Answers to Questions about Chiropractic:
Is Neck Manipulation Appropriate for Herniated
Discs with Spinal Cord Impingement?

Samuel Homola, D.C.

Question

I am currently seeing a chiropractor. I recently received a second MRI report revealing that I have herniated discs in my cervical spine. My chiropractor insists that I can be helped through his care. My primary care physician thinks I need surgery. Please read my reports and tell me what you think?

Report 1: MRI of the cervical spine
Degenerative changes at C4-5 and at C5-6 and to a lesser extent at C6-7. At C4-5. There is a prominent focal right paracentral disc herniation with moderate right-sided cord impingement and normal neural foramina. At C5-6, there is a prominent broad right-sided, right lateral disc herniation with moderate right-sided cord impingement and normal neural foramina. There is a shallow central and left paracentral protrusion at C6-7, likely a herniation as well with borderline impingement and no stenosis.

Report 2: MRI of the lumbar spine
Moderate disc desiccation without significant disc space narrowing at L3-4 and L4-5. At L4-5, there is a moderate broad herniation extending laterally into the left L4-5 neural foramen. There is a mild central protrusion at L3-4.

Answer

Your reports describe several herniated discs that are pressing on your spinal cord or the nerves that emerge from it. Manipulation should not be done. Whether or not you need surgery would depend upon your symptoms and the findings of a neurologist or neurosurgeon. You should be monitored by your primary physician in cooperation with a neurologist who can detect signs of neurologic impairment.

Symptoms or not, I would avoid spinal manipulation when there is disc herniation with encroachment upon a spinal nerve.

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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 article was posted on September 21, 2002.