A recent study in the European Spine Journal concluded that chiropractic treatment for back pain and sciatica due to a bulging or herniated lumbar disc is not risky.
To quote the authors: “We found no evidence of excess risk for acute Lumbar Disc Herniation (LDH) with early surgery associated with chiropractic compared with primary medical care.”
Is Chiropractic Safe?
We know that Chiropractic care is popular for low back pain. Often there is often an underlying fear (concern?) that this treatment may increase the risk for lumbar disc herniation (LDH).
In clinic we often encounter someone who is suffering from significant pain due to a herniated disc. Unfortunately they delayed seeking help because they were very nervous (apprehensive) the chiropractor was going to hurt them or make them worse. They may have heard the chiropractor is going to crack their back. The treatment may involve fast and forceful movements that could hurt or even injure their back.
There is a lot of urban legend out there about the safety of chiropractic treatment so lets see what this study says.
Do Herniated Discs cause Back Pain and Sciatica?
We know that one of the causes of Low back pain (LBP) can be a bulging or herniated disc. There are also clues we get from your history and physical examination that make us suspect LDH may be causing your pain.
You may be worried that the chiropractor is going to crack your back which might aggravate or injure your disc. YOu may be scared if that happens, you would need to go for surgery.
Is that a myth or truth. Lets see what this latest research out of Europe says…
What does the Science tell us?
These authors investigated whether seeing a chiropractor for treatment of back pain or sciatica resulted in increased occurrence of herniated disc requiring them to go for surgery. They compared those patients seeing a chiropractor for their back pain to those that saw their family doctor for their back pain.
The assumption was that those who saw their family doctor did not receive any manual therapy (spinal manipulation) and those who saw the chiropractor likely would.
The authors investigated all adults who visited an emergency department with acute LDH that went on to require early surgical intervention from April 1994 to December 2004. They compared those that had seen a chiropractor prior to the emergency room visit versus those that had not. They also compared this to those who had seen their primary care provider (e.g. family doctor) prior to visiting the emergency room.
As you can imagine, this was an enormous patient population they studied. The number of people, as measured in person-years (number of people x their age) was over 100 million person-years. Try wrapping your head around that number!
What were the results?
195 cases of acute LDH with early surgery (within 8 weeks) were identified in a population of more than 100 million person-years. They found that the risk for acute LDH with early surgery associated with chiropractic visits was no higher than the risk associated with primary care physician visits.
What does this mean?
Back pain can be caused by a bulging or herniated disc. It often begins as back pain but can progress to sciatica (pain running down the leg). People with back pain often visit a chiropractor or their family doctor (or both?). Unfortunately, some of those people experience a rapid progression of their herniated disc and have to visit an emergency department and then go on to need surgery.
This study shows that this progression of symptoms was not not caused by the chiropractic treatment any more that it could have been caused by visiting the family doctor.
Chiropractors offer other more gentle forms of treatment
On a personal note, we see and are able to help a lot of people with back pain and sciatica in the clinic. A mistake is thinking that chiropractic care is only about getting your back cracked (spinal manipulation). Most modern chiropractors have a variety of treatment approaches to help relieve your pain and get you moving again. Treatments such as gentle soft tissue therapies, intermittent traction and graded mobilization.
Good chiropractors also combine your treatment with active care. This would include self-help strategies to:
- relieve your pain
- resume your normal activities in ways that are safe for your back, called Spine Sparing Strategies
Click here to watch a common gentle way we treat a person with a suspected a Disc herniation.
If you are wondering whether a chiropractor can help you with your back pain and/or sciatica but are nervous the treatment might make you worse, feel free to contact us. We’re happy to chat with you on the phone prior to see if our treatment(s) are appropriate for you.
Here is a link to the research article:
