Epidural Steroid Injection Vs. Spinal Manipulation
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.
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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.
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.