Non-surgical Restoration of L3/L4 Disc Herniation

Abstract

We report the case of a 52-year-old Asian man presenting with severe lower back pain and bilateral radiculopathy due to acute L3/L4 disc extrusion, causing severe spinal canal stenosis and bilateral L4 nerve root compression. Following a ten-week conservative management plan consisting of high-velocity, low-amplitude spinal manipulation, adjunctive therapies, and home exercise, the patient experienced significant pain relief, functional improvement, and near resolution of deficits. A six-month follow-up MRI revealed the resolution of the L3/L4 disc extrusion, and the patient remained asymptomatic at nine months. This case highlights the potential for spontaneous resorption of a lumbar disc herniation and symptomatic improvement with conservative management, including chiropractic treatment. A favorable natural course of a disc herniation should be considered when deciding between early surgical intervention and conservative management, warranting further prospective studies to evaluate the effectiveness of chiropractic treatment and the role of spontaneous regression in symptomatic lumbar disc herniation.

Case Report: Integrative naturopathic approach for the management of sequestered lumbar disc herniation with neurological impairments: a case series with two year follow up

“…Conservative management for disc herniation includes addressing ergonomics, postural care, counseling, home-based exercises, physical therapy, and the use of medicines (6). Additionally, spinal manipulation has been reported to be successful in inducing regression of LDH (7,8), further broadening the spectrum of non-surgical options available. Nevertheless, these approaches, while valuable, may not fully address the complex biopsychosocial factors involved in pain management.…”