Answers to Questions about Chiropractic:
How Long Should I Continue Chiropractic
Treatment for a Disc Protrusion?

Samuel Homola, D.C.

Question

I have scoliosis and have suffered back pain most of my life. I am now 28 years old and a mother of two. Four weeks ago, I received a heavy blow to my back, just above the right hip. A CT scan and x-ray have shown a large disc herniation protruding into the spinal canal at the L4-5 level along with a smaller protrusion that was compressing a spinal nerve on the left side.

My doctor has referred me to a specialist and said that I might need an operation. I have since seen a chiropractor who says he is confident that he can fix the problem. How long do I continue treatment for the pain, with the chiropractor, if I am having little or no relief. I don't want a back operation, but I cannot continue in agony.

Answer

I would not continue with chiropractic treatment longer than two weeks if it does not relieve your pain, especially if you have leg pain caused by a disc protrusion. Manipulation is rarely effective when there is a disc protrusion compressing a spinal nerve and might actually aggravate the problem. For this reason, the treatment should be stopped if back or leg pain worsens.

You should be kept under observation by orthopedist or a neurologist who can watch for signs of nerve damage that might indicate a need for surgery. Back and leg pain caused by a herniated disc will sometimes resolve with time as swelling subsides and the disc degenerates. But when leg pain (sciatica) is severe and disabling after one month of conservative therapy and there is loss of nerve function in the part of the leg supplied by the compressed nerve, surgery might be a viable option. Be sure to see the specialist recommended by your family physician.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on June 7, 2002.