Our hernia protocol consists of several steps. After the investigation you will hear which of these suit your complaint; If an operation is required, we will refer you.
On this page6
How does it work?
The core is spinal decompression: a computer-controlled traction technique on a special table. At a specific angle (depending on the level of the herniation — L4-L5, L5-S1, or cervical), dosed traction is applied in intervals (alternating pulling and releasing). The aim is to lower the pressure in the intervertebral disc and on the nerve; it has not been proven that bulging disc material moves back as a result.
The complete protocol combines decompression with gentle chiropractic adjustments, core control exercises and lifestyle advice. If desired and indicated, the doctor can add anti-inflammatory injection therapy.
What can you expect?
A decompression session takes 20-30 minutes. You lie on the table with a belt around your pelvis and chest. The traction feels like a calm, rhythmic stretch — no pain. Some patients notice less radiating pain during or shortly after the session; for others it takes longer or little changes.
A mild muscle reaction afterwards can occur — that is normal. If it helps, the effect usually builds up over the course of the protocol.
Scientific substantiation
International guidelines advise a conservative course first for a herniated disc without neurological deficit. They are cautious about traction: the British guideline NICE NG59 advises against traction for low back pain with or without sciatica. That is why decompression is always one part of our approach, alongside exercises and gentle chiropractic, never a treatment on its own. A few small studies with systems such as the DRX9000 report improvement in lumbar radiculopathy (radiating nerve pain), but good comparative research is lacking.
This is how a session goes
Every course of treatment is tailored, but this is what a typical course looks like — from the first intake to recovery and maintenance; how quickly that goes differs from person to person. You always know exactly where you stand.
Preparation
You check in and we briefly ask how your symptoms are. You lie down on the decompression table with belts around your pelvis and chest.
Spinal decompression
Computer-controlled traction in 60–90-second intervals. You feel a gentle stretch, no pain. Some patients already notice less radiating pain during the session.
Gentle correction + injection?
After decompression: additional gentle chiropractic correction. If inflammation plays a role, the doctor can give an injection (Dordrecht, on Thursdays also Rotterdam).
Recovery exercises
Core control exercises you can do the same day. McKenzie extensions or psoas release if appropriate.
For GPs and referrers
A referral is not needed: your patient makes an appointment themselves. A letter with the symptoms, previous scans and medication does help us with the first examination.
The herniated disc protocol is intended for a herniated disc in the lower back or neck with radiating nerve pain, without neurological deficit. It is not suitable for cauda equina syndrome, progressive deficit, a fracture, severe osteoporosis, a tumour in the spine, recent back surgery, an abdominal aneurysm or pregnancy. If we see warning signs, we send your patient back or refer them on the same day.
Would you like to discuss a patient? Call us on 010-411 27 63.
Frequently asked questions
Does this replace surgery?
In some patients, surgery is no longer needed afterwards. Whether that applies to you depends on your symptoms and the examination. With red-flag symptoms (loss of strength, bladder/bowel problems), surgery is still necessary.
Does decompression hurt?
No. It feels like a gentle, rhythmic traction.
How quickly will I notice improvement?
Often after 4-6 sessions; the full effect after the whole course of 15-25 sessions (6-10 weeks). That is advice per phase, not a fixed series agreed in advance: after each phase we look together at whether continuing makes sense.
What if I lose strength?
Contact us directly. Loss of strength, numbness or incontinence are reasons for emergency referral.
Will the hernia come back?
Core stability exercises and posture advice are essential to prevent recurrence. That is why the herniated disc protocol always includes an exercise component.
Not suitable for cauda equina syndrome (requiring emergency surgery), progressive neurological deficits, fractures, severe osteoporosis, tumor in the spine, recent spine surgery, abdominal aneurysm or pregnancy.
Sources
Independent information from Thuisarts.nl, the patient website of the Dutch College of General Practitioners (in Dutch).
