“My son hurt his back in a football game. Is surgery or chiropractic care best for him?”

Thanks for the question. X-rays would not demonstrate a disc herniation, it is the wrong Imaging for a disc herniation diagnosis. Chiropractic care is considered a safe method of treating lumbar disc herniations, as well as surgery. Depending on the severity and complications, either or could be the best option

I am sorry to hear about your son's injury. Sports injuries can have long lasting or permanent affects if they aren't taken care of properly. I am also sorry to inform you but you cannot diagnose a herniated disc or discs from an X-ray you would need an MRI or CT scan to do so. If your son has not had an MRI to determine the severity of his injury I would recommend he gets one immediately. I would also recommend he see a Board certified fellowship trained pediatric neurosurgeon and let them make the recommendation if he needs surgery or would benefit from conservative care like injury rehabilitation, therapeutic exercise/physical therapy, and/or chiropractic care.
I have several herniated discs from a motorcycle accident and they are and have been well managed with conservative care. Best of luck to you and your son!

X-ray would not show disc herniations as they only show bone. MRI may show disc herniations but this would be uncommon in a 15yo boy. Football injuries in young boys could include spondylolisthesis or spondyloslysis. Surgery is not the first line treatment unless there is severe disability or passive instability. I recommend an evaluation and a trial of care either from a good chiropractor or physical therapist. A brace may be in order, but a thorough evaluation is the best place to start.

Start least invasive to more. A detailed chiropractic assessment can tell you if less invasive care can help your son before more invasive modalities.

Chiropractic before any surgery!

There is an old adage I use:

1. Chiropractic first
2. Medications second
3. Surgery - last resort

It all depends on what the actual problem will be. Just because a patient has a herniated disc is not an indication for surgery. Research tells us that 40% of the population with no history of back pain have at least one herniated disc in the low back. The best place to start is with a good biomechanically based chiropractor. Then, if that does not work, all options are still open.
Good luck.

At 15 the last thing you would want to do is surgery. You must try all conservative care first before the invasive risk of major surgery.

If X-rays show herniated discs, we need to do an MRI to see the degree of his herniation. If it is a grade 1 or 2, we can start with chiropractic care to see how he responds. I would always be conservative first before surgery.

I think you should explore every option available to him before surgery is done.

Mark Klezmer, DC, CCSP, CCST, FIAMA

Chiropractors are the masters of musculoskeletal dysfunctions. Chiropractic care along side with physical therapy can absolutely relief pressure from the nerve, align the spine and reduce your son's pain and discomfort. My advice will be to seek care that involves spinal decompression therapy.

Chiropractic focuses on the relationship between the body’s main structures – the skeleton, the muscles and the nerves – and the patient’s health. Chiropractors believe that health can be improved and preserved by making adjustments to these structures, particularly to the spinal column. They do not prescribe drugs or perform surgical procedures, although they do refer patients for these services if they are medically indicated.

With that in mind, I would suggest that chiropractic care is a great place to start for your son, it is non-invasive and could be the answer to finding relief. If after a period of treatment the symptoms are not improving then a referral to an orthopedic evaluation would be the next step. Your chiropractor can make that referral when needed.

Sincerely,

Dr. Martin

Disc herniation is a serious condition, but it is also seriously misunderstood. The first thing you need to know is that you can't see a disc herniation on an standard x-ray. The discs actually do not show up at all. What you can see on X-ray is that there is less disc height than there should be. This can indicate that the disc is herniated, but it can also simply mean that the discs are compressed. CT scan or MRI can be used to actually visualize the discs and determine for certain if they are bulging, how much, and in what direction. The second thing you should know is that research shows that 70% of people who did not have any back pain showed lumbar disc herniation on MRI. This means that just because your disc is bulging, doesn't mean that it is causing you pain. This also means that if you have pain, it may not be caused by the disc herniation, it may be caused by something else. Third, spinal surgeries as a whole, are only about 25%-35% "successful." Meaning that 65%-75% of those who have some type of spinal surgery still have pain after the surgery. Although, certain types of spinal surgery have higher success rates than this, it is a pretty big risk for something that may not even help. With this background in mind, my answer to you question is: why not consider both? Chiropractic care is excellent at treating most types of back pain. Unlike surgery, it is non-invasive. I recommend that you find a competent Doctor of Chiropractic and see how much conservative care can help. Your son is young and his body will heal quickly. If for some reason he doesn't respond to treatment and his condition does not improve, you can always elect to have surgery at that point. The costs are comparatively small and your son will be no worse off for having tried it. I personally, would refer my patient to an orthopedic surgeon if they were not improving, or were getting worse, after a reasonable amount of treatment. However, you do need to give it a chance. Don't assume that he is going to be "all better" after a visit or two. It may take many treatments, depending on his condition.

I'm sorry to hear your son was injured. We want to first have a clear understanding of the issue in its entirety. I would start by sharing that chiropractic is always a great start before considering surgery.

In health,

Dr. B. Epling, D.C

Sometimes surgery is necessary but I highly recommend starting with Chiropractic for 3 months in this case. Any chiropractor who utilizes Cox Flexion/Distraction technique or the McKenzie Method should have the best results for your son. If there is no improvement after 3 months, consult a surgeon.

Herniated discs are usually weakness on the walls of the joint between one vertebrae and another vertebrae. Usually herniated discs are caused by sports injuries or trauma from heavy lifting. Yes chiropractic can help to relieve the pain from a herniated disc without surgery provided your son refrains from having any contact sports such as football or hockey.

Based on what you’ve told me, your son could do a trial of chiropractic care so as he’s not losing nerve function. If your son has a loss of nerve function, he is a possible surgery candidate. Many people have herniated discs and don’t know it. Sometimes all these people have is mild back pain. Over the years, I’ve had patients with 1-2 disc bulges and only come into our office with mild pain. Chiropractic care is a great conservative approach to treating herniated discs. Adjustments can help the body start to heal itself and the joints to start functioning properly. Hope this helps!

It is my experience that herniated discs cannot be verified with X-rays alone. I would recommend an MRI to confirm the damage to the discs (if any). Many football players have back pain following practices and games. A thorough examination along with the X-rays should determine the level of care needed and if additional imaging is appropriate. The majority of back pain injuries respond well to chiropractic care.

Chiropractic first, medication second and surgery is always last. Never do surgery without exhausting all other conservative measures. Just about everything heals if given proper care and time, especially at that age.

Your son should pursue conservative treatment first (via chiropractic) - and then consider surgery if he does not improve.

Dr. Munse