Effective Diagnosis and Treatment of Low Back Pain

Here's an all-too-common situation. You develop low back pain that lasts for more than a few days and you're uncomfortable enough to go see your primary care physician. He or she tells you it's not clear what's going on and sends you for a magnetic resonance imaging (MRI) study of your lumbar spine. The study comes back showing one or two herniated intervertebral discs. [Intervertebral discs are cartilaginous shock absorbers interspaced between pairs of spinal vertebras.] Your doctor informs you that you have "herniated discs in your back" and prescribes medications and a course of physical therapy. Your doctor may even refer you to an orthopedic surgeon to evaluate the need for surgery on your back.

Now, all of these recommendations may be necessary. Or none of them may be necessary and all that's needed is some rest and an exercise rehabilitation program that you could do on your own if you were given the proper instructions. The culprit here is how the presence of the herniated disc or discs is interpreted. It's important to remember that not all herniated discs are a problem requiring a solution. In fact, a sizable proportion of such disc herniations (30% or more)1 represent the progression of natural processes and are not a problem at all.2,3 But many family doctors and even specialists are not appropriately trained in accurate differentiation among the various possibilities. When faced with MRI evidence of a herniated disc, such doctors see it as a disorder or disease that needs to be treated and fixed. Such an approach results in significant stress and leads to unnecessary procedures and financial hardship for many patients.

Given the frequency of occurrence of such instances of "over-diagnosis", how can a person with back pain expect to receive appropriate care? Of course, people as patients are usually not in a position to be able to overrule their doctor's recommendations. The answer lies in obtaining relevant information. Let your doctor know you're aware that up to one-third of normal persons have herniated discs, and ask whether it's possible that your disc herniation is in fact unrelated to your back pain and merely an incidental finding. Further, if your back pain is not accompanied by leg pain radiating below your knee, it may be that the disc herniation is not affecting spinal nerve roots and may be treated by very conservative measures such as rest followed-up with exercise.

Thus, not all disc herniations have the same impact on a person's health. Some represent normal findings, even if they are present in a person who has back pain. Let your doctor explain to you exactly why your particular problem requires more than watchful waiting. Your local chiropractor will be able to provide you with the very best expert advice and recommendations for any necessary treatment.

1Takatalo J, et al: Does lumbar disc degeneration on magnetic resonance imaging associate with low back symptom severity in young Finnish adults? Spine (Phila PA 1976) 36(25):2180-2189, 2011
2Spontaneous regression of herniated lumbar discs. Kim ES, et al: J Clin Neurosci 2013 Oct 24. pii: S0967-5868(13)00552-3. doi: 10.1016/j.jocn.2013.10.008. [Epub ahead of print]
3Endean A, et al: Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila PA 1976) 36(2):160-169, 2011

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Testimonials

Reviews By Our Satisfied Patients

  • "PAIN FREE! Over the years I have been to several different chiropractors. As a child, I was exposed to chiropractic care through my mother. Having arthritis, chiropractic was the one place she could get relief without drugs. Even so, not all chiropractors are equal and that was never made more clear to me than when I met Dr. Roy. Having complained of lower back pain to a former chiropractor, I was never able to get any relief. It wasn't until I started being treated by Dr. Roy that I was able to go weeks without pain. I even had a manual physical therapist tell me I had scarred tissue and would never truly be pain free. Dr. Roy's methods were new to me and I was a little skeptical at first, but after a month or so of treatment I was able to go for several weeks without ANY pain! I am a believer now and I will be coming back as often as I can!!!"
    Judy Reyes
  • "THE MIRACLE DOCTOR! A friend recommended Dr. Roy to me because I could hardly walk and I was in great pain. He took x-rays and treated me immediately and it really help right away. That was in 2019. He saw me twice a week for many months before I went to once a week. He has educated me on many different situations concerning my back and that's why I call him "The Miracle Doctor.""
    Mary Kathleen Weldon
  • "ALMOST AS GOOD AS NEW AFTER SEVERE CAR ACCIDENT AFTER 2 SESSIONS 5* After decades of chiropractic care, I thought I'd received the best possible outcome for my neck injury from a fall further exacerbated by a severe car accident.
    Little did I know that in just two sessions Dr. Roy would have me almost as good as new!
    Thanks again for hearing my complaint and knowing exactly how to adjust T1/T2/C7 areas on my neck for instant, long lasting relief."
    C Broadway
  • "NO MORE MIGRAINES 5* - Dr. Roy has added a massage therapist and I'm so excited to have that available for my overall wellness care. Dr. Roy always seems to put his finger exactly where I'm needing an adjustment and with his upper cervical adjustments, I've gone from 4 migraines a month to less than one a year! I haven't felt better."
    Chrystal R.
  • "FIVE STAR REVIEW 5*"
    Kelly B.
  • "VETERAN OWNED BUSINESS5* - I know Dr. Roy personally and he does a great job. He is an honorable man who cares about his patients and is an USAF veteran to boot."
    Col Paul S.
  • "TRUST THEM WITH MY BACK 5* - So love this place! Four days ago I came home from a long trip..my back from hurting from the travel. They were able to take me in for an appointment the very next day and put 2 ribs back in place. Besides that, I love the employees there. They are so refreshing and kind and I highly trust them with my back."
    Sara W. F.
  • "VERY PLEASED 5* - Visiting Dr. Roy's Chiropractic Clinic since last year and very pleased with the results so far!
    Thank you so much Dr. Roy!"
    Stephan S.
  • "BACK, KNEES AND HIPS BETTER! Since starting treatments with Dr. Roy not only is my back better and I now know what the issues are - his gentle chiropractic approach has helped my back, knees and hips. Thanks Dr. Roy"
    Susan E.