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Does chiropractic spinal manipulation help treat cervical disc herniation?

Peri Dwyer, DC
Chiropractic Medicine
Chiropractic manipulation can help treat cervical disc herniation. As a chiropractic physician, I have treated many patients with cervical disc herniation successfully with a combination of spinal manipulation, exercises and home traction. It is important to know whether a herniation is present, so when the index of suspicion is high, an MRI is usually needed.
The other alternatives are: prescription medications, epidural injections, surgery or doing nothing. Most disc herniations will improve, without any treatment, over a period of months to years. The question is: can the patient live with the pain and numbness while waiting for this to happen? When I find a herniated cervical disc, I explain that chiropractic care may or may not be helpful, and that there is a possibility it may worsen the symptoms. There are a number of varieties of spinal manipulation ranging from very gentle to more aggressive. Our examination would determine which is most suited to a particular patient. Even if the patient wants to try chiropractic care as a possible means of avoiding neck surgery, I always insist that the patient accept a referral for a consultation with a surgeon as well. It is important for a patient to be aware of all the options.
Even if the patient is certain he or she wants surgery, chiropractic care can help to reduce the discomfort in the waiting period before the surgery. Two of the best predictors for successful outcome of surgery are a lower pain score and greater range of motion prior to the procedure, and chiropractic care can help to control the pain and achieve a better range of motion.
The research supporting any of the three treatments is not conclusive. Large controlled studies have simply not been done. In one research study, patients with disc herniations on MRI, after treatment with chiropractic care, had smaller herniations and less neck and arm pain. However, there are also published cases of disc herniations that have been made worse by too-vigorous chiropractic adjustments. Studies comparing different types of surgeries and injections show that 70-80% of patients rated their pain at less than half its starting intensity 12 months later. The question is: how many of them would have had that decrease in pain without the invasive procedures?  
Daniel Bockmann, DC
Chiropractic Medicine

The short answer is, sometimes spinal manipulation is helpful for cervical disc herniation, and sometimes it's not.

Chiropractic spinal manipulation (CMT) is a treatment tool, and like all tools it has a very specific usefulness. CMT is a tool designed to improve mobility of joints that are restricted, and to that end it can be very effective and safe.

With all our patients who have spinal complaints -- including those with cervical disc herniation -- we assess joint range of motion and mobility. If we find a deficit in mobility of  a spinal joint, CMT may very well be included in our treatment plan.

With disc herniation -- or any other condition, for that matter -- it is, however, imperative that the treatment be comfortable for the patient. If I suspect that the patient will not tolerate CMT comfortably, I'll prescribe an alternative treatment to address the range of motion issue (like, for example, joint mobilization or Active Release Technique). 

Then as we start to lower acute pain levels and improve the patient's ability to function, we may then introduce CMT comfortably and help speed up their overall recovery time.

CMT can be and often is very helpful as part of a treatment plan for cervical disc herniation. As a patient, just make sure to let your doctor know if any of your treatments are consistently painful. We rely on your feedback, and letting us know how you feel helps us craft the safest and most effective treatments possible for you.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.