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Chiropractic Treatment Of Disc-Related Pain
By George Best, D.C.

While chiropractic treatment is often helpful in alleviating the symptoms of disc herniations and degeneration, and in some cases may actually assist in disc healing, not all chiropractors are helpful in such cases. There exists a wide variation in techniques, skill levels, and attentiveness among chiropractors and there is a tendency for some doctors of chiropractic to try to get the patient to fit the chiropractor's style of practice, rather than the doctor modifying his or her style to fit the individual patient's needs. In some types of conditions, this tendency may not be problematic, but in the case of severe disc problems, it is important to find a doctor of chiropractic who is going to "go the extra mile" to get good results for the patient.

Many doctors of chiropractic today run on a "high-volume" practice management model, meaning that they are geared towards seeing a large number of patients each day and typically spend only a few minutes with each patient. This practice management style is often fine for lower-severity types of conditions, but may be lacking for patients with disc problems who need more in-depth care. This lack of adequate attention results in a situation where the benefits of each treatment session are minimal at best and the overall duration of treatment and the number of treatment sessions is extended unnecessarily. This not only translates to unnecessarily high treatment costs, but also to unnecessary suffering on the part of the patient.

As an example, I have seen many patients over the years who had first seen a "high-volume" type of chiropractor before being referred to me. Typically, the "high-volume" doctor was spending 2 or 3 minutes with the patient and then having an assistant apply 10 to 15 minutes of some type of therapy, such as electrical muscle stimulation. In many such cases, the patient was improving, but so slowly that he or she was still largely incapacitated after 3 or 4 weeks of care. Most of these cases were substantially improved after only one or two visits to my office in which I was working on the patient for 30 minutes or longer using a combination of several joint manipulation techniques, massage, stretching, and other soft-tissue release methods. The majority were able to resume normal activities within less than a week of starting treatment with me.

The point of this is not to brag over my abilities, but merely to point out that when you have a serious problem like a bulging disc, you can dramatically reduce your recovery time and cost of treatment by choosing a doctor who is going to take the steps necessary to get you better as quickly as possible.

Let's change gears now and discuss how chiropractic treatment can be helpful in disc cases.

Chiropractic has two main beneficial effects in disc problems. First, by improving spinal joint function, it can reduce abnormal mechanical stress on the discs. In some cases, this reduces pressure on the damaged part of the disc and thereby reduces the sources of irritation and inflammation and improves the chances of healing. The second beneficial effect of chiropractic is that it produces stimulation of special nerve endings in the spine and surrounding tissues called mechanoreceptors. When stimulated, these nerve endings send signals to the brain that block the perception of pain to varying degrees.

In addition, some chiropractors utilize additional types of treatment, including the passive and active therapies often lumped under the term “Physical Therapy”, as well as may provide nutritional supplementation to reduce inflammation and muscle tension.

Certain chiropractic techniques have been developed specifically for the treatment of disc-related problems. These include Flexion-Distraction (also called Cox or Leander technique), Sacro-Occipital Technique (SOT), and a relatively new technique called Advanced Biostructural Correction (Advanced Biostructural Correction is not a “disc treatment technique” per se, but the lumbar adjustment is one of the most effective methods I’ve found for quickly alleviating acute disc-related back pain). One other very new method of chiropractic treatment utilizes a computer-controlled adjusting device (the "Pro-Adjuster") to analyze and correct spinal joint function with minimal force and discomfort to the patient. It is a great technique for those patients who are too fragile or fearful for more traditional types of chiropractic treatment. In addition, a few chiropractors may offer spinal decompression treatment, which is a new, advanced form of traction that is specifically intended for treating disc problems.

The techniques just mentioned are, in my experience, typically more suited to treating disc problems than other chiropractic techniques. Even so, when choosing a chiropractor, I recommend placing a higher priority on the doctor's level of experience and dedication to getting good results than on his or her technique. The best way to find a good chiropractor is to try to get a referral from a friend or family member who has had a good experience, or from another healthcare professional. If you can't get a referral, there is a trick for finding good chiropractors that I have found works in most cases: Simply look in the section for Chiropractor listings in the local yellow pages and look for one that has only a single line listing - no display ad. A chiropractor with only a listing most likely gets most of his or her business from referrals, which is a very good sign.

Once you find a chiropractor to try, I recommend talking with the doctor first to find out what his or her style of practice is (how much time with each patient, what treatment methods are used, etc.), what experience the doctor has with treating disc problems, what his or her average treatment duration and number of visits is for patients with disc problems, and any other questions you might have. Most doctors will meet with you and/or speak with you on the phone for free to handle these issues. If you like the doctor's answers, then I recommend you give him or her a try. If you don't like the answers, look elsewhere.

Just to give you an idea of what to be looking for, you want a doctor who is with you for more than just a couple of minutes. You want someone who uses a variety of techniques and addresses soft-tissue problems as well as spinal joint problems. You want a doctor who has at least a few years of experience (less-experienced doctors can be quite good, but your odds are better of finding a good doctor when you go with someone with experience).

One thing to key in on is the doctor's estimate of how long it will take to get you feeling better. Now, no doctor can give you a definite time frame, because some cases simply take longer than others, but ask the doctor how long it takes most patients with problems like yours to feel better. If that doctor says that it takes more than a couple of weeks in most cases to start getting significant symptom relief, I recommend you go elsewhere. In my experience, most disc pain cases will get at least 50% reduction in symptoms within 1 week. Every so often, I may see a patient who takes 2 weeks. Beyond that time frame, I usually want further diagnostic testing done and/or I will refer the patient for another opinion. In most cases, the patient will be either completely out of pain or mostly out of pain and back to most normal activities within 1 to 3 weeks. The exception to this is if the patient's "normal" activities include heavy lifting, repeated bending/twisting, or high-impact activities, it may take up to a couple of months before he or she can return to those types of activities - and even then they may have periodic flare-ups simply because of the ongoing damage that their activities produce.

Taking the time to carefully choose a chiropractor is usually well worth-it in terms of results and expense. The difference between a good chiropractor and a mediocre or poor one can be huge in terms of your recovery, so I suggest you choose carefully.