PT Pro Talk

Ep 175 - Managing Radicular Syndrome: MDT and Epidural Injections in Lumbar Disc Herniation with Hans van Helvoirt

PT Pro Talk

Show Notes

💭” We took away a little bit of that nerve inflammation, and it gave us space to move again. If it’s inflamed, it’s swollen—you can’t move.’’ - Hans van Helvoirt

Our guest, Hans van Helvoirt, BSc, MA, Dip. MDT, is a physical therapist who earned his manual therapy certification in the Maitland Concept in 1990 and completed the McKenzie Diploma in Mechanical Diagnosis and Therapy (MDT) in 1992 in Wellington, New Zealand. He has taught MDT internationally and presented at global conferences since 1993, focusing on its role in the biopsychosocial model and in anesthesiology. Hans works as a consultant at Rugpoli Brabant in Tilburg, the Netherlands, a center for manual medicine and pain management. He collaborates with VU University Amsterdam on MDT-anesthesiology research and serves on the Faculty Council and Public Health Committee of the McKenzie Institute International. In 2017, he received the Institute’s “Bronze Lady” Extension Award for his research.

📚You will learn about: How epidural steroid injections affect MDT classification

The potential of combining MDT with epidural steroid injections to prevent surgery

Key findings from a randomized controlled trial on the effectiveness and cost-effectiveness of this combined approach

When and which patients' we should refer for epidural injections and more

🔎 Hans van Helvoirt’s resources of information: Rapid non-surgical recovery of chronic sciatica and neurological deficit: A case report by Hans van Helvoirt, Charles N Aprill, Ronald Donelson

Transforaminal epidural steroid injections followed by mechanical diagnosis and therapy to prevent surgery for lumbar disc herniation by Hans van Helvoirt et al.

Masterclass MDT management of radicular syndrome

Reliability of the McKenzie Method of Mechanical Diagnosis and Therapy in the examination of spinal pain, including the OTHER classifications Reliability of the McKenzie Method in spinal pain

Effectiveness and cost-effectiveness of mechanical diagnosis and treatment combined with transforaminal epidural steroid injections for patients on a waiting list for surgery for a chronic lumbar herniated disc: a randomized controlled trial and economic evaluation

📲 Hans van Helvoirt’s contact information: 💻LinkedIn: Hans van Helvoirt, M.A., dip MDT/MT

🎥Link to interview on⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 👉⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Here is the ⁠link⁠ for the quick survey⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 🎙Join our⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠email list⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to receive podcast updates 📸⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 📱⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 💻⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 🐦⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 📩Email⁠ [email protected]

PT Pro Talk Podcast is only possible with the support of forward-looking and innovative companies like:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠NeckCare ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠SaraHealth⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

More from PT Pro Talk

Oct 13, 2026

💡 In this episode of PT Pro Talk, host Mariana Parks speaks with Professor Tasha Stanton, a clinical pain neuroscientist and physiotherapist who leads the Persistent Pain Research Group. This interview breaks down the clinical application of pain neuroscience for knee osteoarthritis, from debunking the harmful "bone on bone" narrative to addressing systemic, low-level inflammation. From utilizing the Protectometer to identify danger and safety cues in a patient's life to enhancing exercise adherence with novel technologies like virtual reality, Tasha shares actionable insights on how to properly deliver pain education, reframe the aging process through bioplasticity, and optimize non-pharmacological treatments for chronic joint pain.

Sep 29, 2026

💭 "I think the biggest mistake is ignoring an irritable knee." - Jill Monson

Sep 15, 2026

💡 In this episode of PT Pro Talk, host Mariana Parks sits down with Dr. Philomena Commons (Specialist Musculoskeletal Physiotherapist, McKenzie Tutor, and PhD) to explore what it really takes to practice physical therapy in some of the most restricted, dangerous, and under-resourced environments in the world. From treating endemic leprosy in Bangladesh to teaching the McKenzie Method (MDT) under government surveillance in North Korea and evaluating back pain in Afghan prisons, Dr. Commons shares extraordinary insights on clinical intuition, cross-cultural adaptation, and patient empowerment. Learn how shifting from a purely mechanistic approach to addressing the social determinants of health (like poverty, education, and social stigma) can completely transform patient care and long-term outcomes. 💭 "I didn't really appreciate what the value of freedom until I left North Korea." - Dr. Philomena Commons 👉🏻 Dr. Philomena Commons PhD MSc Dip MDT Grad Dip Phys MCSP is a highly experienced Musculoskeletal Physiotherapist and McKenzie Tutor specializing in evidence-based treatments for complex, recurrent pain. She has held senior clinical roles in the UK's NHS and served as a Senior Lecturer at Leeds Beckett University. Beyond her clinical and academic work, she integrates her CrossFit and Life Coaching backgrounds to run functional exercise classes for Parkinson's patients. Deeply committed to global and social impact, Dr. Commons has advanced physiotherapy education in developing countries and currently volunteers to provide care for homeless individuals in the UK.

Sep 1, 2026

💡 In this episode of PT Pro Talk, host Mariana Parks speaks with Gregg Johnson, a physical therapist with over 50 years of clinical experience and co-developer of the Functional Manual Therapy (FMT) system. This interview breaks down how shifting your focus from treating local symptoms to evaluating the entire human system can completely transform your daily practice. From curing the "migrating miseries" in chronic pain patients to understanding the feed-forward mechanism of the core, Gregg shares actionable insights to help you look beyond the joint, integrate PNF, and properly assess mechanical capacity and motor control to unlock life-changing patient outcomes.

Aug 18, 2026

💡 In this episode of PT ProTalk, host Mariana Parks speaks with Colin Davies, a physiotherapist with over 50 years of clinical experience who worked directly alongside Robin McKenzie. This interview breaks down how recognizing the spine's hidden role in extremity pain can completely transform your daily clinical practice. From uncovering the true source of recurrent patellar dislocations to solving a professional dancer's 13-year history of hip pain, Colin shares actionable insights to help you look beyond the joint, avoid confirmation bias, and properly assess the spine to unlock life-changing patient outcomes.

See all episodes →