Chances are 7/10 of your friends has back pain . Extremely disabling low back pain with leg pain is usually caused by herniated inter-vertebral disk. A variety of treatment options are available and are grouped into 2 categories: surgical and conservative care. Conservative care may include oral medication, corticosteroids and nerve root injections [NRIs], bed rest, exercise therapy, flexion/distraction therapy, and spinal manipulative therapy (SMT).
The research article “Symptomatic MRI-Confirmed Lumbar Disk Herniation Patients: A Comparative Effectiveness Prospective Observational Study of 2 Age and Sex Matched Cohorts Treated with Either High-Velocity, Low Amplitude Spinal Manipulative Therapy or Imaging-Guided Lumbar Nerve Root Injections Journal of Manipulative and Physiological Therapeutics, 2013 May; 36(4):218–25” compares chiropractic to nerve root injections.
The current standard of care for the 5% of the population with symptomatic lumbar disk herniation is nerve root injection followed by a surgical intervention. Spinal manipulative therapy is almost never recommended even though evidence shows that improvement with a chiropractic adjustment was higher than those treated with a nerve root injection (NRI). This evidence shows that “spinal manipulation, is a safe and cost effective option to treat Lumbar Disk Herniation.”
“Both of the treatment groups had significant decreases in their pain scores at 1 month with a 60% reduction for the Spinal Manipulative Therapy cohort and a 53% reduction for the Nerve Root Injection group.”
This far exceeded the minimum value of 30% required for a clinically meaningful result . Especially when the researchers considered that a higher percentage (76.5% vs 62.7%) of patients in the SMT group reported being “much better” or “better” one month after care.
“Lumbar NRI’s are a commonly used and accepted treatment option for these patients, whereas lumbar spinal manipulation as a treatment for disk herniation remains controversial among some health care professionals.” The goal of this research is to show that chiropractic SMT is equally as effective to nerve root injections.
Self-reported pain and “improvement” of patients with symptomatic, magnetic resonance imaging confirmed lumbar disk herniations improved in both high-velocity, low- amplitude chiropractic spinal manipulative therapy (SMT) or nerve root injections (NRI).
“Improvement” was reported in 76.5% of SMT patients and in 62.7% of the NRI group. Both groups reported significantly reduced pain scores at 1 month (P = .0001). Average cost for treatment with SMT was US $558.75 and US $729.61 for NRI. There is no significant difference in outcomes between NRI and SMT for clinically relevant reduction in self- reported pain level and increased global perception of improvement.
This research shows that chiropractic care is a cost-effective and clinically significant. It needs to be offered as part of the conservative care options offered for people with back pain. We at ProActive Chiropractic can help if you want to try conservative care for your MRI confirmed disk herniation. If you want more information please set up a ten minute consult with one of our doctors.
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