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Disc of the Low Back

Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. Oliphant D. J Manipulative Physiol Ther. 2004 Mar-Apr;27(3):197-210

Findings: The risk of manipulation clinically worsening a disk herniation or Cauda Equina Syndrome in a patient presenting with Lumbar Disc Herniation is 1 in 3.7 million.

Conclusions: The apparent safety of spinal manipulation, especially when compared with other "medically accepted" treatments for Lumbar Disc Herniation, should stimulate its use in the conservative treatment plan of Lumbar Disc Herniation.

Manipulative therapy in lower back pain with leg pain and neurological deficit. Bergmann TF, Jongeward BV.  J Manipulative Physiol Ther. 1998 May;21(4):288-94

Conclusions: “… there is ample evidence to suggest that a course of conservative care, including spinal manipulation, should be completed before surgical consult is considered.”

Chiropractic high-velocity low-amplitude spinal manipulation in the treatment of a case of postsurgical chronic cauda equina syndrome. Lisi AJ, Bhardwaj MK. J Manipulative Physiol Ther. 2004 Nov-Dec;27(9):574-8

Findings: Immediately after each low-back manipulation, the patient reported a transient improvement in sensory deficit. After 4 treatments, the patient reported full resolution of mid-back, low back, and buttock pain. No adverse effects were noted.

Conclusions: “It seems that chiropractic high-velocity, low-amplitude spinal manipulation was safe and effective for relieving back pain in this patient and treatment seems to have had no positive or negative effect on the neurologic deficits present.”… “in this case, it was safe to deliver high-velocity, low-amplitude manipulation to a patient with chronic Cauda Equina Syndrome.”

Disc of the Neck


Manipulation in the Presence of Cervical Spinal Cord Compression: A Case Series. Murphy DR, Hurwitz EL, Gregory, AA. J manipulative physiol ther. 2006 mar-apr;29(3):236-44

Conclusions: “… cervical spinal cord encroachment, as seen on MRI or CT, should not be considered an absolute contraindication to chiropractic cervical spine manipulation, provided the manipulation is applied by an appropriately trained and experienced practitioner, and is performed with the utmost care and skill.”…“Not only was manipulation not harmful in this patient population, but clinical improvement was seen.”

Chiropractic management and manipulative therapy for MRI documented cervical disk herniation. Beneliyahu DJ. J Manipulative Physiol Ther. 1994 Mar-Apr;17(3):177-85

Conclusions: “Patients with and without nerve root compression secondary to cervical disk herniation can and do respond well to chiropractic care.” Chiropractic management of this condition can and should be employed prior to more invasive treatment.”

Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. BenEliyahu DJ. J Manipulative Physiol Ther. 1996 Nov-Dec;19(9):597-606

Findings: 80% of the patients studied had good clinical outcomes with post care visual analog scores under 2/10 and resolution of abnormal clinical examination findings; After repeat MRI scans, 63% of the patients revealed a reduced size or complete reabsorption of disc herniation; 78% of the patients were able to return to work in their pre-disability occupations.

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