Epidural Steroid Injection Vs. Spinal Manipulation

<span class="widget-title__inline">Spinal Injections and Chiropractic care for symptomatic disc herniations</span>

Did you know that there are over 25,000 spinal nerve root injections given in the U.S. each day? This equates to over one million per year in the U.S. alone! These epidural steroid injections (ESI) carry the most common side effects of infections, dural punctures, bleeding, and nerve damage. There is additional research that suggests a 21% increase of vertebral fracture after ESI. A nerve root injection is the injection of steroids, local anesthetic, and/or saline that is performed under fluoroscopy into the epidural space with the intentions to decrease inflammation and improve healing in that region.

Researchers found that both chiropractic manipulation and nerve root injections improved symptomatic MRI confirmed lumbar disc herniations. The groups were split into a chiropractic manipulation group and a nerve root injection group. Pain levels were measured prior to the start of the therapy and again one month post-treatment. After one month, 76.5% of the chiropractic manipulation group found improvement in symptomatology as compared to 62.7% of the nerve root injection group. However, 60% reduction was found with spinal manipulation; whereas, 53% reduction in pain was found with nerve root injections. With nerve root injections, 5.9% of patients found worsening symptoms and with spinal manipulation, 2% of patients found worsening symptoms after one month of treatment.

Already received an injection? Theres more!

A study from 2004 found that chiropractic care following nerve root injections resulted in 76% of these patients having improvement after one treatment procedure. The researchers found that nerve root injections are proposed to address the inflammatory and central components of spinal pain. Spinal manipulation is proposed to address the biomechanical and neural aspects of the pain syndrome. Spinal manipulation is a safe and effective, non-surgical procedure to address low back pain with radiculopathy both before and after nerve root injections.

Sources:Spinal manipulation postepidural injection for lumbar and cervical radiculopathy: a retrospective case series.

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.