The One Exercise You Need For Lower Back Relief

By Dr Ken Nakamura+

Lower Back Relief: Toronto downtown chiropractor

If you had lower back pain so bad you became trapped in your downtown Toronto home, what would you do?


Would you call your doctor, call an ambulance or do back exercises for lower back relief?


Being a chiropractor I have an advantage that I want to share with you. As a chiropractor I was trained in rehabilitation for sports injuries and lower back conditions for over four years and I continually do post-graduate seminars.


With all that training and 18 years of experience I would pick McKenzie Extension Exercises for lower back relief.


McKenzie Extensions are exercises developed by a physiotherapist to basically put a bulging disc back into place. Disc bulges are a lot more common than people suspect.

Disc herniations come in four flavours:

  • Disc Bulge
  • Disc Prolapse
  • Disc Extrusion
  • Disc Sequestration


The disc bulge is the mildest form, while the disc sequestration is the most severe form of disc herniation.


Research [1-5] has  shown that disc herniations are very common among people. In fact 15% of 15 year olds and 30% of 30 year olds have disc herniations, without symptoms.


Eventually with enough bulging, these discs will eventually become painful.


Fortunately, the evidence shows that these exercises decreases the pressure from your disc herniation and give you relief. [7-10]



Herniated DIsc Cobra Exercise to Put your Disc Back In & Prevent Herniated Discs

Above is a photo of a McKenzie Extension Exercise. If you can’t do this try lying on your front (prone). If you can lie on your front try getting up on your elbows and holding it there for up to 30 seconds like the picture below.  Work your way up to one minute, as long as the lower back pain isn’t increasing or you aren’t getting sharp pains.
Finally you can get in to the McKenzie Extension position like the picture above. Try this 6-8 times holding for a few seconds.  You can do this every two hours.

Herniated Disc? Put your Disc Back In & Prevent Herniated Discs

So if I were trapped in my downtown Toronto condo and couldn’t move because of the pain in my lower back pain and didn’t know why, I would do my McKenzie Extension Exercises for lower back relief.


Keep in mind if you fell down and hurt your lower back you should call for help.


Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section.




1) Jensen MC, et al. “MRI imaging of the lumbar spine in people without back pain.” N Engl J Med – 1994; 331:369-373

2) Boden SD et al. “Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects: A prospective investigation.” J Bone Joint Surg Am 1990; 72A:403-408

3) Weishaupt D et al. “MRI of the lumbar spine: Prevalence of intervertebral disc extrusion and sequestration, nerve root compression and plate abnormalities, and osteoarthritis of the fact joints in Asymptomatic Volunteers.” Radiology – 1998; 209:661-666

4) Boos N, et al. “1995 Volvo Award in clinical science: The diagnostic accuracy of MRI, work perception, and psychosocial factors in identifying symptomatic disc herniations.” Spine – 1995; 20:2613-2625

5) Powell MC, et al. “Prevalence of lumbar disc degeneration observed by magnetic resonance in symptomless women.” Lancer – 1986; 2:1366-7

6) Boos N, et al. “Natural history of individuals with asymptomatic disc abnormalities in MRI: Predictors of low back pain-related medical consultation and work incapacity.” Spine 2000; 25:1484

7)  Scannell*, J.P., McGill, S.M. (2009) Disc prolapse: Evidence of reversal with repeated extension. SPINE, 34(4): 344-350. (This is for a cervical spine)

8) Stuart McGill: Low Back Disorders-Evidence Based Prevention & Rehabiliation: 193-194

9)  Fact and Fiction of Disc Reduction: A Literature Review

10)  Effects of backward bending on lumbar intervertebral discs. Relevance to physical therapy treatments for low back pain.Spine (Phila Pa 1976). 2000 Feb 15;25(4):431-7; discussion 438.


Dr Ken Nakamura

Who is Dr. Ken? I’m a father, spouse, chiropractor, and I love what I do! I created Bodi Empowerment to bring you and everyone-else safe and effective methods for self-treatment by basing my articles on research to everything I can. Still many parts will be based on 18 years of experience, seminars, and collaboration with other health experts; which means you will get opinions as well. Sometimes my articles won’t agree with what is currently accepted, but I am not here to please everyone. I’m here to empower you through the knowledge that I give you. Dr. Ken works at Rebalance Sports Medicine in downtown, Toronto.

22 Responses to The One Exercise You Need For Lower Back Relief
  • Aharon Bolshinsky says:
    October 16, 2017 at 2:10 am

    Hello, I have low back pain and pain irradiate to the anterior tight region above and near my knee. MRI says I have
    Large disc herniation L1-L2.
    Will Mackenzie exercises help me?

    • Dr Ken Nakamura says:
      October 17, 2017 at 5:14 pm

      Thanks for your question Aharon. You need to describe your pain in much more detail for me to unravel the problem. You need to give a full history of the problem including what makes the problem worse, better, what position makes it hurt etc…Then I can give you an opinion.

      If you want to give you an answer based on what you said so far. I would say likely.

      Hope that helps gives you lower back relief.

  • chalam says:
    December 5, 2014 at 8:47 pm

    ,iam 63y,and suffering from severe pain from buttack to toe of the left leg for the last 8 weeks and unable to walk or sit more than 5 min.
    The MRI report says Disc extrusion with caudal migration at L4-L5,indentation of thecal sac,oblitration of bilateral nerves and compression of L5 spinal nerve root left side. (And I donot have any back pain.)
    I request you to sugest to improve my condition.
    Thank you .

    • Dr Ken Nakamura says:
      December 7, 2014 at 6:56 am

      Thanks for your question Chalam. You should try laying down face down at first for a few minutes or longer. If you can lay down face down move on to the sphinx (explained in the link below). If you can do the sphinx try doing the cobra. But don’t do it the Yoga way do it exactly the way I have explained.

      If you get pain going further down the leg or foot or you feel worse than the exercises are not for you. While you may need surgery, you have a chance to get better with the exercises.

      Hope that helps your lower back disc extrusion.

  • Kiran says:
    August 7, 2014 at 3:12 am

    Dr Ken Nakamura,

    I have a slip disc issue L4 L5 and sciatica since March 2013. After going through various physio therapy and healing yoga therapy sessions my pain reduced n I was back in action. However the pain didnt go completely. Moreover im 14 weeks pregnant now and d pain has increased to a point that im not able to go to work. Im limping even wen I have to go to the toilet. Its getting frustrating as im not sure of the exercises that can be done in pregnancy. My yoga therapist has been visiting me from past 6 days but makes me do relaxing n 15 mins of exercise only. Im not sure if 15 mins is enough. Please guide me.

    • Dr Ken Nakamura says:
      August 7, 2014 at 9:01 am

      Thanks for your comment Kiran. Pregnancy is a special situation. The hormone relaxin has loosened all your ligaments especially around the hip and pelvis area. The low back becomes less stable. So you need stability exercises. Here are 5 stability exercises you can do at this time to make your back sturdier. Please make sure you ask the your medical doctor or mid wife first as if you have complications such as pre-eclampsia, bleeding etc… You should not do these exercises. Also balance can be an issue and you or your baby can get hurt. You must consult the person looking after the health of you and your baby before you start.

      Hope that helps your slipped disc.

  • Louise says:
    July 30, 2014 at 2:47 am

    thank you for your help Dr Ken.

  • Louise says:
    July 29, 2014 at 8:28 pm

    Hello again, i forgot to add, what is the best exercise to get back muscles, (i have read so much that i cannot remember if i have gone past it!)

    thanks for you’re previous reply. i had been told to do certain exercises by one physio which i done religiously and then another physio told me i was doing completely wrong exercises! so i am stuck at the moment and don’t know what exercises i should be doing to strengthen my back muscles.

  • Dr Ken Nakamura says:
    April 18, 2014 at 10:04 am

    Thanks for your comments Vijay. Aero cycling is often done in a forward bent or flexed position. This is a sure way to put your back out if you have a disc herniation. You say that the nerves are “punched” I think you meant pinched which is likely from a disc herniation unless you are in your 60’s.

    You should do your Aero Cycling with an upright posture while trying to keep the natural curve in your back.

    Hope that helps.

  • p vijay says:
    April 18, 2014 at 9:52 am

    Dr Nakamura ,
    i have problem with L4 L5&S1 nurbes are punched as per MRI report
    i am doing that you show four exercise only in morning & also doing 5 minutes Aero cycling , i want to know that can i continue cycling is it good for my problems or discontinue it pls reply

  • Phil says:
    April 2, 2014 at 1:09 am

    Dr. Nakamura,
    I saw the Neurosurgeon yesterday. He said surgery would be advised but is OK with me waiting things out.

    I spoke to a chiropractor today about something I had not hear of before. What your thoughts on Cox Flexion Distraction Therapy? He suggested I see him for this therapy, in combination with McKenzie therapy.

    Thank you in advance,

    • Dr Ken Nakamura says:
      April 2, 2014 at 11:26 pm

      Phil, glad the surgeon is very open to you waiting to see if conservative therapy will help.

      Regarding the chiropractor there are over 300 techniques in chiropractic. Any one chiropractor will only know a handful of techniques. Basically I am saying I don’t know a lot about this technique. Having said that the technique involves flexion while the the McKenzie involves extension. You are doing the exact opposite. My opinion doing both will just neutralize the benefits of the other.

      You need to pick the technique that you think will benefit you the most and stick with that for at least a month. If you are getting worse step by step the other will other technique will likely help you.

      For disc herniations I would side with McKenzie and flexion exercises for facets or stenosis.

      Phil with back problems 1+1 isn’t always 2. Sometimes it’s a zero. Sometimes less is more.

      Hope that helps.

  • Phil Monk says:
    March 30, 2014 at 3:20 am

    I had an MRI done on March 12, 2014 for low back pain. My physiatrist requested it, as I have had increasing burning down my left leg. After seeing my MRI my physiatrist told me to see a neurosurgeon, which I am planning to do on Monday.

    I am copying you my MRI report below in case you can tell me if the McKenzie exercises are an option for me, and if you’ve ever seen non-surgical solutions work for patients with my level of disc protrusion/etc, to recover using natural means, perhaps including McKenzie exercises.

    I am hoping to avoid surgery. I live in Virginia/USA. I’m 42 yrs old, 175 lbs, pretty good health, though I need to exercise. I’m right handed.

    This whole situation was not started with a specific incident, rather, it came upon me gradually, starting with what seemed like an extremely tight left hamstring that would not release. Over time it seemed to spread to my left buttock, calf, and back of leg, and ankle, yielding very high pain, for which I’ve been given pain medication, and also Neurontin and Diclofenac. If I am on my feet, I feel tingling down my left leg. If I lay down, it gets better but does not go away 100%.

    My MRI report:
    INDICATION: Increasing low back pain for 10 weeks.
    TECHNIQUE: Sagittal T1, T2, STIR and axial T1 and T2 MRI of the lumbar spine.
    CONTRAST: None
    Alignment within normal limits
    Bone marrow within normal limits. No bone marrow edema or marrow replacing process. No compression deformity.
    Disc signal: Mild disc desiccation at L4-5 and L5-S1. No evidence of discitis.
    Conus medullaris termination: L2
    Spinal Cord: Normal signal and calibre.
    Paraspinal soft tissues: Within normal limits.
    T12-L1, L1-L2, L2-L3, L3-L4: No herniation or stenosis
    L4-L5: Diffuse disc bulge. No stenosis.
    L5-S1: Left central disc protrusion measures 17mm at its base and extends 9mm dorsally. Mass effect on the descending left S1 nerve in the subarticular zone. Displacement of the left S2 and S3 nerves. Mild central spinal canal stenosis.
    L5-S1 left central disc protrusion likely affects the descending left sacral nerves.

    Also, my most noticeable MRI image of this bulge is at on facebook.

    I thank you for taking the time to look at these results and share your thoughts with me.
    Phil Monk

    • Dr Ken Nakamura says:
      March 31, 2014 at 2:09 am

      Thanks for your comment Phil. Your MRI basically says that the disc at L5S1 is 17 mm wide and your disc herniation goes into the spinal canal 9 mm (the place where your spinal cord is -your spinal cord ends at L2 but there are still nerves that keep going down the spinal canal). Basically it’s pinching your S1 Nerve.

      1. Trying conservative care first does not affect your outcome. ie. After one year people who delay surgery or do surgery right away have the same result. (From research) Neither conservative care or surgery is guaranteed.

      2. You can do conservative care while getting your appointments in line for possible surgery, than you can delay the surgery date if you are improving well. (in the US it is much easier to get surgery just ask when the first date of surgery that is available)

      3. Yes McKenzie extension might aggravate you but lying prone than doing the sphinx exercise may help you. When both are comfortable I would attempt to do the full extension. You will know if it is too much if you get sharp pain or if you have extra pain for more than an hour.

      4. Make sure you watch for incontinence with your bowel & bladder or if you get constipated to the point you cannot move your bowels or your bladder does not empty this means you are getting worse and warrants a trip to the emergency room.

      In the end I would always attempt conservative care before surgery.

      Hope that helps Phil.

      • Phil says:
        April 1, 2014 at 1:19 am

        Thank you very much for taking the time to share your input. Blessings to you,

        • Dr Ken Nakamura says:
          April 1, 2014 at 3:49 am

          Try 3 months of conservative care and see how you are. I wish you the best of luck.

  • Kelly says:
    March 26, 2014 at 9:35 pm

    Thank you so much. I am a health care professional and a student in Kinesiology. I am researching disc bulging for a paper that I am writing and couldn’t seem to find anything but what you provided is exactly what I need. Thanks for being so helpful.

    • Dr Ken Nakamura says:
      March 26, 2014 at 11:35 pm

      While there is evidence in the research it is always interesting what happens at the clinical level. From an anecdotal experience point of view of 18 years I can say that the exercises are very helpful for many patients. Couldn’t give a % but very helpful indeed. For anterior and lateral disc herniations you obviously change directions.

      Glad it was helpful.

  • Kelly says:
    March 26, 2014 at 9:34 am

    Hi Dr. Ken,

    Do you have any references handy saying that the mckenzie exercise will relieve low back pain due to disc bulging? I can’t seem to find a study about this.

    • Dr Ken Nakamura says:
      March 26, 2014 at 5:35 pm

      Thanks for your comment Kelly. Are you a health care professional or are you interested in only doing the exercises if there is evidence. ie evidence based care. Either way I am happy to help. Below are 3 research papers and one book reference. Two of the references are from Dr. Stuart McGill a world renown researcher for low back disorders.

      Hope that helps your inquiry about disc herniations and bulging discs.

      1.Scannell*, J.P., McGill, S.M. (2009) Disc prolapse: Evidence of reversal with repeated extension. SPINE, 34(4): 344-350. (This is for a cervical spine)

      2.Stuart McGill: Low Back Disorders-Evidence Based Prevention & Rehabiliation: 193-194

      3.Fact and Fiction of Disc Reduction: A Literature Review

      4.Effects of backward bending on lumbar intervertebral discs. Relevance to physical therapy treatments for low back pain.Spine (Phila Pa 1976). 2000 Feb 15;25(4):431-7; discussion 438.

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