Review of “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”

Chances are 7 of your ten friends has had back pain at one point in time.1 Extremely disabling low back pain with leg pain is caused by herniated inter-vertebral disk. A variety of treatment options are available to the patient that can be grouped into 2 categories: surgical and conservative care. Conservative care may include oral medication, corticosteroid and anesthetic infiltrations (nerve root injections [NRIs]), bed rest, exercise therapy, flexion/distraction therapy, and spinal manipulative therapy (SMT).

Chiropractic is More Cost Effective Than 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 controversial all 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 very safe and cost-effective option to treat Lumbar Disk Herniation.” “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.”

This far exceeded the minimum value of 30% required for a clinically meaningful result.24 Although a higher percentage of patients in the SMT group reported being “much better” or “better” (ie, clinically relevant improvement)25,26 on the PGIC scale (76.5% vs 62.7%) at 1 month, this was not statistically significant. “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 SMT is equally as effective to NRI.

Slipped Discs in Your Back Improved with Chiropractic

Self-reported pain and “improvement” of patients with symptomatic, magnetic resonance imaging — confirmed, lumbar disk herniations improved in both high-velocity, low- amplitude 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 NRS 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 both cost effective, clinically significant and needs to be offered as part of the spinal care algorithm. I work closely with nearby clinics offering nerve root injections to ensure that you get the best care possible.

Check out my eBook on Chronic Neck Pain.


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Article originally published on Medium.