Should you adjust that herniated disc? Thoughts from a chiropractor/molecular scientist

Area of Science:

• Orthopedics and Sports Medicine
• Regenerative Medicine

Background:

• Low back pain is a leading cause of global disability, with disc herniation (DH) and degenerative disc disease (DDD) being common contributors.
• Inflammation plays a significant role in the pain and progression of disc degeneration.

Discussion:

• Current conservative treatments for DH and DDD include rest, exercise, and anti-inflammatory medications.
• There is a lack of established evidence supporting spinal manipulation's efficacy for treating degenerative or herniated discs.
• Serious adverse events have been reported following spinal manipulation in patients with suspected painful intervertebral discs (IVD).

Key Insights:

• Inflammation is a key factor in disc degeneration and associated pain.
• Anti-inflammatory and pro-anabolic strategies are emerging as promising therapeutic avenues.
• The safety and efficacy of spinal manipulation for painful IVD remain questionable due to limited evidence and reported adverse events.

Outlook:

• Further research is needed to elucidate the role of inflammation in disc pathology and develop targeted therapies.
• Investigating the mechanisms of action and potential risks of spinal manipulation for IVD conditions is crucial.
• Developing evidence-based guidelines for managing painful IVD is essential for patient safety and effective treatment.