Is Surgery The Only Option for Disc Herniations?

Is Surgery The Only Option for Disc Herniations?

Here at Nightlight Chiropractic, one of my favorite patient groups in Orlando is people with disc herniations.  I love treating disc herniation patients, especially when I can help prevent them from having surgery. And this happens all the time for us here, where we run across a patient, and we’re able to get them symptom-free without having to go through any surgery. We want to keep them off the narcotics. We want to keep them from having that surgery. And I bet you right now, you’re thinking about that person you know, whether it’s your friend, your family member, maybe just some acquaintance you met one time that’s struggling with a disc herniation.

They were told, “You have a disc herniation, and you have one option: surgery. Do you want it, yes or no?” I’m trying to say that there’s another option and that another option is chiropractic care. I wanted to spell out what we can do and how we can help give you that third option. Because even the surgeons would agree that surgery should be your last resort, it shouldn’t be something you go into lightly. It should be chosen only when everything else has failed.

Many medical doctors and chiropractors get stuck on the MRI result. So you get an MRI of a patient’s spine, it comes back, and it says, disc herniation, and that’s it, you have to follow this algorithm, and there are no other choices for you. And what really should be driving our commentary, which should be driving our thought process, are symptoms. Do your symptoms match this MRI? Because if not, the MRI is meaningless. Your MRI shows that you have this horrible disc herniation, but you feel fine. There’s no pain whatsoever. I’d be careful, I might change a bit of what you’re doing, but do you need any care? No, not really. Do your thing. Do some core exercises and new stretches and go on with your life.

And you’ll also have those patients who come in, and the MRI shows a minimal disc herniation, or maybe even a disc bulge that the radiologist doesn’t commit to saying a disc herniation. Meanwhile, the patient has terrible symptoms. They can’t feel their foot, they can’t walk right because of this pain, so we get hung up on these MRIs and these mixed results, these mixed symptoms that go along with these MRIs. So the MRI doesn’t define what you have going on. The symptoms represent what you have going on. The MRI is a piece of that, it’s a clinical piece of that puzzle, but the symptoms should drive what care you’re going to get. So it all comes down to those symptoms. People want to know, well, what can the chiropractor do? Many people ask me when I start talking about this disc herniation, well, can you make it worse?

Patients tell me, “My medical doctor said you’re going to make it worse, and if you make it worse, he can’t even do surgery on me.” I wanted to go over what that looks like, what that means, and why the research will support that it’s not true. And I have these giant goofy vertebrae here (see the video linked below) to help explain it to you. So this is a vertebra, then the disc, and then another vertebra. In the front, you have that disc. In the back, you have these joints, So these two joints are called facet joints. And what they do is they limit motions, so as you can see, I am pulling on it, and I cannot pull these two bones apart, I can’t rotate them as I would need to do to injure those ligaments that hold the disc together because the joints would have to be injured first.

Those joints limit rotation to just a couple of degrees. No matter how hard we twist you, we would have to break bones before we could injure that disc, and that’s what the research says is that you can’t do it. Those facet joints limit that motion, so it can’t be done. So what do we do here? So as we’re making those adjustments, the chiropractic adjustment, the old turn on your side and crunch, click, we get those joints moving and help restore normal motion there. That normal motion helps to reduce the amount of swelling in the area, which can help the symptoms feel better because you’re decompressing those nerve roots. The other thing that we do a lot of here is that flexion-distraction, where we’re pulling apart the spine, we’re pulling apart that disc, we’re pulling apart those joints, because they’ll move that way, they’ll pull apart.

And when we’re doing that, we’re helping to pump some blood into the area. We’re helping to open up those nerve roots so that you’re not feeling those symptoms. The nerve is not as entrapped. People think about nerves as static immobile things, almost like bone, but realistically those nerves are put together elastically. They stretch, they pull, and they can also be compressed from that stretching, and so every little inch, every tiny millimeter of pressure taken off of those nerves can help to reduce those symptoms. So we’ve had some great results with patients whose medical doctor has said, “We can’t help you. Your disc herniation is too big on your MRI.” That’s insane. We’re not treating the MRI. We’re treating the person.

So if you know somebody who has one of these disc herniations and they’ve been told they need surgery, or maybe they got stuck in that trap of just continuing to take narcotics and medications and hoping that one day, this thing is just going to spontaneously resolve and just not hurt anymore, send them my way. I’d love to do a free, no commitment whatsoever review with them, not just of their MRI, but of their symptoms where they’re in front of me.  And if I can’t, no hard feelings, maybe you need surgery. Perhaps I’m going to be the last person that says, “You need the surgery. They were right. There’s nothing that can help you here. Symptoms are too bad, and you’re past that point of conservative care. Maybe you’ve already done conservative care and failed conservative care.”

If you haven’t tried some home care, including stretching, maybe an inversion table, if you haven’t tried changing some of what you do during the day, you probably need to try that first.  Surgery is maybe not as dangerous as you think, but it’s perhaps not quite as helpful as you think either, and so it should be a last resort, and I hope that you’re using it that way. I would welcome the opportunity to help anyone struggling with disc herniations here in Orlando, just give my office a call!

About Dr. Merrill

headshot of Dr merrill
Dr. Andrew Merrill is a passionate active clinician and owner of Nightlight Chiropractic Orlando where him and his team treat hundreds of patients each month. With a strong background in exercise science from Stetson University, clinical skills from Palmer College of Chiropractic, and continued postdoctoral training in spinal disc injuries and clinical nutrition, Dr. Merrill is very well versed in the healthcare landscape. With topics ranging from "what to do for common ailments" to "why the medical system is failing you" Dr. Merrill and this blog in particular aim to keep readers up to date on what the research shows and how you can put it into practice NOW to keep yourself healthy for a lifetime.