Among the treatments for a herniated disc, also known as a bulging or slipped disc, are surgery and chiropractic therapy. A herniated disc arises when the cartilage discs that cushion the vertebrae (the bones of the spine) move out of position and burst. Surgery for a herniated disc involves removing or repairing the disc, while chiropractic treatment is nonsurgical and can also help with symptoms.
Though both treatments have the same goals, there are key differences between them. This article highlights the differences between chiropractic treatment and surgery for a herniated disc. If you’re experiencing back pain, see a healthcare provider for a diagnosis, so you can receive the best treatment for you.
What to Know About Chiropractic Care
Chiropractic is a system of therapy that focuses on adjusting the alignment of the spine to help with back pain and posture problems. Practiced by chiropractors—trained and licensed professionals—this nonsurgical approach is a longstanding therapy for chronic pain and mobility issues.
How Does It Work?
At its core, the goal of chiropractic therapy is to encourage and support the body’s natural healing processes. Considered for cases of joint pain in the back, neck, legs, arms, feet, and hands, it typically involves sessions in which the chiropractor physically adjusts the vertebrae—known as spinal manipulation or chiropractic adjustment—combined with exercise, nutrition counseling, and lifestyle adjustments.
Similar to conventional medicine, the chiropractor first performs a thorough medical evaluation and tests to establish a working diagnosis. Not only will chiropractors start treating affected areas with spinal manipulation techniques, but they will also develop a treatment plan and keep an eye on your progress.
Spinal manipulation, at the heart of this therapy for back pain, involves the chiropractor carefully adjusting the vertebrae by hand. Combined with stretching and the application of sustained pressure, these techniques can increase joint mobility, which eases herniated disc symptoms.
Alongside spinal manipulation, other approaches may be used to supplement chiropractic therapy. These include:
- Heating and icing inflamed or painful areas
- Using devices to electrically stimulate muscles and nerves
- Developing relaxation and deep breathing techniques
- Incorporating exercises to promote rehabilitation
- Establishing a regular fitness routine
- Making adjustments to diet and lifestyle
- Taking certain dietary supplements
A chiropractic adjustment does not yield instant results, rather the effects are seen as the health of the affected disc improves.
Chiropractic treatments are generally well-tolerated and adverse events rare. Though they generally resolve within a couple of days, spinal manipulation can cause several side effects, such as:
Does Chiropractic Adjustment Work?
Spinal manipulation and chiropractic adjustments have been shown to ease symptoms and restore mobility in cases of chronic back pain. One wide-ranging review found that those with chronic lumbar, or low back, pain reported significant improvement after six weeks of chiropractic treatment.
- Stiffness in the back or neck
- Radiating pain
- Neck pain
The severe side effects of chiropractic care are more debilitating and require care. These very rare adverse events include:
- Worsening of the existing herniated disc
- Cervical arterial stroke, a blockage of blood to the brain
- Injury to the spinal cord
- Cauda equina syndrome, a compression of the nerve roots in the spine
Prices & Where to Get It
As with any medical treatment, the out-of-pocket expenses of chiropractic care depend on a range of factors. Insurance may or may not cover this treatment, and how much you pay can range based on the severity of your case as well as where you live. One review from 2018 found the costs ranging between $264 and $6,171.
What to Know About Surgery for Herniated Disc
Surgeons employ a range of minimally-invasive techniques to treat herniated discs. These work to ease compression on the nerves by removing or replacing damaged discs or stabilizing the vertebrae, easing pain and inflammation.
A herniated disc can arise in the neck—known as the cervical spine—or, more commonly, the lumbar spine. Surgery is considered when:
- More conservative treatments, such as medications for pain and inflammation and physical therapy aren’t managing symptoms.
- The herniated disc causes difficulty walking, muscle weakness, and loss of bladder or bowel control.
- Standing or walking becomes difficult or impossible.
- The patient is in reasonably good health, with no infection, osteoporosis, or arthritis.
- The pain is impacting daily life and functioning.
Several specific techniques are used, including:
- Fusion surgery: Spinal fusion is the most common surgery for a lumbar herniated disc. It involves essentially using artificial bone material to fuse together two vertebrae to increase stability and prevent nerves from being impacted.
- Laminotomy/laminectomy: The symptoms of herniated discs arise due to compression placed on the nerves of the spine. Laminotomy involves making a small cut in the lamina, the arch of the spinal vertebrae, to ease that pressure. In some cases, the entire lamina is removed, which is called a laminectomy.
- Discectomy: The most common approach, discectomy (also known as microdiscectomy) can be performed on the lumbar or cervical spine. The surgeon accesses the affected disc via a small incision and removes portions of the disc.
- Artificial disc surgery: Another approach involves implanting an artificial disc into the affected area. More often used for hernia in the lower spine, the worn or damaged disc is first removed, and a specialized prosthetic is positioned. This allows the spine to retain more mobility.
The success of surgery for herniated disc surgery depends on many factors. Advances in minimally invasive techniques have greatly improved long-term outcomes, with one review finding approximately 80% of patients reported “good/excellent” results at a six-year follow-up.
However, there’s a chance of recurrence: About 20% to 25% of those with herniated lumbar discs experience re-herniation at some point in their lifetimes.
Though most patients don’t experience serious side effects or adverse events, there’s always that risk with surgery. Potential side effects or complications include:
Depending on the case, you’ll need to spend one to three nights in the hospital following surgery for a herniated disc. Overall recovery times vary depending on the procedure used, though you can expect four or more weeks before you can resume normal activities. During this period, you’ll need to incorporate walking exercises to promote recovery, while avoiding heavy lifting or strenuous activities that can injure the spine.
- Tenderness and swelling in the affected areaDiscomfort during recoveryBleedingInfectionTearing of spinal nerve roots (dural tear)Nerve injuryRe-herniation of the disc
Surgery for a herniated disc is specialized work, and, like other surgeries, the costs depend on the scope and scale of the treatment. Expenses are also determined by what insurance plans do and do not cover, so it’s important to talk to a surgeon’s staff about how much you can expect to pay. The typical costs of this surgery range between $14,000 and $30,000.
Which Treatment Is Best for You?
When choosing between chiropractic treatment and surgery for your herniated disc, a number of factors impact the decision, including:
- Chiropractic treatment doesn’t involve any surgery, so it’s the less invasive option.Surgery provides pain and symptom relief faster than chiropractic care or conservative treatment.Certain, severe cases of herniated disc cannot be helped by chiropractic adjustments.Chiropractic adjustments prevent herniated disc from getting worse and ease symptoms but don’t treat underlying symptoms.Surgery may not be appropriate if you have an infection, osteoarthritis, or osteoporosis.
Can Chiropractic Care and Surgery for Herniated Disc Be Used Together?
Chiropractic therapy is among the more conservative treatment options for a herniated disc. Generally, surgery is only considered when noninvasive methods haven’t been able to stop the pain. As such, chiropractic therapy may be tried first before going ahead with the surgery.
An Informed Choice
When you meet with your healthcare provider, they will give you the options that would be most effective in treating your type of herniated disc.
Additionally, after recovery from spinal surgery, chiropractic adjustments may help with lingering symptoms. That said, it’s important to get medical clearance before going ahead.
Coping With the Side Effects
Special care needs to be taken to cope with the side effects of recovery after treatment for a herniated disc. This may involve:
- Pain medications: A range of over-the-counter and prescribed medications can help with pain and tenderness following surgery. These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) or Aleve (naproxen); Tylenol (acetaminophen); and opioids, among others.
- Icing and heating: Applying ice for 10 minutes at a time can help with acute pain in the back or neck. Heating affected areas may also help, especially with chronic pain.
- Mobility: Following surgery, especially in the early recovery, it will be important to walk around and get some activity. This is also important after chiropractic treatment and can help ensure better outcomes.
- Restricted activity: Following surgery, you’ll need to steer clear of lifting heavy objects, as well as strenuous or contact sports. Prolonged sitting should be avoided following chiropractic treatment.
- Exercises: Certain stretches and exercises may also be recommended following surgery to help regain strength and stability in the spine, which can ease symptoms. This may also be part of the broader treatment plan following chiropractic treatment.
Chiropractic treatment and surgery are therapy options for herniated discs, in which the disc that cushions the vertebrae of the spine slides out of position and ruptures. The former involves physically manipulating the position of the vertebrae and can help manage symptoms and prevent the progression of the condition.
Surgeries for a herniated disc work to remove the damaged disc and stabilize the area, treating the cause of the problem. Though both are effective in taking on back problems, each has its own set of advantages and disadvantages.
A Word From Verywell
Living with back pain can be a tremendous burden, and yet many people struggle without seeking care. Nowadays, surgeries and noninvasive techniques are better than ever at treating the source of spine problems and managing their symptoms. If you suspect you have a herniated disc or are curious about what you can do about your back pain, call your provider to learn of your options.