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Herniated Disc Treatment

Conveniently Located in Fairfax, VA
Dr. Robert J. Zapf, M.S., D.C., Chiropractic Physician
 
Former Associate Professor

Palmer College of Chiropractic

Your Conservative Treatment for Herniated Discs

A herniated disc can be painful and frustrating, but the good news is that most cases can heal naturally with the right conservative treatment. At our clinic, we specialize in non-surgical solutions that help your body recover while relieving pain and restoring function. We use a combination of proven therapies, including chiropractic manipulative therapy, spinal decompression, therapeutic exercise, electric muscle stimulation, therapeutic ultrasound, and shortwave diathermy.

Hikers on a mountain trail enjoying their healthy backs

Why Choose Our Conservative Treatment for a Herniated Disc?
 

You may think surgery is your only option for a herniated disc, but research shows that non-surgical treatments can be just as effective for most cases. Our conservative approach:

  • Reduces pain naturally without the risks of surgery or long-term medication use.

  • Supports the body’s natural healing process for lasting relief.

  • Restores mobility and function so you can get back to your daily activities.

Understanding a Herniated Disc

A herniated disc occurs when the soft inner core of a spinal disc pushes through the tough outer layer, often pressing on nearby nerves. This can happen in the cervical spine (neck) or lumbar spine (lower back), causing pain, numbness, weakness, and reduced mobility. However, with the right approach, your body can heal naturally in stages.

Disc Herniation Diagram Compared to a Healthy Spine
Patient receiving herniated disc treatment

Causes and Symptoms of Herniated Discs

Common Causes:

  • Aging and natural wear and tear

  • Repetitive stress or heavy lifting

  • Sudden trauma or injury

  • Poor posture and spinal misalignment

Symptoms:

  • Localized pain in the lower back or neck

  • Numbness, tingling, or weakness in the legs or arms

  • Sciatic pain radiating down one leg (if the sciatic nerve is affected)

  • Increased pain with sitting, bending, or sneezing

How Your Body Heals a Herniated Disc

Your body goes through three key healing stages when recovering from a herniated disc: inflammation, repair, and remodeling. Our treatment modalities support each stage to optimize your recovery.

 

 

 

Stage 1: Inflammation (0-3 Weeks)

 

 

What Happens?

Your body reacts to the injury by increasing blood flow to the area, which can cause swelling and pain. Inflammatory cells, such as macrophages, help clear out damaged tissue, while cytokines signal the start of the healing process.

Collagen and Cellular Changes:

  • Inflammatory cells break down damaged extracellular matrix components.

  • Type III collagen begins forming as a temporary framework for early tissue repair.

  • Fibroblasts start migrating to the injured area to lay down new structural proteins.

 

How We Help:

  • Chiropractic Manipulative Therapy – Gentle adjustments help realign the spine, reducing mechanical stress and promoting better blood circulation, which enhances the inflammatory response.

  • Electric Muscle Stimulation (EMS) – Uses mild electrical currents to relax muscle spasms, improve oxygenation, and stimulate cellular activity to accelerate early tissue repair.

  • Shortwave Diathermy – A deep-heating therapy that increases blood flow, promoting macrophage activity and fibroblast migration for effective tissue breakdown and rebuilding.

  • Therapeutic Ultrasound – Uses sound waves to reduce inflammation, increase fibroblast proliferation, and enhance early collagen synthesis.

  • Spinal Decompression Therapy – A specialized treatment that gently stretches the spine to relieve pressure on the affected disc. This therapy creates negative pressure within the disc, allowing bulging material to retract, reducing nerve compression and promoting nutrient flow. This enhances collagen remodeling and hydration.

  • Passive Therapy - Passive therapy uses things like heat, ice, massage, or electrical stimulation to help relieve pain or improve movement, with the patient mostly resting and not actively participating.

 

 

 

Stage 2: Repair (2-6 Weeks)

 

 

What Happens?

The body begins rebuilding damaged tissues by producing more collagen and restoring structural integrity. Fibroblasts continue laying down new connective tissue, replacing the weaker Type III collagen with stronger Type I collagen.

 

Collagen and Cellular Changes:

  • Type III collagen is gradually replaced by Type I collagen, which is stronger and more durable.

  • Fibroblasts increase in number and activity, forming a dense collagen matrix.

  • Increased proteoglycan production helps retain water and improve disc hydration.

 

How We Help:

  • Spinal Decompression Therapy – A specialized treatment that gently stretches the spine to relieve pressure on the affected disc. This therapy creates negative pressure within the disc, allowing bulging material to retract, reducing nerve compression and promoting nutrient flow. This enhances collagen remodeling and hydration.

  • Chiropractic Manipulative Therapy – Improves spinal alignment to reduce strain on healing tissues, allowing fibroblasts to lay down collagen in a more organized manner.

  • Therapeutic Ultrasound & Shortwave Diathermy – Enhance tissue healing by stimulating fibroblast activity, improving the organization of new collagen fibers, and reducing scar tissue formation.

  • Active Therapeutic Exercise - Active therapy involves the patient doing exercises or movements—like stretching, strengthening, or balance training—to take a hands-on role in their recovery.

 

 

 

Stage 3: Remodeling (6+ Weeks)

 

 

What Happens?

New tissues strengthen, and the body adapts to normal movement patterns. The newly formed Type I collagen fibers realign along stress lines, increasing tensile strength and durability of the healed tissue.

 

Collagen and Cellular Changes:

  • Collagen fibers mature, thickening and aligning according to mechanical forces.

  • Fibroblasts decrease in activity as the tissue stabilizes.

  • Proteoglycan levels normalize, maintaining disc hydration and elasticity.

 

How We Help:

  • Therapeutic Exercise – Strengthens the muscles that support your spine, improving stability and flexibility. Loading the tissues through movement encourages collagen cross-linking and proper fiber orientation, enhancing overall resilience.

  • Chiropractic Manipulative Therapy – Ensures proper alignment to maintain optimal biomechanical stress on the spine, preventing excessive scar tissue formation and facilitating long-term disc health.

  • Spinal Decompression Therapy – Continues to hydrate and decompress the discs, reducing residual pressure and maintaining healthy proteoglycan levels, which support disc elasticity and durability.

Frequently Asked Questions About Herniated Discs

FAQ 1: Is chiropractic safe for herniated discs?

Yes. Chiropractic care, when appropriately applied by a trained clinician, is widely recognized as safe and effective for herniated discs.¹⁰,¹¹ Our approach is gentle, evidence-based, and tailored to your specific disc type and location.

Research shows the risk of chiropractic manipulation causing a clinically worsened disc herniation is less than 1 in 3.7 million.¹² In contrast, surgery carries risks of infection, nerve damage, and complications.

We use precise, low-force techniques specifically designed for disc conditions. You're in experienced hands.

FAQ 2: Will my herniated disc heal without surgery?

Most likely, yes. Research consistently shows that 66-67% of herniated discs spontaneously shrink (resorb) with conservative treatment.¹,² This phenomenon is well-documented on repeat MRI imaging.

The larger and more severe the herniation (extrusions and sequestrations), the more likely it is to naturally resorb because these trigger stronger healing responses.²,⁴

With proper conservative treatment—including chiropractic care, targeted exercise, and rehabilitation—most patients experience significant improvement within 4-12 weeks.⁵,⁸

FAQ 3: How long until I feel better?

Most patients experience noticeable pain reduction within 1-3 weeks of starting treatment.⁵,⁸ Significant functional improvement typically occurs within 4-8 weeks.

Complete resolution varies based on:

  • Disc type and severity (extrusions often heal faster than protrusions)

  • Duration of symptoms before treatment (earlier = faster)

  • Your consistency with home exercises

  • Overall health and age

  • Presence of other spinal conditions

Typical timelines:

  • Mild herniation: 4-6 weeks to major improvement

  • Moderate herniation: 6-10 weeks to major improvement

  • Severe or chronic herniation: 8-16 weeks to major improvement

We provide a personalized timeline after reviewing your MRI and examination findings.

FAQ 4: Do I really need an MRI?

For herniated disc cases, yes—MRI is the gold standard for diagnosis. Here's why:

MRI allows us to:

  • Confirm the presence, location, and type of herniation

  • Determine severity (bulge, protrusion, extrusion, sequestration)

  • Identify nerve compression and which nerve is affected

  • Rule out serious conditions (tumors, infections, fractures)

  • Create a targeted, effective treatment plan

  • Track healing progress with follow-up imaging

X-rays alone cannot show disc herniations—only MRI or CT can visualize soft tissues.¹³

If you don't have recent MRI (within 3-6 months), we'll discuss ordering one or can refer you for imaging if needed.

FAQ 5: What will treatment feel like?

Our herniated disc treatment is gentle and designed for your comfort:

  • Spinal manipulation - Controlled, low-force adjustments. You may hear a "pop" (gas release), but it's not painful. Most patients feel immediate relief.

  • Flexion-distraction - A specialized table gently stretches your spine. Feels like a gentle rocking motion. Very comfortable.

  • Soft tissue therapy - Similar to deep massage. Releases muscle tension.

  • Therapeutic modalities - Electrical stimulation (gentle tingling sensation), ice/heat (soothing), ultrasound (you feel nothing).

  • Exercises - Targeted stretches and movements you can do at home.

Most patients describe treatment as relaxing. Temporary soreness (like after a workout) can occur in the first few sessions but resolves quickly.¹⁰,¹¹

FAQ 6: How often will I need to come in?

Visit frequency depends on disc severity, but typically:

Weeks 1-3: 2-3 times per week
Intensive pain relief and inflammation control phase. Frequent visits help accelerate healing.

Weeks 4-8: 1-2 times per week
Rehabilitation and strengthening phase. Less frequent as you improve.

Weeks 8+: As-needed or maintenance
Periodic visits for monitoring and prevention, or discharge if fully recovered.

Most herniated disc patients require 12-20 visits over 8-12 weeks.¹⁴ We also provide home exercises you perform daily to speed recovery.

Your specific schedule will be determined after your initial evaluation.

FAQ 7: What if I've had symptoms for months or years?

Chronic herniated discs (symptoms lasting 6+ months or years) are more challenging but absolutely treatable.¹⁵

The longer symptoms persist, the more changes occur in:

  • Nerve sensitivity (central sensitization)

  • Muscle weakness and atrophy

  • Movement patterns and compensations

  • Psychological factors (fear of movement, anxiety)

However, research shows that even chronic disc herniations respond well to comprehensive conservative treatment.¹⁵ It simply takes longer—often 12-20 weeks instead of 6-10 weeks.

We've successfully treated many patients with chronic disc herniations who avoided surgery.

FAQ 8: Will my herniated disc come back?

Recurrence risk exists but is significantly reduced when treatment includes:

✓ Core stabilization - Strengthening deep spinal muscles that protect discs. Research shows this reduces recurrence.⁹,¹⁶
✓ Proper movement mechanics - Learning how to lift, bend, and move safely
✓ Postural correction - Addressing positions and habits that stress discs
✓ Ongoing exercise - Maintaining strength and flexibility long-term

Studies show that exercise-based rehabilitation reduces recurrence rates of disc-related back pain by approximately 50%.¹⁶

Our approach treats the root cause—not just symptoms—so recurrence is uncommon. Most of our successfully treated herniated disc patients remain pain-free long-term.

REFERENCES 

  1. Zhong M, Liu JT, Jiang H, et al. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Pain Physician. 2017;20(1):E45-E52. PMID: 28072796.

  2. Macki M, Hernandez-Hermann M, Bydon M, et al. Spontaneous resorption of herniated lumbar discs: illustrative cases. J Neurosurg Case Lessons. 2025;10(3):CASE25116.​

  3. Houweling TAW, Braga AV, Hausheer T, et al. Association between chiropractic spinal manipulation and lumbar discectomy in adults with lumbar disc herniation and radiculopathy: retrospective cohort study using United States' data. BMJ Open. 2022;12(12):e068262.​

  4. Ruan J, Wang C, Ma C, et al. Prediction and Mechanisms of Spontaneous Resorption in Lumbar Disc Herniation: A Narrative Review. World Neurosurg X. 2024;21:100235.​

  5. Jacobs WCH, van Tulder M, Arts M, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245-2256.

  6. Gugliotta M, da Costa BR, Dabis E, et al. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. 2016;6(12):e012938.​

  7. Schoenfeld AJ, Weiner BK. Treatment of lumbar disc herniation: Evidence-based practice. Int J Gen Med. 2010;3:209-214.​

  8. Huang W, Qin X, Li J, et al. Recent advances and evolving strategies in the treatment of lumbar disc herniation. Front Neurol. 2025;16:1706784.​

  9. Wang XQ, Zheng JJ, Yu ZW, et al. A Meta-Analysis of Core Stability Exercise versus General Exercise for Chronic Low Back Pain. PLoS ONE. 2012;7(12):e52082.

  10. Trager RJ, Daniels CJ, Laryea D, et al. Association between chiropractic spinal manipulation for sciatica and opioid-related adverse drug events. PLoS ONE. 2025;20(1):e0317663.

  11. Rubinstein SM, de Zoete A, van Middelkoop M, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain. BMJ. 2019;364:l689.

  12. Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004;27(3):197-210.​

  13. Stable MR, de Vet HCW, Pijl HB, et al. Magnetic resonance imaging for diagnosing lumbar spinal pathology in adult patients. Eur Spine J. 2012;21(2):220-227.

  14. Haas M, Groupp E, Kraemer DF. Dose response for chiropractic care of chronic low back pain. Spine J. 2004;4(5):574-583.

  15. Ahmad H, Farhan M, Farooq MU, et al. Surgical vs. Conservative Management of Chronic Sciatica: A Systematic Review. Cureus. 2024;16(5):e59648.

  16. Choi BKL, Verbeek JH, Tam WWS, Jiang JY. Exercises for prevention of recurrences of low-back pain. Cochrane Database Syst Rev. 2010;(1):CD006555.

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