by Dr. Max Widmer, Chiropractor

1 = First lumbar vertebra body 2 = Disc L1/L2 3 = Leg nerve 4 = Disc herniation L3/L4 right

It is probably not a coincidence that today a 35-year-old businessman who designs and builds kitchens came to me for a consultation. Mr. "X" has been coming for treatment since 1984 because of recurring backaches, i.e. "lumbago" and "sciatica". Since (*) a fourth computer tomography was performed on this patient yesterday, I would like to explain the diagnosis based on the following chronology:

• 1984: The first CT (computer tomography) was made of the last two discs and two disc protrustions were diagnosed. (Protrusions are discs which bulge outwards and/or to the side into the vertebral canal.)
  Assessment: A relatively harmless and almost everyday finding.
  
  
• 1990: Another CT was made of the last two discs. This time the diagnosis was less encouraging, considering that a disc herniation of the last disc (L5/S1) was discovered. Since it did not respond to therapy, it was operated in 1991.
  Assessment: The decision to operate was made because all conservative measures remained unsuccessful.
  
  
• 1993: This time a CT was made not only of the last two, but for the first time also of the third last lumbar disc (L3/L4). Diagnosis: A new disc herniation of the second to last disc (L4/L5). Also identified were a slight protrusion of the operated disc (L5/S1) as well as scar tissue.
  Assessment: This renewed disc herniation of the second to last disc was an unpleasant surprise. The question may be asked as to whether the problem was triggered by improper lifting, and/or by an instability resulting from the operation in 1991 (an instability between the sacrum on the one hand and the second to last lumbar vertebra on the other hand).
  
  
• 1998: For the first time a CT was made of the last four discs. The first very big and rather unpleasant surprise was the discovery of two new disc herniations on the level of L3/L4 and again on L5/S1which had been operated on in 1991! On the other hand, we were happy to note that the DHL4/L5 discovered in 1993 had completely disappeared!

The yellow numbers refer to the cervical vertebrae C2 - C6

This example proves that a disc herniation can cure itself and that operating a disc herniation is not always a promising solution.
Before operating a disc herniation, it is wise to undergo an examination by a qualified and experienced chiropractor, and depending on the resulting diagnosis, to obtain a second opinion from an orthopedic surgeon or a neurosurgeon. A therapeutic alternative certainly also means well-coordinated teamwork between chiropractor and a medical doctor, respectively between a medical doctor and chiropractor.
In the above example, cooperation between chiropractor and medical doctor functioned well. There are times when I can help patients using various chiropractic techniques but other situations may call for different methods, such as drug treatment by a medical doctor. Another very important influence is the disc herniation patient’s frame of mind, i.e. his or her emotional intelligence. When the patient faces the problem optimistically, with hope for recovery, this attitude can positively influence the course of recovery. Furthermore, there are cases in which patients have been relieved of pain using acupuncture. In addition, walking in a thermal bath can also help.

Summary: Disc herniations vary from case-to-case and can be compared to the lines in your hand - very individual. A therapy that may be good for one patient may prove useless or unsuitable for another patient. The same can be said for the course of nonoperated and operated disc herniation patients.