Conservative Nonoperative Treatment of the Cervical Soft Disc Herniation

By David BenEliyahu

Recently, literature in the medical journals has begun to document what DCs have claimed all along, that conservative care is effective in the reduction of intervertebral disc herniation. Chiropractic researchers and clinicians such as Cox, Cassidy, and others have published much in this area in the chiropractic literature. Yet while opinions on technics have differed, relative success in chiropractic methods was seen for the treatment of the disc syndrome.

Recently in a 1993 journal of Spine, articles were published on the effectiveness of conservative medical care in the treatment of lumbar disc herniation as assessed by posttreatment CT scans.¹ The authors found a large percentage of herniated discs to either decrease or resolve over the course of time. In a similar study Maigne et al., published an article in Spine in 1994 on the efficacy of nonoperative medical care for cervical disc herniation as assessed by follow-up CT scans.² In this study they again found that accompanied with the resolution of radiculopathy, reduction in disc herniation occurred in 75 percent of the larger herniations and 40 percent of the smaller ones. In a study presented at the ICSM/FCER conference in 1991 on chiropractic treatment of cervical disc herniations as assessed by pre and post infra-red imaging, conservative chiropractic management was shown to be effective and correlated well with the patients resolution of symptoms.³ There are cases in the chiropractic literature which have been published and have demonstrated a reduction in size of herniation as well.^4,5,6

Chiropractic treatment inclusive of manipulative adjustments are generally not contraindicated and are efficacious in the reduction of cervical disc herniation with associated radiculopathy. However, as with any treatment for disc herniation, the judicious employment of manipulation cannot be overemphasized since it will not be tolerated by all.

In Suffolk County (Long Island, New York), we are currently conducting a research project in conjunction with MRI facilities to determine the percentage and time-frame of disc herniation resorption/resolution in both cervical and lumbar disc herniation cases as a result of chiropractic care. We hope to document more rapid pain resolution and disc resorption time than that documented by our medical colleagues.

Anyone interested in participating in this research project may call me for our protocols: (516) 736-4414.

References

Cavallier MC, Brdet C. Lumbar Disc Herniation, 17(8):927, 1992.
Maigne J, Deligne L. CT follow-up of 21 cases of nonoperatively treated cervical soft disc herniation. Spine, 19(2):189-191, 1994.
BenEliyahu DJ. Efficacy of chiropractic manipulation of treatment of cervical disc herniation. Proceedings of the 1991 FCER Conference/ICSM.
Tibbles AC, Cassidy JC. Cervical Disc Herniation JCCA, 36(1):17-21, 1992.
Siciliano MA, Bernard TA. Reduction of a confirmed C5/6 disc herniation. Journal of Chiropractic Res. and Clin Invest, 8(1):17, 1991.
Hughes BL. Management of cervical disc syndrome utilizing MVA. JMPT, 16(3):174, 1993.

David J. BenEliyahu, DC, CCSP, DABCT
Selden, New York