Many patients with herniated nucleus pulposus of the lumbar spine can be expected to resolve their conditions with conservative management. Two exercise protocols for the conservative managements are the Williams' flexion exercise and the lumbar hyperextension exercise. The extension exercise may be attempted with paraspinous extensors in a flexed or neutral position in order to improve motor strength and endurance, or attempt in the hyperextended position with the goal of improving mobility, strengthening the back extensors, or promoting a shift of nuclear material to a normal position. Some controversy exsists in beneficial effects advocated by McKenizie protocols. This paper demonstrates the clinical recovery patterns of the lumbar hyperextension exercise of 2 weeks duration wihich may contribute to evaluate the effectiveness of the treatment.

Of 30 patients who met the criteria for inclusion in the study, 21 patients (70%) were improved in the clinical symptoms and physical findings within the 14 days. Thirteen (92%) of the patients that have the duration of less than 6 months were improved, and 8 (50%) of the patients that have the duration of less than 6 months were improved. It appeares that the application of the lumbar hyperextension in the patients with short duration of the symptoms was more effective than the long duration. Some of these patients demonstrated so dramatic effect that the hyperextension exercise could be recommended as essential therapeutic modality.