More Effective Than Epidural Injections for Spinal Disc Herniation

More Effective Than Epidural Injections for Spinal Disc Herniation

In a study done, Chiropractic adjustments were just as effective as epidural injections for patients with back pain. However, Chiropractic care had insignificant risks with no side effects.

The results of the study show that chiropractic can significantly reduce pain in patients with lumbar disc herniation, and is less expensive and 14% more effective than lumbar epidural injections.

Lumbar epidural injections are frequently used for back pain and sciatica nerve pain in patients with lumbar disc herniation, failed back surgery syndrome, and spinal stenosis. During the procedure, a physician injects a high dose of pain medication, and sometimes steroids, into the area of the lumbar spine around the damaged nerve. This temporarily reduces inflammation and pain and poses risks than Chiropractic Treatment does not.

There are risks associated with Epidural Steroid Injections in which Chiropractic treatment does NOT have. These health risks include:

  • Numbness of the bowels and bladder
  • Spinal Infection
  • Dural Puncture (a blood patch maybe needed if puncture occurs)
  • Bleeding
  • Nerve Damage

Although the injections are widely used, controversy lingers due to the lack of studies with placebo controls, and questions about the effects of steroids versus anesthetic alone. Side effects of steroids include a weakening of muscles and spinal bones around the affected nerve and a disruption of the body’s natural hormone balance. It’s also unclear whether epidural injections are more effective than other conservative treatments for lumbar disc herniation.

While a number of studies have established the efficacy of chiropractic for low-back pain, fewer have tested its comparative effectiveness with other treatments for lumbar disc herniation.

In a study filed by the US National Library of Medicine the Journal of Manual and Physiological Therapeutics, researchers from Switzerland compared the effects of Chiropractic Spinal Manipulative Therapy and Epidural Nerve Root Injections (ENRI).

The study included 102 patients similar in age and sex patients with symptomatic, MRI-confirmed lumbar disc herniation who were treated with either Chiropractic Treatment or Spinal Injections.

After one month of treatment, both groups experienced significant improvements. However, patients receiving Chiropractic care had a higher rate of benefit without any potential side effects.

Of the patients under chiropractic care, 76.5% said they were “much better” or “better” compared to 62.7% of ENRI patients. Sixty (60%) percent of chiropractic patients had a significant reduction in pain compared to 53% of ENRI patients.

While none of the chiropractic patients received surgery, three of the ENRI patients eventually opted for an operation after treatment.

This study suggests that patients can experience substantial relief from chiropractic care without worrying about the side effects of steroids or drugs. It may even save them money, since research suggests that chiropractic patients have lower annual medical costs compared to patients under traditional care.


Peterson, CK, et al. Symptomatic Magnetic Resonance Imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Journal of Manipulative and Physiological Therapeutics 2013; doi: 10.1016/j.jmpt.2013.04.005.

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  1. chiropractor

    I am so thankful to have been mentored by two of the top Upper Cervical Chiropractic Doctors in California, Dr. Tom Forest and Dr. Truong. They specialize in treatment of chronic diseases that Medical Doctors prescribe life time medication for with no hope of a cure. Diseases such as vertigo, chronic neck, shoulder, arm, hand, back, and leg pain; chronic headaches, migraine headaches, fibromyalgia, chronic fatigue, stomach problems, whiplash, and neurological disorders. I have been truly blessed by the knowledge these world class upper cervical Chiropractors have generously passed on to me.