Those of us who have been in or around chiropractic circles for long know that we are a drug-free, surgery-free health modality. We check and adjust subluxations, knowing that the body is a self-healing, self-regulating system that knows how to do the rest. With all that said, we know when to cross-refer when a patient presents with an emergent condition.
Spinal Disc Herniation is often a condition that people assume fits into that second category – when pain and disability is so intense that surgery must be the only option. A recent case series in the Journal of Contemporary Chiropractic has thrown a big question mark over that assumption by putting forward four cases in which a successful combination of chiropractic care and non-surgical disc decompression resulted in three cases fully recovering, and a third reaching 90% reduction in the numerical pain scale.
All of the cases suffered from high-moderate to severe pain. Two of the patients (a 36-year-old female and a 54-year-old male) reported their pain to be a 10/10 on the numerical pain scale. A 45-year-old male reported his pain as an 8/10 on the same scale. Finally, a 59-year-old woman reported hers at a 7/10. All of the patients had disc herniations in the Lumbar spine, with three of them herniating at L5/S1, three of them herniating at L4/L5, and one at L2/L3.
All of the patients were assessed via MRI (magnetic resonance imaging) to assess their herniations, and all of them received an assessment according to a Herniation Index Equation (see case report referenced below for this). Their care plans included 20-30 sessions of spinal decompression over an 8-10 week period. Each session included 20-30 minutes of active treatment, in which the person under care was lying supine on a decompression table fitted with adjustable body harnesses.
The treatment is an excellent example of how computerized algorithms can assist us by calculating exactly how gentle a treatment can be while also being effective. In these cases, computerized algorithms assessed the degree to which the patient’s muscles were resisting the traction and then reduced tension until the muscles relaxed, at which point the stretch was applied again to achieve maximum decompression. The protocol was very specific, with the studies authors outlining the following.
“The ratio of hold to rest time was 1:1 and the oscillation ranged from 10%-50% decrease between hold and rest. This indicated that if the patient was stretched at 60 pounds, the table hold was at full strength for 30 seconds, then reduced hold for 30 seconds in the range of 54 to 30 pounds followed by 60 pounds.”
As all of these patients came in via presentation at a chiropractic clinic, and all of them were care for using a combination of chiropractic care and this non-surgical decompression technique before recovering either fully or to 90% of prior function, this surely warrants further investigation. We know that low back pain contributes highly to the global burden of pain and disability. We know that it has a significant economic, social and quality-of-life impact on sufferers. We also know that chiropractic has a significant role to play as we have been shown time and time again to be of benefit when it comes to low back pain.
While research is increasingly showing the brain and body changes chiropractic care can facilitate beyond back and neck pain alone, it is important to recognise that this low back pain problem remains a significant issue for many, many people. The more tools we have at our fingertips, the better.
The full case report and protocol can be accessed below.
References:
Dudum J, Gatterman B. REDUCTION OF THE SIZE OF A LUMBAR DISC HERNIATION USING NON-SURGICAL SPINAL DECOMPRESSION COMBINED WITH CHIROPRACTIC CARE. JCC. 2024;7(1):146-155. https://journal.parker.edu/article/123984-reduction-of-the-size-of-a-lumbar-disc-herniation-using-non-surgical-spinal-decompression-combined-with-chiropractic-care
