Answers to Questions about Chiropractic:
Should I Get a Third Opinion from a Chiropractor?

Samuel Homola, D.C.

Question

I am a healthy 33-yer-old woman who fell off a horse nearly two years ago. A couple of weeks after that, I started having pains in my lower back. Months later, I started getting the pains at night, spreading to my tail bone area. During the day, I had no real problem, but at night I had overwhelming stiffness.

Last October, I started seeing a chiropractor who gave me relief from my restless nights. For the first time in one-and-a-half years, I slept good again at night and dreamed like mad! The chiropractor said that she had possibly unlocked some emotional stuff. She performed neck manipulations because she said that if my neck was properly aligned my lower back would not have to compensate. I have never had trouble with my neck, but what she told me seemed to make sense. After a month of adjustments to sort out my unequal leg length, I thought my problem was solved.

When my pain returned a week later, a second chiropractor in the same clinic told me that I had a degenerated L4 disc that could definitely be regenerated. She said that she had seen it and had done it. But I would need six months of twice-weekly treatments. She also said that my neck was compensating for my lower back which was too straight, that I had once broken my tail bone, and that my fertility was risk because of blocked nerves. This really hit home because I have been trying to conceive for the past year with no luck. I am seeing a fertility specialist in January, but if the chiropractor is correct I am afraid I will never get pregnant. I asked her about the danger of neck manipulation and she said that only those with a history of strokes and high blood pressure were at risk. She has never checked my blood pressure!

A month-and-a-half of treatment has not relieved my symptoms. A series of x-rays showed that my L4 disc had narrowed more than expected. Would the adjustments chip away more of my disc space? She also said that it looked like a whiplash had caused my neck to curve the wrong way. I am not having any neck trouble.

Now I am really confused and in doubt. I don‚t know what to do. Will my disc space get narrower? Will I end up in a wheel chair before I‚m 40? Will I have to continue seeing my chiropractor? I was told that if I do not get treatment, my back will give me major trouble in the future. I generally do all the right things and I am totally puzzled as to how my back got so messed up at the age of 33.

I am getting one more opinion from a chiropractor elsewhere in Ireland. She offered to have a look at my x-rays and she told me that she would be straight with me. She won't be able to treat me as she lives too far away, but hopefully she will be able to give me a clear conclusion on what my problem is and how to proceed. I wonder if a few solid guidelines with regards to exercise, diet, and lifestyle would benefit me more.

Answer

A narrowed intervertebral disc never regenerates and tends to become progressively thinner with time. When there is sudden thinning of a disc space due to rupture or herniation of disc cartilage, there may be no obvious degenerative changes, just thinning of the disc space. But as time goes by, the damaged disc cartilage gradually degenerates and degenerative changes will become evident in the adjacent bony and ligamentous structures. Manipulation will not prevent such degenerative changes. This does not mean, however, that you will become disabled, even if the disc totally degenerates, leaving little or no disc space. It is a natural course for a damaged disc to degenerate. This reduces chances that surgery might be needed to remove nerve pressure caused by protruding disc cartilage. Many people get along quite well with one or more degenerated discs. If you should develop pain, numbness, or weakness in one of your legs, however, you should see an orthopedist or a neurologist for an evaluation.

Since six weeks of manipulation has not provided relief for your back pain, it might be a good idea to discontinue such treatment and see how you get along. Excessive manipulation could very well aggravate a degenerated disc or "chip away" your disc space. Massage and physical therapy might help relieve your symptoms. If symptoms persist, see an orthopedist for an evaluation. Since you have been given misleading information by the first two chiropractors you have seen, it might not be a good idea to see a third chiropractor for another opinion.

If your back quits bothering you, leave it alone. Don't worry about the "abnormal" curves in your neck and back. Such deviations from normal rarely cause a problem. There is no reason to believe that "blocked spinal nerves" can cause infertility. Nor is there any reason to believe that neck manipulation will relieve or prevent low-back pain.

The Chiropractor's Self-Help Back and Body Book, which I wrote, might provide the "solid guidelines" you are looking for.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This article was posted on December 12, 2004.