| Dr.
Cady can help to resolve or improve the pain associated
with disc herniations. He has handled hundreds of disc herniations
and has had great success in stabilizing even severe pain
associated with disc bulges and herniations. Conservative
care is the best initial course of treatment in most cases.
Call us at 408-739-2273 to schedule an
evaluation.
A recent study
examined 27 patients in a private chiropractic practice
who presented with neck or back pain and who had MRI-documented
cervical or lumbar disc herniations that corresponded with
clinical findings.
“Patients
were treated with a course of chiropractic care consisting
of traction for the cervical spine or flexion distraction
in the lumbar spine in the acute phase of care, in addition
to interferential/ultrasound combination and cryotherapy.
In the sub acute phase, rotational manipulation was judiciously
added, as were isometric and flexibility exercises. In the
chronic stage of care, distraction manipulation and rehabilitative
exercises were continually employed. Rehabilitative exercise
included extension exercises in addition to pelvic tilts,
lifts and knee flexion stretching.”
“Treatment
frequency was typically four to five times/wk for weeks
1 and 2, then three times/wk with decreasing frequency as
the patient progressed. Duration of active care varied from
6 wk to 6 months.”
“When
patients reached the point at which their VAS [visual analog
scale] score was [2, their exam findings reversed and their
extremity pain resolved, a repeat MRI was obtained. This
scenario occurred as early as 6 wk after initiation of care.”
If the patients
did not reach these milestones, follow-up MRI was performed
1 year after the initiation of care.
Effectiveness:
The
study found that 22 of 27 (80%) had good clinical outcomes;
17 of the 22 (77%) “had not only good clinical outcome
but also evidence of reduced or resolved disc herniation
upon repeat MRI scanning. ”
Five patients
(18.5%) had a marginal or poor outcome, but none had worse
clinical signs or pain ratings at the end of the study.
At the beginning
of the study, all 27 patients had left work because of the
severity of the pain; at follow-up, 21 (78%) were back to
work in their former occupations.
VAS scores decreased
from an average of 6.9 before treatment to 1.9 following
treatment.
Safety:
One
important issue that the author addresses is the controversy
of whether manipulation is contraindicated for disc herniation.
After reviewing the literature, and from his clinical findings,
he concludes that manipulation is indeed safe for disc herniation:
“…in the cervical and lumbar spine, rotational
manipulation most likely cannot be implicated in disc failure
or exacerbation of a disc herniation and for rotational
forces from a manipulation to be involved in disc failure,
facet fracture must occur first.” No complications
occurred in this study.
BenEliyahu DJ. Magnetic resonance imaging and clinical follow-up:
study of 27 patients receiving chiropractic care for cervical
and lumbar disc herniations. Journal of Manipulative and
Physiological Therapeutics 1996;19(9):597-606.
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