Evidence-based care is bringing major changes to the management of patients with pain associated with disc-herniation. There is now broad agreement in medical practice that surgery should generally not be considered for these patients until there has been a trial of conservative non-surgical care.1, 2, 3 Current surgical techniques, even through less invasive than in the past, have significant problems in terms of effectiveness, safety and cost. Most have no scientific evidence of effectiveness.4
Chiropractic is a good example of conservative non-surgical care and has been a blessing to many sufferers of spine and disc problems. Many patients show not just symptomatic improvement of their main problem, but are often pleasantly surprised at the holistic or whole-body effect of chiropractic care. 5,6
In one study, 27 patients documented with a disc-herniation were given chiropractic care. Post-care MRIs revealed that 63% of the patients had a reduced or completely reabsorbed a disc-herniation and 78% returned to work.7
In another study, 21 patients were diagnosed by CT scan with lumbar (lower back) disc-herniation. After chiropractic care, their pain disappeared and a follow-up scan six months later showed the disc-herniation had reduced or disappeared in most patients.8
In another study of 517 patients, with protruded lumbar discs, 76.8% had satisfactory results under chiropractic care.9
In another study, 51 patients with disc protrusion confirmed by myelography and electro diagnosis, the adjusted/manipulated chiropractic patients showed significantly greater improvement of spinal mobility and ‘straight leg-raising’ than patients in the physiotherapy group.10
In a study of 102 patients with disc protrusion, the adjusted chiropractic patients did significantly better than the control group.”Patients receiving manipulations enjoyed significantly greater relief of local and radiating acute LBP, spent fewer days with moderate-to-severe pain, and consumed fewer drugs for the control of pain”.11
- Weber H (1994) The Natural History of Disc Herniation and the Influence of Intervention, Spine. 19:2234-2238.
- Saal J (1996) Natural History and Nonoperative Treatment of Lumbar Disc Herniation, Spine 21:2S-9S.
- Postacchini F (1996) Results of Surgery Compared with Conservative Management for Lumbar Disc Herniations, Spine21:1383-1387.
- Gibson JNA, Grant I, Waddell G (1999) The Cochrane Review of Surgery for Lumbar Disc Prolapse and Degenerative Lumbar Disc Prolapse and Degenerative Lumbar Spondylosis, Spine 24:1820-1832.
- Leboeuf-Yde C, Axen I et al. (1999) The Types and Frequencies of Improved Nonmusculoskeletal Symptoms Reported After Chiropractic Spinal Manipulative Therapy, J Manipulative Physiol Ther, 22(9):559-564.
- Leboeuf-Yde, Pedersen EV, Bryner P et al. (2005) Self-Reported Nonmusculoskeletal Responses to Chiropractic Intervention: A Multination Survey, J Manipulative Physiol Ther, 28:294-302.
- Ben Eliyahu DJ. Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care of cervical and lumbar disc herniations . JMPT. 1996:19(19).
- Delauche-Cavallier MC, Budet C, Laredo JD et al. Lumbar disc herniation: computed tomography scan changes after conservative treatment of nerve root compression. Spine 1992: 17 (8):927-933.
- Pang-Fu Kuo P, Loh Z. Treatment of lumbar intervertebral disc protrusions by manipulation. Clinical Orthopaedics and Related Research.1987:215:47-55.
- Nwuga VCB (1982) Relative Therapeutic Efficacy of Vertebral Manipulation and Conventional Treatment in back pain management, Am J Phys Med 61:273-278.
- Santilli V, Beghi E, Finucci SA (2006) Chiropractic Manipulation in the Treatment of Acute Back Pain and Sciatica with Disc Protrusion: A Randomized Double-blind Clinical Trial of Active and Simulated Spinal Manipulations, The Spine Journal, 6:131-137.