Herniated Disc Treatment and Chiropractic Care:

Herniated Disc Treatment involves a combination of (NSAIDs) and conservative care including Chiropractic spinal adjustments and targeted home exercises. It is sometimes MORE important to learn WHAT NOT TO DO, for example, activities that are likely to aggravate a herniated disc, than what TO DO.

Non-prescription non-steroidal anti-inflammatory medications such as ibuprofen or naproxen can help with pain relief, reduce inflammation and relax muscles.

Fortunately, most cases of lumbar herniated disc symptoms resolve on their own within six weeks. Approximately 30% of patients experience symptoms for up to six months and 10-15% for up to one year.

Chiropractic spinal adjustments have been well-researched and numerous randomized controlled trials have shown Chiropractic adjustments and spinal mobilization to be safe and effective for the treatment of acute lower back, neck pain and chronic lower back pain. These trials by design excluded patients who had radicular symptoms related to disc herniation and those who have undergone prior spine surgery.

Current quality research to date shows that spinal manipulation and therapeutic exercises are of potential benefits for patients with sciatica and back pain, even following laminectomy and decompression surgery.

A Chiropractic Adjustment (also known as manual spinal manipulation) is one of the treatments available that Chiropractors specialize in. Adjustments are generally utilized to promote separation between the joint surfaces, enhance smooth joint gliding, promote joint gapping and pain reduction.

In 2006, a randomized double-blind clinical trial study in the Journal “Spine” reported on102 people with acute back pain and sciatica with related disc protrusion that were treated with chiropractic manipulations. They found that patients treated with Chiropractic adjustments had statistically greater pain relief than people who received only a placebo (sham) “manipulation”.

When considering the use of manual Chiropractic adjustments for a patient with radicular pain due to disc herniation, Dr. Horowitz uses extra care in determining if a patient is a candidate for manual adjustments. For example, Dr. Horowitz takes time to place a patient in the treatment position to first determine if the position can be tolerated and to ensure there is no increase in pain, particularly into the leg.

The Pulstar^TM computerized Spinal Scan and Mobilization device is advantageous in patients who cannot tolerate manual manipulation. When used, no twisting of the spine is used. The computer can be altered to change the force of mobilizations and treatment can even take place with a patient lying on his side, sitting or even standing up.

What the Research Says:

In summarizing the highest quality data treatments for disc herniations as of 2016, Marinella Gugliotta and other researchers reported in the British Medical Journal that most randomized, controlled trials on disc herniation treatments are difficult to interpret for various reasons and that there is no high-quality evidence that in the long run, surgery reduces the severity of sciatica symptoms or improves the quality of life of patients.

If no gold standard or “best” treatment exists, what should I do?

It is generally recommended that patients should undergo a course of exercise-based conservative therapy including Chiropractic manipulation, exercise and physical therapy modalities. Your general medical practitioner may recommend a trial of non-prescription non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen or naproxen to treat pain and inflammation and or muscle relaxants which may offer some relief.

If with the passage of time symptoms continue, or conservative interventions do not resolve symptoms, patients may consider a lumbar epidural glucocorticoid injection to aid alleviation or resolution of symptoms or surgery as a last resort could be considered.

Conservative treatment of lumbar disc herniation has a lower risk of complications than surgery and is preferred by the vast majority of patients.

In less common case where progressive neurologic deficits exists a referral to a surgeon may be indicated. In the short term, patients may experience immediate relief from this painful and debilitating condition.

However, surgery may not have long-term effectiveness and could cause the possibility of more harm than good. Chronic pain after surgery is common. It has been reported that about 1 in 5 patients who have undergone various surgical procedures experience severe post-operative pain or only poor to fair pain relief despite pain management therapies.

For help, Call Toronto Orthotics Foot, Leg & Back Pain Clinic at (647)349-4909 or to ask Dr. Horowitz a question, complete and submit the form below: