Treatment for herniated discs is done with
a technique known as Cox® Flexion -Distraction.
In our office we combine Cox® Technic with
other conservative, non-surgical treatment.
Here is a video from a fellow chiropractic
demonstrating Flexion-Distraction:
The Cox® Technic is spinal manipulation, a non-surgical,
established, evidence-based treatment for spine
pain performed by a trained physician and supported
by years of clinical experience, many publications
of clinical and laboratory outcomes, and clearly
defined protocols for application to attain the
highest positive clinical outcomes for acute and
chronic back pain as well as failed back surgical
syndromes. All this to help restore a patient's
quality of life.
Since the Cox® Technic is spinal manipulation,
most insurances cover this treatment unlike Spinal
Decompression.
Pain
No Pain
Here are some facts to consider when deciding
treatment for a herniated disc:
There are approximately 1.2 million spinal
surgeries in the U.S. each year, double the
rate in those other countries. (1)
Epidural steroid injection is moderately effective
for short-term (but not long-term) symptom relief.
(2)
Prolotherapy, facet joint injection, intradiscal
steroid injection and percutaneous intradiscal
radiofrequency thermocoagulation are not effective.
(2)
Surgery for leg pain and herniated disc gives
short-term benefits that decline long-term
compared with non-surgical therapy. (3)
Guidelines sponsored by the American Pain
Society and the American College of Physicians
recommends spinal manipulation as an effective
treatment option for low back pain. (4)
Surgical outcomes for disc herniations' leg
pain (sciatica) are nearly equal those of conservative
care (69% vs 61% respectively)(6), yet no surgical
intervention opened the spine.
Four to 6 weeks of non-operative, conservative
treatment is recommended prior to imaging studies
and surgery. (7, 8, 9, 10) The American Academy
of Orthopaedic Surgeons states that "acupuncture
or chiropractic manipulation can also be attempted"
prior to surgery for stenosis. (11)
References
1. Dance A: For back pain
sufferers, surgery isn't always the answer. LA
Times January 12, 2009, http://articles.latimes.com/2009/jan/12/health/he-backpain12
accessed on 6/8/09
2. Chou, R; Atlas, SJ;
Stanos, SP; Rosenquist, RW. Nonsurgical Interventional
Therapies for Low Back Pain A Review of the Evidence
for an American Pain Society Clinical Practice
Guideline. SPINE 2009; 34 (10):1078-1093
3. Chou, R; Baisden, J;
Carragee, EJ; Resnick, DK; Shaffer, WO; Loeser,
JD Surgery for Low Back Pain A Review of the Evidence
for an American Pain Society Clinical Practice
Guideline. SPINE 34 (10). MAY 1 2009. p.1094-1109
4. Chou, R; Loeser, JD;
Owens, DK; Rosenquist, RW; Atlas, SJ; Baisden,
J; Carragee, EJ; Grabois, M; Murphy, DR; Resnick,
DK; Stanos, SP; Shaffer, WO; Wall, EM: Interventional
Therapies, Surgery, and Interdisciplinary Rehabilitation
for Low Back Pain An Evidence-Based Clinical Practice
Guideline From the American Pain Society. SPINE
2009; 34 (10):1066-1077
5. Atlas SJ, Keller RB,
Su YA et al: Long term outcomes of surgical and
nonsurgical management of lumbar spine stenosis:
8 to 10 year results from the Maine Lumbar Spine
Study. Spine 2005;30(8):936-43
6. Atlas S, Keller RB,
Wu YA, Deyo RA, Singer DE: Long term outcomes
of surgical and non-surgical management of sciatica
secondary to lumbar disc herniation: 10 year results
from the Maine Lumbar Spine Study. Spine 2005;
30(8):927-35
7. Deyo R: Annals of Internal
Medicine 112(8) 8. Frymoyer: Backletter 10(7)
9. RAND Study: Journal
of Chiropractic 29(11)
10. ACHPR (Agency for Health
Care Policy and Research) - a federal government
research organization - Clinical Practice Guideline
No.14. AHCPR Publication No. 95-0642. Rockville,
MD: Agency for Health Care Policy and Research,
Public Health Service, U.S. Department of Health
and Human Services, December, 1994.
11. http://orthoinfo.aaos.org/topic.cfm?topic=A00329
accessed on 6/8/09, American Academy of Orthopaedic
Surgeons website, "Lumbar Spinal Stensosis"
