Distraction manipulation reduction of an L5-S1 disk herniation.
OBJECTIVE
A computed tomography (CT)-confirmed L5-S1 disk protrusion is reported to be reduced following chiropractic adjustment, as seen on repeat CT scanning. Correlation of the CT reports with the patient's symptoms before and after manipulation is reported.


METHODS
A 38-yr-old female was treated for low back pain and right lower extremity first sacral dermatome sciatica. CT confirmed disk herniations at both the L4-L5 and L5-S1 levels were found. Motor weakness of the right gluteus maximus muscle was found and extremely tight hamstring muscles accompanying positive straight leg signs were elicited. A clinical and imaging diagnosis of an L5-S1 disk herniation was made.


RESULTS
Distraction type chiropractic manipulation, electrical stimulation, exercises, nutrition advice and low back wellness class were administered with complete relief of sciatic pain and nearly complete relief of low back pain.


CONCLUSIONS
Chiropractic distraction manipulation is an effective treatment of lumbar disk herniation, if the chiropractor is observant during its administration for patient tolerance to manipulation under distraction and any signs of neurological deficit demanding other types of care.
Cox
J M
JM
Hazen
L J
LJ
Mungovan
M
M
D000328:Adult; D002684:Chiropractic / Q000379:methods*; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D017116:Low Back Pain / Q000209:etiology*; D008159:Lumbar Vertebrae; D008349:Manipulation, Orthopedic / Q000379:methods*; D052756:Nutritional Sciences / Q000193:education; D010353:Patient Education as Topic; D012447:Sacrum; D012585:Sciatica / Q000209:etiology*; D014057:Tomography, X-Ray Computed