the leading causes of back and leg pain that cause sciatica-like symptoms. Our methods of treating leg pain slipped discs, and back pain is through advanced evidence-based practices of chiropractic combined with physiotherapy. Our clinical team’s chiropractic and physiotherapy treatment include sophisticated therapy devices targeting the root causes of back and leg pains, including sciatica and sciatica-like nerve symptoms.

      1. Eric

        I have the same symptoms. My doctor is requesting surgery because I have done a one-month recovery program, and my leg pain has lasted almost two years. Could you provide me with advice if I provide my MRI result?

        1. Dr. Yama Zafer, D.C.

          Dear Eric,
          I am sorry, but I do not provide consultation or review medical records of patients in pain for diagnosis and treatment advice. However, I would happily assess you in my office if you book an appointment. This is the best way to eliminate mistakes and provide the best non-surgical options; please WhatsApp our center to book a consultation.

  5. Barbara Rabideau

    Would you know anyone you can refer me to in Southern California, USA?

  6. Vijay Chaware, Nagpur

    I have a problem with L3-L4, l-l5, and L5-S1. The spinal canal dimensions are 9.3 and 9.8 mm, respectively, with the most recent MRI. I have undergone three sitting of Chiropractic, but the problem is not resolved. Further, the chiropractor asked for guidance from Neurosurgeon. I have radiating pain in the buttock, thigh, and right leg when walking. I could walk for 4 KM without pain in the past, but now everything has changed. Also, at present, I am undergoing IFT in a physiotherapy center.

    Please advise what to do?

    1. Dr. Yama Zafer, D.C.

      Dear Mr. Vijay,
      Thanks for posting your question. L3-L4 and L4-L5 problems are common back-related issues that impact millions. Based on what you have related, you also suffer from spinal canal stenosis. And as such, there may be additional findings present in your MRI assessment. Other issues such as facet hypertrophy and ligamentum flavum hypertrophies are expected when the L3-L4 and L4-L5 spinal segments cause canal stenosis.

      Also, you mentioned that you had received chiropractic treatment and IFT (electrotherapy) from a physiotherapy center. Chiropractic treatment alone will not make much of a difference with this level of damage. And IFT as a standalone therapy is a waste of time.

      To recover, you will require focused therapies that incorporate chiropractic treatment spinal disc methods combined with slipped-disc-specific physiotherapy methods.

      At Chiropractic Specialty Center®, we provide NSD Therapy®. NSD Therapy® services is the most advanced form of non-surgical spine care, specific to patients like you. I am a chiropractor who has treated patients like you successfully for over 25-years, and I am confident that we can provide you with the precision treatment needed to help your recovery.

      Please get in touch with our main center on 03 2093 1000 or WhatsApp us to schedule a detailed assessment or for more information about our methods of care. Please ask to be seen by Dr. Yama (that’s me).

      I hope this helped.

  7. Muhammad Zahid Sharif

    I have an L3-L4 right paracentral disc protrusion with severe stenosis of the right lateral recesses. Is this treatable without surgery?

    1. Dr. Yama Zafer, D.C.

      Dear Mohammad,
      Thanks for posting a question, and please forgive us for replying to you late. An L3-L4 disc protrusion is treatable without surgery. NSD Therapy® is the best non-surgical method of care. It incorporates disc-specific chiropractic, physiotherapy, and rehabilitation methods during the same session. Treatments are personalized to the needs of patients and non-painful. Over the years, we have helped thousands recover with a 95% success rate. Contact us today for more information about the best chiropractic and top-rated physiotherapy treatment you can get from a slipped disc. You may call or WhatsApp us when ready. I hope this helped.

  8. Trish

    My question. I’m 71 years old with heart and kidney disease. My L4 vertebra is hanging over the L5. The neurosurgeon says spine surgery with nuts, bolts & plates is needed. I have rejected the surgical option for now.

    What is the long-term outcome if nothing is done? Will I be a handle pain for now
    Just how will it affect me other than pain over the long term?

    I can handle the pain for now; please advise. How will it affect me other than pain over the long term?

    1. Dr. Yama Zafer, D.C.

      Dear Trish,
      Please forgive us for not replying sooner. From your description, it appears that you have a spondylolisthesis. Spondylolisthesis is a congenital or developmental disorder of the spine that leads to a forward displacement of a spinal bone. In general, there are two types; stable and unstable.

      Unstable spondylolisthesis is prone to progression and can rapidly progress through the four stages. Condition is graded based on severity, ranging from grade 1 to 4. A grade-1 describes an instance where the forward slippage ranges from 0 to 24%. A 25-49% slippage is classified as a grade-2. Grade 3 is 50-74%, and grade 4 is an instance where the slippage is more than 75%.

      Here are some helpful links:

      Developmental forms of spondylolisthesis are entirely due to degenerative changes or premature wear and tear. In all cases, spondylolisthesis presents with slipped discs (bulging or herniated discs), hypertrophy of facets (degenerative arthritis of spinal joints), and hypertrophy of ligamentum flavum. The combined effects cause shrinkage of the spinal canal and impingement of nerves.

      The main issue with spondylolisthesis is that it is a progressive condition. You don’t have to have surgery to stabilize it or to get rid of the pain. You must treat it as early as possible to avoid severe pain or disability.

      How bad can it get?
      Spondylolisthesis can become quite unbearable and may lead to disability, including paralysis.

      Are there any alternatives to surgery for spondylolisthesis?
      If you have spondylolisthesis, a conservative course of action is your first step. However, conservative care or treatment must be precise and personalized to each patient with spondylolisthesis.

      What types of treatment or activities should to avoid?

      You should avoid any bending or twisting movements. Do not do Yoga or Mckenzie exertion exercises.

      Can chiropractic help patients with spondylolisthesis?

      Chiropractic is excellent for patients with spondylolisthesis. However, it must be through either the Activator methods or Thompson.s. Try to combine your chiropractic treatment with physiotherapy (physical therapy) during the same session for the best results.

      Here is a helpful link on chiropractic treatment techniques:

      Avoid the rotatory methods of chiropractic, including the Diversified and Gonstead methods.

      I hope this helps, do contact us on 03 2093 1000 or Whatsapp us at +(60)17 269 1873 for more information.

  9. Tammie

    What do you recommend? What should one do if surgical fusion fails? For example, what to do for persistent pain after spine surgery that fussed the L4 and L5 with bars, plates, and screws?

    1. Dr. Yama Zafer, D.C.

      Dear Tammie,
      We apologize for not getting back to you soon enough. Spine surgery is not a cure. Spinal fusion is an aggressive surgical intervention using screws, rods, and plates to fuse segments. Contrary to common belief, fusion surgeries at L4-L5 will not cure the pain or condition. According to published research that reviewed the success rate of spine fusion in over 1,400 patients, 74% of patients will have residual pain.

      Once the spine is fussed, there is no further surgical intervention. However, that doesn’t mean that there is nothing that you can do! To eliminate the pain, you need precision treatments by our chiropractors and physiotherapists. Post-surgical pain, especially those resulting from fusion, needs specialized skill sets and advanced therapy devices. Patients with failed spine surgery or post-surgical pain must avoid any therapy or exercise that twists or bends the spine. Yoga, twisting, or turning at the waist is destructive and harmful.

      If you live in Malaysia or if you can visit our Chiropractic Specialty Center® in Kuala Lumpur, we can help.


    I am 51 years. After recovering from covid, I had severe pain in my back while walking and standing. I was advised to rest. My MRI report says I have L4-L5 listesis (spondylolisthesis). I am on medication and light exercises. Pain persists. Please advice.

    1. Dr. Yama Zafer, D.C.

      Dear Arindam,

      Listheisis means slippage, which is commonly caused by spondylolisthesis. Spondylolisthesis is a spinal condition where one vertebra slips forward or backward relative to the adjacent vertebrae. This can lead to compression of the nerves and spinal cord, resulting in back pain, muscle weakness, and numbness or tingling in the legs. Various factors, including degenerative changes, trauma, or genetic predisposition, can cause spondylolisthesis. The best treatment option for spondylolisthesis is NSD Therapy® combined with spondylolisthesis-specific methods of chiropractic and physiotherapy.

      Unfortunately, there is little I can tell you online that would make a difference. I need to assess you and review your MRIs in detail before I can help. Please WhatsApp my office if you wish for me to assess you

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