
Disc Derangement
End-Range Loading Exercises: The goal of assessment is to find a direction that benefits the patient's pain. That movement should reduce the pain, improve range of motion, and/or bring pain up and out of an arm or leg to a more central location in the spine. Please see Figure 1 for an example.
Flexion Distraction Therapy (distraction manipulation): This technique is utilized to increase the space within the joints of the low back as well as within the spinal canal and creating a negative pressure within the disc to alleviate pressure. Increasing the space is accomplished by flexing and stretching the low back; therefore potentially providing for relief from disc derangements and spinal cord compression as well as providing an excellent stretch of the joints of the low back. Please see Figure 2 for an example.

Figure 1. End-range loading
exercises.

Figure 2. Flexion-distraction therapy