Medical massage for cases of herniated, ruptured, slipped, or bulging disks

Medical massage for cases of herniated, ruptured, slipped, or bulging disks

From the Author,

Following the publication of my recent article titled "Claiming Evidence-based Massage Practice," a knowledgeable colleague of mine made a comment that I found appreciable: " I appreciate you being open to colleagues’ thoughts and feedback.

I briefly scanned the linked article and regarding your summary, “Now days,no massage practitioner should or can consider themselves advanced practitioners, without capability to perform medical stress management massage.”

I may be wrong, but I believe most massaged. Therapist advanced or not are capable of performing a stress management massage.

However, I would not consider adding the word “medical”

Regardless of the technique, modality, or approach used in a session with a client, the differentiation is between the intent to initiate a relaxation response, versus another clinical outcome / goal. ????

In response, I shared the following thoughts: "Thank you for your input. When discussing medical massage, we should strive for clarity. Medical massage is a straightforward approach to the massage procedure. However, we cannot oversimplify medical full-body stress management massage, nor other medical massage protocols. The physiological effects of massage on the human body, strategies for individual treatment plan adjustments, and the sequence of massage techniques have all been developed through intensive research and extensive clinical trials over many years. These methods have been proven to be highly effective in stress management.

We begin a full-body medical stress management massage from the toes, paying particular attention to the lateral parts, and dedicating 50% of the procedure to various kneading techniques. There is a scientific rationale behind focusing on the lower extremities and neck to normalize blood perfusion to the brain. Without addressing these areas, and in particular sequences ,sustaining results in cases of essential hypertension, mental fog, sleep disorders, muscular aches and pains, and other stress-related disorders would be challenging, probably impossible.

In my program,#2

I cover protocols for essential hypertension, dizziness, headaches, worsening of vision (secondary to vertebral artery syndrome), greater occipital neuralgia, and neck rehabilitative exercises. Additionally, I emphasize the importance of teaching and demonstrating the medical full-body stress management massage protocol. This comprehensive approach is available to participants at any time for continued learning and practice.

Repeatedly observing my hands-on demonstrations assists in developing a proper understanding of touch. For further details, please refer to the provided links.

Best wishes, Boris."

Dear friends,

Science-based medical and sports massage isn't rocket science, but as mentioned earlier, each protocol has been developed through rigorous research, observation, and the selection of the most effective approaches and techniques. Within the framework of these protocols, we can innovate and refine our individual mastery. However, we must adhere to the protocols established by scientists. We are addressing life-threatening stress-related diseases and significant suffering and disability in cases of herniated, ruptured, slipped, or bulging disks.

In my teachings, I emphasize the necessity of understanding that while the science of medical massage originates from general medical science, it is a distinct discipline tailored specifically for clinical application in massage procedures. Our clinical thinking, analysis of patient-provided information, palpation, soft tissue diagnostic procedures, and treatment planning differ significantly from other medical professionals.

Often, patients express confusion when they notice improvements after our treatments despite being advised to undergo surgery by their doctors due to conditions such as ruptured or herniated disks. Physicians typically base their recommendations on MRI results and the severity of a patient's symptoms. Historically, before the advent of MRI technology and modern spinal surgical techniques, few cases of permanent nerve damage or disability were recorded.

It is essential to question why there is a significant increase in spinal surgeries, including spinal fusions, in the United States annually, compared to previous decades. Why are there rising trends in unnecessary spinal surgeries and surgery failures? These are critical questions that warrant further examination and reflection.

I believe I know the answer. At US we do not have integrative medicine and specifically integrative approach to herniated disks , ruptured disks ,slipped disks, bulging disk. Some can claim, yes we have integrative approach, physical therapy fields, orthopedic surgeons referring to, yes and no, in most cases orthopedic surgeons referring with treatment prescriptions, including exercise, when patients in terrible pain. I would say physical therapists should unite with medical massage practitioners, to develop the best our own protocol approach, and not to follow orthopedic surgeons, to convince medical society including but not limited to orthopedic surgeons by clinical proof. that correct applications of medical massage protocol can prevent surgeries, contribute to complete rehabilitation, as well as can be very beneficial in postsurgical rehabilitations. Meantime please spend time to listen to patients reported outcome.

Specifically presentation by Phil,Jon,Annie,Mark, Tristan, and Drew’s presentation. In this article I will refer you to this cases.

Medical massage protocols and approaches

I'm not differential between Herniated disks , ruptured disks ,slipped disks, bulging disk, Although I do realize importance of MRI examinations , including tremendous valuable in specific clinical situations, including but not limited to excluding spinal tumors , spinal cord edema ,compression fractures , necrosis , infections etc , but when treating intervertebral disc herniation cases, in medical massage approach,the specific clinical assessment cannot be overstated. Not the size of the herniation, as well as not an a intensity of pain determining my treatment plan strategy. For me prior to start soft tissue examinations, as well as treatment, important to find out if patient didn't lose reflexes, such as developments of incontinence, as well as different forms of areflexia. Not that I am doublechecking examinations by referring physicians, just for my self, better to connect to patient/ case, I do my own very innocent testing. For example, in order to exclude motor deficits /muscular weakness In cases of lumbar spine herniated disks I wouldn't ask patients to stay on toes , because of pain patient wouldn't be able to sustain staying on toes, nothing to do with weakness. Instead I am asking to lie on back face up, to perform dorsal flexion in ankle/foot, and to resist to my attempt to extend. If resistance is solid, then most likely there is no identified severe peripheral neuropathy ,then I am asking to lie on stomach, flexed knee, slightly using ulnar part of the palm, hitting against. achilles tendon , In . presents of reflex, foot will jerk decreasing dorsal flexion. In most difficult cases patients coming to us after visits to ER, or other doctors offices, we can be sure they were tested if reflexes are present. At my program #1, step by step I am teaching protocols for cases of L/ spine disorders including but not limited to disc herniation , piriformis muscle syndrome and more.

When piriformis muscle compresses sciatic nerve and results in pain and inflammation , what we call sciatica, sometimes it have nothing to do with disc herniations, arthropathy and other MRI findings, it just muscular syndrome. We are successfully addressing , and no surgery needed, but because of MRI findings :” Herniated disks , ruptured disks ,slipped disks, bulging disk, doctors performing unnecessary surgeries. Once sometime ago I was presenting about medical massage to group of orthopedic surgery residents, and one of the program directors, experience fellow, asked for my explanation, why performing thousands of spinal surgeries, immediately after surgeries original symptoms of radiculopathy are disappearing. My answer is very simple, under total anastasia, all muscular tones are dropping, and in cases of muscular syndromes of course drop of muscles tone under anastasia, will stop compressing sciatic nerve, or matter-of-fact other including but not limited to brachial plexus compression by anterior scalene muscle. My other question is,, what about post surgical complications? Necessity to repeat surgeries? Statistics all out there. You're welcome to Google. I saw data observation of 545 patients, 60% was scheduled for unnecessary spinal surgery .Please don't understand me wrong, orthopedic surgeons are doing important job , God bless their hands. I'm talking on integrative approach, when not necessary to have surgery, when the medical massage can be very effective sides effects free, methodology of treatment. And patients can be totally rehabilitated, by receiving specifically designed medical massage protocols. Please listen to Eileen O'Farrell patient reported outcome. Seven years ago looking on MRI, two orthopedic surgeons ,told her that MRI shows her hip joint being bone on bone. I asked her to move, yes it was painful but no evidence of bones fusions. when palpating I have detected a lot of tension within fascia and muscles, starting from L/spine, including but not limited significant tension within all hip muscles , I have careful implemented entire protocol combining protocols of program #1 and program #9.

After performing special techniques I am teaching at program #9, which is gentle pressure on projection of hip joint in order to decrease inter hip joint pressure, when I asked her to get up on her feet, she immediately reported being able to put weight on left leg. I provided 15 treatments, and already 7 years she walking on her own hip. What does it mean bone on bone? Hopefully you have careful listen to Jon’s presentation. His right knee was replaced, and he was scheduled for spinal fusion surgery, as well as left Knee replacement. He is walking, working physically, free of pain. When I have palpated T and L/spine on T12 andL/1 as well as L/2 level , slightly compressed, he reported radiated ,increased pain in his left knee. Was knee arthritis solo responsible for him not to be able to walk, to experience significant pain in knee? I clinically proved answer to this question. What I did discover significant tension of fascia and muscles within iliocostalis and Quadratus Lumborum Muscles. At program #1 I am teaching very easy to perform techniques to detect/palpate buildups of tension within fascia and muscles, as well as techniques how to reduce and eliminate this tensions. Simple like this, compressing against muscles, and when they not pushing back against your fingers, it is objective evidence on muscular tension. What this information clinically means for us? I would say crucial importance. When this muscles in spasm, they are dysfunctional, insufficient to withhold weight bearing. We cannot cancel gravity , then this weight bearing that this muscles must carry most of it, will be distributed to intervertebral disc, facet joints, ligaments and tendons. This components not designed to withhold this weight, it traumatizing them, causing inflammation with all this other anatomical components I mentioned. This inflammation significant contributing to pain, including but not limited to neurological picture like radiating pain. At program #1 I am teaching step-by-step how to perform introductory massage, to activate gate pain control, to increase threshold of pain, that allow us to perform all necessary techniques without triggering muscular protective spasm, and successfully to normalize muscular tone. Only restoring sufficiency within iliocostalis and Quadratus Lumborum Muscles, on repeated MRI can show decreased size of intervertebral disc herniations, simply because weight bearing on injured disc , inflamed ligaments, and tendons, will be reduced. Please listen careful to Phil’s presentation. Repeated MRI shows no evidence of disc Herniation. The same MRI machine, the same radiologist readed . you can search for a record, reports of so-called disappearing of disc herniation. Now I would recommend to hear to Mark’s case presentation. When I saw him first time, after my initial evaluation/palpation , I have detected a lot of tension within fascia and muscles, after performing my tests, it was 100% positive that anterior scalene muscle, compressing against and compromising brachial plexus, as well as vertebral artery was compromised. Wasn't in MRI report, but clearly hypolordosis, secondary to or over tense cervical muscles was present, of course it would aggravate compromise of spinal nerves. Thank God, I could fully rehabilitate him. Annie’s presentation similar case, but she gave me an opportunity to help, and didn't listen to 3 orthopedic surgeons who tried to convince her urgently to do surgery. There was no urgency in her case, because all reflexes were intact. And matter-of-fact I could prevent complicated including fusion unnecessary surgery. On both Annie and Mark, I have implemented protocol I am teaching at program #4. European Cranio-Sacral Therapy - CEU Volume #4

Obstacles to help people

Like I stated, big obstacles for us to help people who are suffering, and to whom we can help with out surgeries, is an unexisting of integrative medicine. I mean there is departments of integrative medicine, as well as a lot of writings about integrative medicine, but for a cases I presented, there is total absence of integrative medicine approach. Orthopedic surgeons as well as neurosurgeons, interpreting MRI images only, trying in 10 minutes teaching patients radiology, showing patients “terrible images “of nerve compressions, explaining that surgery must be done, better sooner than later, threatening of possible irreversible damages, often I hear from my patients, Dr. show me on MRI where is my nerve compressed, it looks terrible. Few times I asked my patients:” what do you think, if Dr. will show you MRI images of large dog, would you be able to identify that this is not your MRI images? I don't know if this intentional , or not intentional , ethical or not ethical but to me this is scare tactics to show MRI images. 100% of patients reported experiencing much more pain after” 10 minutes radiology lessons” The other obstacle is, we are dealing with patients that terribly suffering including but not limited to nerve pain, fear, exhaustion, physical and mental exhaustion. Like in case of Mark, under pressure of orthopedic surgeons, he didn't want to give me a chance, despite evidence of improvement after first treatment. I helped, didn't perform surgery, performed no nerve block Injections . Because of integrative approach absence, I have no supports from orthopedic surgeons, at the time when patients suffering and scared . Most of my referrals are from MDs, who are encouraging patients to give me a chance to help without surgery, it always helping, impossible to overestimate this support. Actually in such cases we are implementing integrative medicine approach.


1.In cases of intact reflexes, medical massage approach must be considered when come to the treatment of cases of Herniated disks , ruptured disks ,slipped disks, bulging disk.

2.For a sake of patients, we must develop integrative approach.

3. Science based Medical and sports massage, isn't rocket science, but as I stated in my reply above, each protocol was developed through research , observation, the most effective approaches were trialed and selected, sequence of specific massage techniques, were trialed and selected during the research I have mentioned. In the frame of proposed protocols we can improvise, we are developing our individual mastery, but in frame of protocols proposed by scientists.In no case we can simplify as my colleague proposed in her comment.

Best wishes. Boris

Add New
  • March 24 2024 06:26 PM Boris
    Crossing my mind is a case from approximately six years ago that we can learn from. I received an urgent call from a lady MD whom I knew. She was screaming and crying, "I cannot move, terrible pain in lower back radiating to my left leg." I made a home visit, and after the first treatment, she reported feeling better, experiencing less intense pain, and being able to walk. In my article, I have explained why a properly applied medical massage protocol can make an immediate difference in the clinical picture.
    We planned a treatment for the next day, which further contributed to her improvement. Unbeknownst to me, she had scheduled an MRI. We both personally knew the radiologist at this particular imaging facility, a well-known MD, PhD professor at the local medical school. I received a call from him saying, "Boris, she is sitting in front of me. I am referring her to the emergency room, probably for emergency surgery. The disk protrusion is 1.2 centimeters." Honestly, I became worried; we were on a speaker call. I asked her how she was feeling, and she said she was better. I asked if she experienced any incontinence or weakness, to which she answered no. Then I apologized to the MD, PhD professor of radiology for essentially teaching him medicine. I explained that when I started my practice, there were no MRIs available, but from autopsies and other examinations, we knew that a slightly bulged disc could leak fluid, chemically inflaming the spinal nerve and causing significant swelling or increase in size. Nowadays, MRI images would interpret this as a 1.2-centimeter disk protrusion. As I have explained in the article, we address the causes by reducing tension within the erector spinae muscles, contributing to the sufficiency of these muscles, reducing weight-bearing pressure on the injured intervertebral disc, and by increasing blood supply, we suppress inflammation and reduce the size of the swelling. This often leads to immediate positive changes in the clinical picture. I continued, "Dear Dr., in the medical massage approach, we recognize radiological findings, but decisions on following treatment plans are directed by clinical phenomena, not by MRI findings." To my pleasant surprise, the doctor thanked me for the presentation and lesson and changed his mind about referring her to the ER for emergency surgery. By the way, I frequently talk and see this lady MD, and for six years, there have been no repeated episodes. From time to time, about once a month, I perform maintenance treatment.
    Please feel free to post questions, comments, and share your own experiences.
    Best wishes, Boris Prilutsky
    P.S. During my practice, I faced similar cases as I presented. Most of the time, I convinced patients to continue treatments despite MRI findings. Sometimes, patients became scared by the images, as I have mentioned in my article, and agreed to unnecessary surgeries.
  • March 10 2024 04:27 PM boris prilutskt
    Dear readers,
    I hope you find my articles informative and practically useful, especially when facing cases of disk herniations. I find that explaining patient-reported outcomes gives me an opportunity to share my knowledge in a much more practical way. I would like to extend on Drew’s case presentation.
    I believe that even when surgery is necessary, addressing all buildups of tension within the fascia is crucial for a successful outcome. As I mentioned, total anesthesia causes an immediate drop in muscular tension, but this does not happen with fascia tension. Anesthesia has no effect on fascia tensions, so after surgery, it is difficult to rehabilitate and takes longer to recuperate. If you listen to Mark’s presentation, you'll hear that I could succeed, but the terrible post-surgical pains were 100% attributable to tension within the fascia, which triggered severe muscular spasms and, of course, pain and limitation of motion.
    Returning to Drew’s case, the MRI revealed partial tears but no retractions. In my program number 4, I demonstrate and explain how to stimulate the regenerative process by providing periosteum massage, triggering fibroblasts migration, as well as stimulating the diffusion process. This is why all healed without surgical intervention. Medical massage protocols, when applied correctly, possess huge therapeutic power. Please post any questions or comments you may have. Here is the link

    Best wishes, Boris

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