At Gentle Care Chiropractic, we’re always exploring effective, research-backed techniques to help our patients find relief from back pain and nerve-related symptoms. One such promising method is positional nerve root decompression, particularly through a specific posture called the Modified Reversed Contralateral Axial Rotation (MRCAR) position. Recent research using advanced 3D imaging has confirmed its potential in relieving pressure on compressed nerves caused by lumbar disc herniations.
What Is Nerve Root Compression?
If you’ve been diagnosed with a herniated disc or lumbar radiculopathy, you may have experienced sharp pain, numbness, or tingling that travels down your leg. This is often due to nerve root compression, where a spinal nerve exiting the low back becomes pinched or irritated, typically in the lumbar intervertebral foramen (LIVF)—the opening through which spinal nerves travel.
The size and shape of the LIVF can change based on your posture. That’s why some positions make your symptoms worse, while others bring relief. This idea is the basis of positional decompression therapy—using specific body positions to relieve nerve pressure without surgery.
What Is the MRCAR Position?
A recent study by Raffet et al. introduced the MRCAR position, a strategic trunk posture that combines three types of spinal movement:
- Axial rotation (twisting),
- Lateral flexion (side bending),
- Forward flexion (bending forward).
By combining these movements, the MRCAR position helps open up the space around the nerve root (the LIVF), giving the nerve more room and reducing pain and inflammation.
How the MRCAR Position Works
Here’s how the MRCAR position is performed:
- Lie on your pain-free side to avoid aggravating the affected nerve.
- Place a firm wedge or pillow under your pelvis, just above the hip bone. This helps tilt your lower spine.
- Rotate your upper body slightly forward, away from the painful side.
- Bend your trunk laterally (side bend) toward the pain-free side.
- Position your top leg (affected side) straight, and gently press it back and down.
- Your bottom leg stays bent for support.
- Keep both arms relaxed and resting comfortably at shoulder height.
We recommend holding this position four times a day for 20 minutes, as tolerated.
What the Research Shows
In the study, 90 patients with lumbar disc herniation used the MRCAR position over a 48-hour period. Using 3D CT scans, researchers measured the space in the foramen and tested nerve mobility. The results were compelling:
- The nerve passageway (LIVF) increased in size by up to 70–100%, depending on the disc level.
- Nerve flexibility, measured by the straight leg raise (SLR) test, also improved significantly.
- Patients reported reduced radicular symptoms in just two days.
This suggests that MRCAR is a safe and effective non-surgical technique to help decompress irritated nerves.
Why This Matters for You
The MRCAR position is especially helpful for:
Patients with unilateral lumbar disc herniation (pain on one side).
Those who feel worse with lumbar extension or standing upright.
Anyone looking for conservative, non-invasive options to manage sciatic-like pain.
Unlike some traditional methods that focus on extension (like McKenzie therapy), the MRCAR position offers an alternative approach for patients who respond better to flexion-based or side-lying techniques.
Is It Right for You?
While the research is exciting, it’s important to note that:
- This study only included younger male participants, so more research is needed on broader populations.
- It was conducted over a short period (48 hours), so long-term outcomes are still being studied.
- Not everyone can easily achieve or maintain the MRCAR position without guidance.
At Gentle Care Chiropractic, we can assess whether this technique is appropriate for your condition and teach you how to safely perform it at home or incorporate it into your therapy plan.
Final Thoughts
Nerve root decompression through the MRCAR position is a promising, evidence-based method that aligns well with our holistic approach to spinal care. If you’re dealing with lumbar disc issues and nerve pain, this may be the next step in your recovery.