Possible slipped disc - chiropractor or orthopedist? Other suggestions?

[Bliz]

I tweaked my lower back (left side) pretty badly on thursday. Had my wife pick me up from work, since I didn't feel safe driving, and she made me an appt with a chiropractor recommended to her by a co-worker that same afternoon. While I was there it started spasming and I had to go to the ER to get proper muscle relaxers and pain killers to stop the spasming. I'm still hobbling a bit, but am generally mobile and doing ok.

A similar thing happened to me about a year ago, but this was the first serious bout I've had since then, and I realize it's time to start being more proactive about it.

For those that have had similar experiences (or know anything about it generally) am I better off seeing a chiropractor or an orthopedist? From the x-rays and tests taken at the chiro office before the spasming started, they're pretty sure I have a slipped disc, but probably need to take an MRI to be sure of the specifics. The chiro also indicated she would be doing mostly stretches and physical therapy as opposed to "adjustments". I'm not sure exactly what an orthopedist does, or how their treatment methods would differ.

Any info or suggestions would be appreciated.

[Siven]

ART licensed Chiropracter.

[Ford]

ART licensed Chiropracter.

LMAO

I had a slipped disc several years ago and my money is going to an MD every single time.

Do you have any pain in your legs? And yes, and MRI is definitely needed to know for sure what your condition is.

[Bliz]

ART licensed Chiropracter.

What's the ART?

LMAO

I had a slipped disc several years ago and my money is going to an MD every single time.

Do you have any pain in your legs? And yes, and MRI is definitely needed to know for sure what your condition is.

[

Not constant, but I definitely feel it in my thigh and calf at times. Which I believe means that the disc is pressing against the sciatic nerve.

[SkinsTerps26]

Slipped disc is such a bad term for a herniated disc, if that's what you have.

Herniations are normally due to degeneration of the disc prior to any injury of the outer casing (anulus) of the disc. Your chiropractor should be doing something called end range loading, where she will determine if you pain is most likely due to a internal disc disruption (ie herniation) or if its muscular in origin.

Most people have non symptomatic herniations, so make sure that your pain is being generated by the disc.

Secondly, ALWAYS go the conservative method first. Co manage with your MD and obtain some pain killers, but remember they are masking the pain, no fixing it.

An chiropractic adjustment won't "fix" a herniation, but will help if there is an actual joint problem (ie its not your disc that is causing pain), otherwise, muscular instability exercises, diet and rest will go further in helping your back pain than immediately going for surgery.

[SkinsTerps26]

What's the ART?

[

Not constant, but I definitely feel it in my thigh and calf at times. Which I believe means that the disc is pressing against the sciatic nerve.

This is not always true.

Try laying on your stomach and extending your back (if it doesn't hurt too much to try) If your pain centralizes (ie u feel it just on your back and not your leg/thigh) its most likely disc related.

If your thigh/leg pain remains, it could be a joint/muscular thing. Not always sciatica, but it could be.

Like i said earlier, try the conservative approach first. You want to have a chiro who is doing more than the adjustments, trust me.

also ART means, a chiro who belives that everything can be fixed by an adjustment. However, considering nerve impingement happens like 1% of the time, whereas disc pain happens in 40% of cases, i'd try to rule disc/muscle etc first.

[rdsknbill]

I have two degenerating discs in my lower back. I have been seeing a Chiro for two years. Any time I see an MD about it, their solution is "Cut it open and let me fuse your spine" To which I say :finger:

I go to my Chiro once a month and don't have any problems

[PeterMP]

Go see the MD. There is a reason that MD's are MD's, and the others aren't.

[Mad Mike]

Trust me. I'm the king of back problems. :doh:

Go to and orthopedist and have it checked out. They have better technology and can find out exactly what is going on. Chiropractors do Xrays and they don't show disk damage. If the orthopedist says it's not bad, go to a chiropractor and get an adjustment AND do some physical therapy (I would just go once or twice to learn what to do on my own) But if it's bad, at least an orthopedist can tell you. A chiropractor may never know and could do more harm than good if you have a serious problem.

:2cents:

[SkinsTerps26]

Go see the MD. There is a reason that MD's are MD's, and the others aren't.

Spinal Surgery Not Always the Best Choice for Low Back Pain

Low back pain affects four out of five people at some point in their lives, according to the American Academy of Orthopaedic Surgeons. The pain and discomfort - which typically stem from strained, stressed muscles and other soft tissues around the spinal column - generally go away after a few days or weeks of rest, gradual resumption of activities and avoiding overuse that can aggravate those soft tissues near the spine.

But in some cases, the pain persists longer than a few months, or the patient experiences nerve pain that radiates to the hip and legs. Then, surgery may provide some relief.

Low-back surgery, however, should only be performed in a relatively few, well-chosen cases, emphasizes Raj D. Rao, MD, Associate Professor and Director of Spine Surgery in the Department of Orthopaedic Surgery at the Medical College of Wisconsin - and only when non-invasive methods such as over-the-counter pain medications, plus stretches and exercises prescribed by a physical therapist, have been tried, but failed to provide relief.

and MD will prescribe Drugs, and refer you to a PT, Chiro, Osteopath.

[SkinsTerps26]

Trust me. I'm the king of back problems. :doh:

Go to and orthopedist and have it checked out. They have better technology and can find out exactly what is going on. Chiropractors do Xrays and they don't show disk damage. If the orthopedist says it's not bad, go to a chiropractor and get an adjustment AND do some physical therapy (I would just go once or twice to learn what to do on my own)

Better technology as in sending you out to get films taken and analyzed by a radiologist? lol. Chiro's do the same thing too, as do osteopaths and PTs

What MD are you going to that has their own MRI machine, i'd like to know b/c i want his number.

But if it's bad, at least an orthopedist can tell you. A chiropractor may never know and could do more harm than good if you have a serious problem.

:2cents:

This is not a fair statement to make:

First, acute herniations are normal contraindications to adjusting anyways. Most chiropractors won't adjust a bad herniation. An adjustment doesn't do much for herniations (its disc related after all), as say Sacroiliac joint dysfunction or spinal joint pain etc, but some people do get relief.

2nd, studies have shown that spinal manipulation rarely cause complications with a herniation.

finally, Consdiering iatrogenic cause of death is a problem in this country, I wouldn't say that MD's are always right.

[MonkeySkin]

I messed up my disc about 2 1/2 years ago. Really bad pain thoughout my entire left leg. My foot would go numb and stuff...hurt bad to sit.. I saw a doc, had a MRI, XRays and stuff... I saw a Chiro for about a month or so, and started thinking it probably wasn't good for me so stopped going.

I just did the stretches and I think it worked for me, cause I've been fine for about 6months or so. This was one of the worst things I've ever gone through, and what I pretty much did was try to live my life normally. I didn't even take any time off from work, but should of. I was even going to Redskins games in horrible pain :laugh: I'd literly come home from work and go straight to the bathtub everyday. It was horrible.

It hurts like hell, but I think if you do the stretches and stuff, just be patient cause it takes time to get better.

[SkinsNut73]

Four years ago I ruptured the L5 disc and herniated the L4 and L3 discs.

Worst. Pain. Ever.

I went to my personal physician (insurance requires that I do this first) who referred me to an orthopedist. The ortho decided the best way to treat this was with a cortisone injection and physical therapy. I would say there was an 70% improvement immediately following the injection, and 6 months of therapy had me back to normal.

Since then I have re-aggravated the back on two occassions, and both times resulted in further herniation of the discs. Both times the ortho recommended surgery as he said this will be a continual problem throughout my life. He wants to do the micro-surgery and go in and "lop off" the bulging portion of the disc. Both times I said no thanks, give me another injection. Both times I felt 100% relief as soon as they injected the cortisone into the disc.

While the ortho is probably right in that I will have this problem for life...I'm much smarter now ...I take pretty good care of my back. When I sense something is not right I use ice/heat, exercises, and rest until the back feels better.

If you do go to an ortho I would say be informed about the different treatment options available to you (like an injection of cortisone). The way my ortho pushes surgery you would think he gets commission on every operation . In fairness to him, I'm sure he honestly believes that is the best way to permanently resolve my problem...but surgery on my back ain't happenin' until it is absolutely necessary.

....one other thing...I never take pain killers for my back anymore. I did for about a week when I first injured the back, but found that it just masked my problem. I felt like I was doing more damage to my back that way. Now, when pain comes, I "listen" to what my back is saying and treat it accordingly.

[Corcaigh]

I have two degenerating discs in my lower back. I have been seeing a Chiro for two years. Any time I see an MD about it, their solution is "Cut it open and let me fuse your spine" To which I say :finger:

I go to my Chiro once a month and don't have any problems

I agree with this point of view. First get a professional diagnosis via an MD and then determine treatment options. Doctors like to recommend surgery or heavy doses of pharmaceuticals because they believe, correctly in 95% of cases, that their patients aren't dedicated to follow the physical therapy or dietary routine to make themselves healthy without surgery or drugs.

My wife is a national standard competitive runner and relies on chiro and an intensive physical training program to keep her healthy. When she visits MDs for other reasons and discusses her ailments their recommendation to her is always to have surgery which would require her to have long rehabilitation before being able to run again, if at all.

We also know two Olympic class runners who had the spine fusion treatment and it has turned them into old men and ruined their running careers prematurely, while physical therapy wasn't given a chance.

[Destino]

I've had a herniated disc and trust me - get an MRI done. It's the only way to know for certain how bad it is. I went to both a chiropractor and an orthopedist for treatment after my MRI. The MD would look at it in terms of nerve damage and the chrio provided some PT and gave better advice on work outs to strengthen the area than the MD did.

[JosephGibbs]

I would go to a physical therapist for physical therapy. Chiropractors have their place, but have different training and knowledge than a physical therapist. Most physicians are not sold on chiropractors and will usually reference you to a physical therapist in your condition.

[Bozman777]

Buy a reverse hyperextension exercise machine. It decompresses the spine. Best 1200.00 I ever spent and my MD recommended it.

[Larry Brown #43]

Go to a chiropractor. Medical doctors know absolutely nothing about the musculoskeletal system. They don't learn about it, and they don't know about it.

In a 2005 study published in the Journal of Bone & Joint Surgery...

A validated musculoskeletal cognitive examination was given to medical students, residents, and staff physicians in multiple disciplines of medicine to assess the adequacy of their musculoskeletal medicine training.

Seventy-nine percent of the participants failed the basic musculoskeletal cognitive examination. This suggests that training in musculoskeletal medicine is inadequate in both medical school and nonorthopaedic residency training programs.

www.ejbjs.org/cgi/content/abstract/80/10/1421

[Mad Mike]

Go to a chiropractor. Medical doctors know absolutely nothing about the musculoskeletal system. They don't learn about it, and they don't know about it.

In a 2005 study published in the Journal of Bone & Joint Surgery...

A validated musculoskeletal cognitive examination was given to medical students, residents, and staff physicians in multiple disciplines of medicine to assess the adequacy of their musculoskeletal medicine training.

Seventy-nine percent of the participants failed the basic musculoskeletal cognitive examination. This suggests that training in musculoskeletal medicine is inadequate in both medical school and nonorthopaedic residency training programs.

www.ejbjs.org/cgi/content/abstract/80/10/1421

Oh please

The mean passing score (and standard deviation) that they

recommended for the assessment of basic competency was 73.1 ± 6.8 per cent. The mean score for the eight orthopaedic chief residents was 98.5 ± 1.07 per cent

In other words, see a specialist. And since the paper does not eve rate chiropractors, I don't see how it can prove chiropractors know more. :doh:

[Mad Mike]

Better technology as in sending you out to get films taken and analyzed by a radiologist? lol. Chiro's do the same thing too, as do osteopaths and PTs

What MD are you going to that has their own MRI machine, i'd like to know b/c i want his number.

This is not a fair statement to make:

First, acute herniations are normal contraindications to adjusting anyways. Most chiropractors won't adjust a bad herniation. An adjustment doesn't do much for herniations (its disc related after all), as say Sacroiliac joint dysfunction or spinal joint pain etc, but some people do get relief.

2nd, studies have shown that spinal manipulation rarely cause complications with a herniation.

finally, Consdiering iatrogenic cause of death is a problem in this country, I wouldn't say that MD's are always right.

Show me a chiropractor that gets MRIs done. I haven't seen one yet. I've been through it. They take xrays and start talking about adjustments. In the mean time I had problems that no amount of adjustments could fix. Waiting to go to a doctor cost me more than I can ever get back. I have permanent nerve damage in my left leg.

So I'll say it again and I don't care what you think. First go to a doctor and make sure you are not dealing with something serious. THEN if it's not too bad you can see a chiropractor.

[Larry Brown #43]

Oh please

In other words, see a specialist. And since the paper does not eve rate chiropractors, I don't see how it can prove chiropractors know more. :doh:

Medical doctors know a lot more than chiropractors about a lot of things, but the spine is not one of them. The report doesn't rate chiropractors, but it challenges the fallacious assumption that you should see a general MD if you have back trouble.

[Mad Mike]

Medical doctors know a lot more than chiropractors about a lot of things, but the spine is not one of them. The report doesn't rate chiropractors, but it challenges the fallacious assumption that you should see a general MD if you have back trouble.

Who the hell said see a general MD? NO. See a specialist. And if you do see a general MD, what is he or she going to do if you show any sign of a real problem? Send you to a specialist.

[Larry Brown #43]

Who the hell said see a general MD? NO. See a specialist. And if you do see a general MD, what is he or she going to do if you show any sign of a real problem? Send you to a specialist.

Several in this thread have suggested a general MD, and obviously enough people in society think this way for the authors of the study to bother conducting the study in the first place.

Here's the problem with your scenario of an MD sending you to a specialist.

MDs have historically boycotted chiropractors for financial reasons (this was proven in federal court), so even if you SHOULD be seeing a chiropractor, your MD is unlikely to send you to one.

Besides, if a general MD is unequipped to understand your back problem, what confidence would you have that he/she would even know who to send you to?

I'm not saying that chiropractors have all the answers...far from it. But tons of people (including lots of elite athletes) find relief from them, and numerous MEDICAL studies have shown that back pain medicines and back surgeries are over-utilized and often ineffective. But they remain prescribed because they are excellent money-makers.

[pjfootballer]

They have the Disc decompression machines at my chiropractor. I get monthly adjustments on my lower back and for my TMJ. It's been great. My unsurance gives me up to 30 visits a year. Try the disc decompression before any surgery.

[dockeryfan]

lol, there is a lot of misinformation on this board.

Orthopedists and neurosurgeons have surgical solutions to lumbar pain.

One thing they may do is perform cortisone injections.

Cortisone injections do nothing but temporarily mask pain. They do nothing to actually fix the problem.

Many times they will refer you for therapy before performing surgery. Rarely will they have any say in terms of what therapy is done. The script will say "evaluate and treat". That's it. So, no, orthopedists and neurosurgeons are not the people to take advice from in terms of SPECIFICS of therapy.

Talk to someone who does this every day.

Lumbar surgical success rates nationally are 77% to 87%. Success rates for relieving leg pain are 70%-75%. A surgical success is defined as a patient not being any worse when they get up off the operating table. If you have the exact same symptoms after the surgery, it's a surgical success.

Try all non-invasive methods first. Chiropractic first. Then Acupuncture or PT. Actually, it really depends on the practitioner. Talk to your friends and get good recommendations of doctors who do good work.

Also,

there are some very unscrupulous MDs in this area now. They will prescribe 4-6 weeks of therapy, and then make a decision on surgery. If a patient still has pain, which they probably will because that is too short a time frame, they will recommend the surgery. It is very disingenuous, because they know you will still be in pain in 6 weeks. They know you will be back for surgery.

Then you can join the ranks of people with FBSS.

Failed Back Surgery Syndrome. Is back surgery always wrong? Of course not. But the rates of recurrence of pain are alarmingly high. A surgeon will claim to have a 95% success rate for his surgical team, but that rate tracks the success of the surgery (meaning the patient didn't get worse) not the reduction of pain, and certainly not the recurrence of pain years down the road. So you can still be in just as much pain and be considered a surgical success.