Disc Herniations- Injections or Chiropractic Care? - by The Evidence Based Chiropractor

Disc herniations (also known as slipped discs, disc bulges, disc extrusions, etc) are a common problem which can lead to disabling pain.  Pain down the extremities (arms or legs) is called radicular pain and can stem from a disc herniation which is affecting a nerve root.  Radicular pain can result in numbness, tingling, burning, or muscle cramps.

Many people who suffer from a suspected disc herniation visit their primary care physician.  Usually, their primary care physician will examine the patient and refer them for a MRI.  If the MRI shows a disc herniation the patient is often sent to an orthopedic specialist and injections may be recommended as a treatment option.  

Last year over 9 million injections were given in the United States, which is roughly 25,000 per day.  

Many patients don't know that injections are only effective about 50% of the time (per Columbia University Neurosurgery Department).  Also, they have substantial risks.  The Journal of Bone & Joint Surgery found that every injection increases the risk of a vertebral fracture by 21% (in the lumbar spine).  

As a matter of a fact, a research article produced in 2013 compared the effectiveness of chiropractic care by spinal manipulation to nerve root injections for symptomatic disc herniation's.  They concluded,

“A systematic review of the literature done the next year concluded that spinal manipulation is a very safe and cost-effective option to treat lumbar disc herniation"

and

“Both of the treatment groups had significant decreases in their NRS scores at 1 month with a 60% reduction for the Spinal Manipulative Therapy cohort and a 53% reduction for the Nerve Root Injection group.”  

In this study, spinal manipulative therapy, the hallmark of chiropractic care, provided greater relief than the injections!  

While many physicians are beginning to embrace the overwhelming research showing the efficacy of chiropractic care, their are still other physicians who are reluctant to provide evidence-based care.  If you or someone you know is suffering from a disc herniation, it may be in your best interest to be evaluated by a chiropractic physician.  

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-The Evidence Based Chiropractor is the fastest growing chiropractic marketing group in the profession.  The service, founded and run by Dr. Jeff Langmaid, is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is proven, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together.

Back Pain and Narcotics - The Evidence Based Chiropractor

“A recent meta-analysis revealed that narcotics provide little to no benefit in acute back pain, they have no proved efficacy in chronic back pain, and 43% of patients have concurrent substance abuse disorders, with aberrant medication-taking disorders as high as 24% of cases of chronic back pain.” - Martel et al. 2007

So why are so many medications still prescribed for acute back pain?  Well, the truth is that primary care physicians have a limited skill set to deal with musculoskeletal complaints.  Add to this the constant marketing by pharmaceutical companies and the desire to "help" the patient through the acute pain; and you start to see the formula for ill advised treatment.

Evidence based management guidelines continue to support the use of chiropractic care for these patients.  However, the impetus is on us, as chiropractors, to get out and let our local physicians know about the research.  

Martell BA, O’Connor PG, Kerns RD, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Ann Intern Med. 2007;146(2):116-127

-The Evidence Based Chiropractor is the fastest growing chiropractic outreach group in the profession.  The service is dedicated to increasing chiropractic utilization by showcasing research.  Marketing to medical doctors through research is efficient, cost effective, and can dramatically improve your incoming referrals.  Join us.  Lets grow chiropractic together