Question
I have a herniated disc at t11-t12.  My doctor is wanting to do surgery on it and my wife would like me to see a chiropractor before I consider surgery.  I have heard a lot of different things both for and against both options(Surgery and Chiropractic).  While the Internet is a wealth of knowledge it can be hard to figure out what is what and to sort all of the information in a manner that you can make a proper decision.  My question is what in your expert opinion would be the better way to treat this type of injury?

Answer
Micheal,

Thank you for your questin.

Thoracic (mid-back) disc herniations are far less common than disc herniations in the cervical (neck) and lumbar (low back) spine, but they do occur.

The indications for disc surgery are generally severe, intractable pain that has been unresponsive to aggressive conservative care or the presence of progressive, worsening neurological deficits that have been unresponsive to aggressive conservative care.

Many people (estimated to be at least 35 to 45%) of those with disc herniations have no symptoms; those with symptoms generally experience pain, numbness, or some impairment of function due to compression of the spinal nerve by the disc, or by chemical irritation of the nerve caused by inflammation resulting from the disc herniation.

There are a number of options for treating non-surgical disc herniations, which include physical therapy, chiropractic, cortisone injections in the spine, and oral medications (pain medications and corticosteroids to reduce the inflammation of the disc herniation).

Picking the right modality to treat the disc lesion in part depends upon the type of disc herniation you have as well as the symptoms you are experiencing. In general, physical therapy tends to emphasise rehabilitative exercise, while chiropractic tends to emphasize manual manipulation. Often, combinations of both approaches with the use of the appropriate medications are quite helpful.

One effective chiropractic technique for treating disc lesions is called flexion-distraction, which is a form of intermittent spinal traction. This technique does not involve thrusting manipulations. The patient lies face down on mechanical table that gently stretches the spine by bending the body from the trunk towards the floor while the doctor holds a contact above the level of the affected disc. This manuever allows the disc to reduce the herniation. An alternate technique used by both physical therapsist and chiropractors is the McKenzie extension exercise, which involves repetitive backwards-bending maneuvers to force the disc that has herniated backwards in the spinal canal forward again.

Acupuncture has also been helpful for reducing pain when used in combination with chiropractic and physical therapy.

As with chosing any other doctor, it may take some research on your part to find a good chiropractor. If you are interested in pursuing that option, feel free to send me a private follow-up inquiry with your e-mail address through this website, and I'll contact you privately if I can help you find a good, evidence-based chiropractor in your area through my network of colleagues across the country.

I hope that this answers your question, and I wish you happy and healthy holidays.