I’ve always maintained that the work I do is pretty good at treating cervical disc herniation. Now it seems, once again, I was right. This is all set out in study snappily called:
‘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.’
In it, scientists looked at how a (small) sample responded to chiropractic spinal manipulation for problems associated with neck disc herniation. (Note the US spelling of disc – disk. helpful, eh?)
A cervical disc herniation can lead to compression of the nerves as they leave the spinal cord in the neck. Typically, this involves the C6 and C7 nerve roots. This can cause severe, unrelenting, pain. However, more commonly, it causes pins and needles (paresthesia) usually down a dermatome. It can also lead to weakness of the muscles innervated by that nerve. This is called a cervical radiculopathy if it happens in the neck. This is caused by a disc bulge compressing or irritating the nerve. However, a degenerative spondylosis (bone growth in response to wear and tear) can also cause similar pain. And, helpfully, this can also happen as a combination of these two!
How common is this?
Now, this happens a fair bit. 83.2 out of every 100 000 people suffer from a painful compression of a cervical nerve root.
Usually, these patients are treated with lifestyle changes, activity modifications, pain medications, physical therapy, epidural injections and sometimes spinal manipulative therapy (SMT). This is touched on elsewhere, such as here in this article describing disc bulges. But currently, research does not show sufficient evidence to advocate the use of manipulation as a therapeutic modality. In spite of this, many practitioners use our experience and best clinical judgement to help patients with cervical disc herniation.
So, the purpose of this study was to investigate the clinical outcomes in patients suffering from cervical radiculopathy after a course of care using chiropractic spinal manipulation. Most of the patients had a gold-standard MRI-proven disc herniation. Pleasingly, they reported clinically significant improvement at all selected data points, especially at the 3 months point.
The findings were:
- Two weeks after the first treatment, 55.3% of all patients reported that they had significantly improved. At this point, no one reported worsening of their symptoms.
- At 1 month after the first treatment, 68.9% of individuals were significantly improved. Only one patient reported being slightly worse (one patient in the subacute/chronic group).
- By 3 months, this figure rose to 85.7% of patients noting significant improvement.
- In general, acute patients reported faster improvement compared to those who were included in the subacute or chronic group.
- However, 3 months after the first treatment, 76.2% of the subacute/chronic patients reported clinically relevant improvement. None of these patients reporting they were worse.
- The acute patients reported statistically significant reductions in their neck and arm pain measured at all 3 data points.
It is important to note that even the subacute/chronic sufferers showed clinically significant improvement. This is an important result to report. These patients that are often the most costly to the healthcare system and they are having the most wretched time.
So, if you are suffering please give us a call and let’s start to get you going again.