January's Chiropractic Tip: Chiropractic Adjustment vs. Spinal Injections for Disc Herniations

Outcomes in patients with MRI-confirmed lumbar disc herniations treated with chirpractic adjusments were recently compared to patients that recieved spinal nerve root injections. 102 patients were included (average age ~ 47, 62.7% were male).  Subjects received either chiropractic adjustments or contrast fluoroscopy- or CT-fluoroscopy guided injections of Kenacort and Ropivacaine.  A follow-up was conducted up to 3 months in this study as well.  Pertinent results of this study include:

•  The average number of adjustment treatments was 11.2 (ranging from 5 to 20).
• Only 1 adjustment patient reported being worse after treatment compared with 3 injection patients.
• No adjustment patients required surgery during the study period, while 3 injection patients received a second injection and 3 had surgery.
• In the adjustment group, 76.5% of patients were “improved” (Odds Ratio & Confidence Intervals in the review) while 62.7% of the injection patients were “improved”.

The results: chiropractic adjustment is as effective (if not better) than injections. 

References:

1. Peterson CK, Schmid C, Leemann S et al. Outcomes from Magnetic Resonance Imaging-Confirmed Symptomatic Cervical Disk Herniation Patients Treated with High-Velocity, Low-Amplitude Spinal Manipulative Therapy: A Prospective Cohort Study With 3-Month Follow-Up. Journal of Manipulative & Physiological Therapeutics 2013; 36: 461-467.
2. Peterson CK, Leeman S, Lechmann M, et al. Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Journal of Manipulative& Physiological Therapeutics 2013; 36(4): 218-225.