Dr. Vince Sferra, DC

This is a great question. It certainly will depend on the region, nature and extent of the herniation as well as what impact it is having on the surrounding neural tissue (spinal cord and nerves). These factors can be determined by a comprehensive examination from a qualified doctor (MD or DC) who is experienced in this area along with a MRI of the region. My 35+ years of clinical experience has shown me that many spinal disc problems, including herniations, can be managed with conservative measures which would include chiropractic care. It should be noted that the chiropractic approach/technique that is implemented needs to be clinically appropriate for the specific disc condition of the patient. Additionally, when a frank disc herniation that demonstrates on MRI, infringement to neural tissue with clinical signs and symptoms of nerve compromise on examination, it is my opinion that a neurosurgical consult with a spine surgeon is warranted. In this instance, a patient may still be able to manage their condition without surgery but is advised to get that surgeons opinion as well. I hope this helps.

So, the answer to this question is predicated on a number of things. Regarding the hernia itself, a couple of questions immediately come to mind: Is the hernia new and was there acute injury that created it? Can you perform and complete all of your basic daily activities without exacerbating your pain? What is the level of pain and dysfunction you are in? Is there nerve involvement? And then of course we must ask, exactly what type of exercise are we looking to do? Exercise can range from walking and very light stretching to weight training, aerobic classes or even playing a sport. The only real way to determine the potential for further injury of your disc with exercise is to be evaluated by a doctor who cares for spines and is experienced in rehabilitative exercise and their progressions. Wrong exercises and/or wrong timing of doing specific exercises can certainly worsen a disc problem. With all of that said, I will say that ultimately, exercise is exactly what will be necessary to get your spine stabile and strong. First and generally speaking, it will be with rehabilitative exercises that are progressive in building stabilizing strength and mobility which can blend into functionally oriented exercises for ones usual activities at work, recreation or competitive sport. As a matter of fact, aside from acute trauma creating a disc herniation, most disc problems have been created, at least in large part, by weak and imbalanced musculature around the spine. I know everyone would love a yes or no answer to this question, but its just not possible to do that in good conscious. As a matter of fact, if a doctor answers this question without knowing the answers to the questions listed above, I can honestly say that it would expose him or her to their naiveness of the subject. Like most things in healthcare, this cannot be a one size fits all approach.

Thats a loaded question in that not all herniated spinal discs are created equal, nor do they result in the same amount and severity of symptoms from person to person. And quite commonly, the herniation found on an MRI is not even the primary cause of the persons symptoms. Each person with a suspected disc herniation needs to be evaluated by a competent doctor who has experience in these types of spinal related conditions. There certainly are times when surgical removal of the herniated disc material is the best option. Fortunately, many herniated disc conditions can be managed and respond quite well to conservative management with chiropractic and rehabilitative care that almost always include therapeutic exercise with progressions in order to build and maintain spinal mobility and stabilizing strength.