When Chiropractic is Necessary: Herniated Disc Rehabilitation

Herniated, slipped, or ruptured discs affect 80% or more of the population. Most individuals don’t even realize they suffered a vertebral subluxation, as it shifted slightly but returned on its own and healed itself. Herniated disc/s symptoms can subside over time and can heal on their own. However, there are times when chiropractic is necessary to help the slipped or ruptured disc back into correct alignment and to help prevent re-injury or the development of new ones.

When Chiropractic Is Necessary

When an individual’s ability to move is limited is definitely when chiropractic is necessary. Individuals twist and turn their bodies, and the rotational force that comes from lifting and moving objects at home, work, school, sports, or lifting weights increases the risk of disc injury.

• The lumbar spine or lower back is the most common location for a herniated disc injury.
• The pain can spread to the glutes and legs, causing sciatica or sciatica-like symptoms.
• When back pain spreads to the shoulder through the arm, it s caused by a herniated neck/cervical disc.
• When the cushioning material from the disc/nucleus pulposus presses on surrounding nerves, it causes inflammation, pain, and numbness.
• Individuals can suffer a herniated disc after changing a flat tire, stepping/slipping out of the bath/shower, or coughing and sneezing.

Healing

Herniated discs can be treated with ice packs and heat, over-the-counter medications, and anti-inflammatories. However, if these approaches are not producing results, chiropractic and physical therapy could be necessary to address the pain, reactivate the body’s healing system, and get the body’s circulation energy flowing. Exercises/movements are recommended depending on the injury to allow the musculoskeletal system to realign and circulate the nutrient-rich blood.

Evaluation

The chiropractic team must check if the individual is cleared for chiropractic care. Some individuals cannot undergo chiropractic adjustments because of the following:

• Spinal cancer
• Advanced osteoporosis
• Bone abnormality in or around the upper neck
• High risk of stroke

Once The Patient Is Cleared:

• The chiropractor will assess the injury and damage by evaluating the spine’s overall health, not just the painful areas.
• They will inquire about medical history and conduct a physical examination.
• Diagnostic tests could be necessary depending on the condition.

The team will evaluate the following criteria:

• If reflexes are normal.
• If there is muscle loss or decreased muscle strength.
• If there is numbness or loss of sensation.
• Loss of reflexes, muscle strength, and sensation could indicate the need for more aggressive treatment.

Depending on what is found, they may refer the individual to a spinal surgeon or specialist.

Techniques

Chiropractic focuses on restoring structural integrity to the body, reducing pressure on neurological tissue, and re-establishing a normal range of motion. With this treatment, pain and inflammation will be reduced or eliminated, and regular movement and reflexes will return. The body is realigned, stress is reduced, and the body’s natural energy can repair the damage. Adjustments involve:

• HVLA is a high velocity, low amplitude short thrust to vertebrae that are out of position.
• Mobilization involves low-velocity manipulation, stretching, and moving affected muscles and joints.
• Joint cavitation expels oxygen, nitrogen, and carbon dioxide from the vertebrae and releases pressure on the affected area.

Specialized Adjustment Techniques

Activator

• Activator Adjusting Instruments emit mechanical low-force, high-speed impulses to the body.

Active Release Technique

• This soft tissue technique treats issues with muscles, nerves, ligaments, tendons, and fascia.

Cox Flexion Distraction

• Special tables with movable segments gently stretch and decompress spinal facets and ligaments.

Diversified

• These are specific manual thrusts to restore biomechanical function.

Gonstead Technique

• This specific analysis method uses nervoscopes, spinal X-rays, and precision adjustments.

The Toggle Recoil Technique

• This technique uses a drop table while the chiropractor uses quick thrust and release manipulation.

Logan Basic Technique

• This technique uses a light touch to level the sacrum.

Thompson Terminal Point Technique or Thompson Drop

• This table technique adjusts with a weight mechanism to keep the patient in the correct position before the thrust is applied.

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DOC Decompression Table

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References

Danazumi, Musa S et al. “Two manual therapy techniques for management of lumbar radiculopathy: a randomized clinical trial.” Journal of osteopathic medicine vol. 121,4 391-400. 26 Feb. 2021, doi:10.1515/jom-2020-0261

Kerr, Dana, et al. “What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study.” Clinical orthopedics and related research vol. 473,6 (2015): 1920-30. doi:10.1007/s11999-014-3803-7

Lurie, Jon D et al. “Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial.” Spine vol. 39,1 (2014): 3-16. doi:10.1097/BRS.0000000000000088

Wang, Jeffrey C et al. “Epidural injections for the treatment of symptomatic lumbar herniated discs.” Journal of spinal disorders & techniques vol. 15,4 (2002): 269-72. doi:10.1097/00024720-200208000-00001

Yussen, P S, and J D Swartz. “The acute lumbar disc herniation: imaging diagnosis.” Seminars in ultrasound, CT, and MR vol. 14,6 (1993): 389-98. doi:10.1016/s0887-2171(05)80032-0