For individuals experiencing back pain from a herniated disc, can understanding the difference between surgery and chiropractic help individuals find the right treatment plan?

Managing Back Pain: Exploring Surgery and Chiropractic

Surgery or Chiropractic

Living with back pain can be a nightmare, and yet many struggle without seeking care. Today, there are a vast number of surgeries and noninvasive techniques that are better at treating spine and back problems and managing symptoms. For individuals who may have a herniated disc or are curious about ways to relieve their back pain, a health care provider, physical therapist, spine specialist, and chiropractor can inform them of treatment options. Surgery and chiropractic therapy are popular treatments for a herniated, bulging, or slipped disc.

  • A herniated disc is when the cartilage discs that cushion the vertebrae shift out of position and leak out.
  • Surgery for a herniated disc involves removing or repairing the disc.
  • Chiropractic nonsurgically repositions the disc and realigns the spine.
  • Both treatments have the same goals with key differences.

Chiropractic Care

Chiropractic is a system of therapy that focuses on adjusting and maintaining spinal alignment to help with back and posture problems. Chiropractors are trained and licensed medical professionals who take a nonsurgical approach, a proven therapy for chronic pain, flexibility, and mobility issues.

The Way It Works

Chiropractic treatment encourages and supports the body’s natural healing processes. It is considered for joint pain in the back, neck, legs, arms, feet, and hands. It typically involves sessions in which the chiropractor physically and carefully adjusts the vertebrae by hand, also known as spinal manipulation or chiropractic adjustments. (MedlinePlus. 2023). A chiropractor performs a thorough medical evaluation and runs tests to establish a diagnosis. A chiropractor will develop a treatment plan that may involve a team of massage and physical therapists, acupuncturists, health coaches, and nutritionists to treat affected areas with various techniques, recommend targeted exercises, adjust lifestyle and nutrition to support the treatment, and monitor progress. Combined with stretching and sustained pressure, the multiple methods can increase joint mobility and relieve pain symptoms. (National Center for Complimentary and Integrative Health. 2019) Added protocols to support or enhance chiropractic therapy include:

  • Heating and ice therapies to reduce inflammation and increase blood circulation.
  • Using devices to stimulate muscles and nerves electrically.
  • Developing relaxation and deep breathing techniques.
  • Incorporating exercises to promote rehabilitation.
  • Establishing a regular fitness routine.
  • Making adjustments to diet and lifestyle.
  • Taking certain dietary supplements.

Spinal manipulation and chiropractic adjustments have been shown to improve symptoms and restore mobility in cases of chronic back pain. One review found that individuals with chronic lumbar/low back pain reported significant improvement after six weeks of chiropractic treatment. (Ian D. Coulter et al., 2018)


The out-of-pocket expenses of chiropractic treatment depend on a variety of factors.
Insurance may or may not cover the treatment, and the amount an individual has to pay can vary based on the severity of their case, what their plan covers, and where they live. One review found the cost can range between $264 and $6,171. (Simon Dagenais et al., 2015)


There is a range of minimally invasive surgical procedures to treat herniated discs. These work to ease nerve compression by removing or replacing damaged discs or stabilizing the vertebrae, relieving pain and inflammation.

The Way It Works

A herniated disc can happen in any part of the spine but is more common in the lower back/lumbar spine and in the neck/cervical spine. Surgery is recommended when: (American Academy of Orthopaedic Surgeons. 2022)

  • More conservative treatments, like medications and physical therapy, are unable to manage symptoms.
  • The pain and symptoms impact daily life and functioning.
  • Standing or walking becomes difficult or impossible.
  • The herniated disc causes difficulty walking, muscle weakness, and bladder or bowel control loss.
  • The individual is reasonably healthy, without infection, osteoporosis, or arthritis.

Specific surgical procedures used include:

Fusion Surgery

  • Spinal fusion is the most common procedure for a lower back herniated disc.
  • It involves using artificial bone material to fuse vertebrae to increase stability and release and prevent nerve irritation and compression. (American Academy of Neurological Surgeons. 2024)

Laminotomy and Laminectomy

  • Herniated disc symptoms appear from compression placed on the nerves.
  • Laminotomy involves making a small cut in the lamina, or the arch of the spinal vertebrae, to release the pressure.
  • Sometimes, the entire lamina is removed, known as a laminectomy. (American Academy of Neurological Surgeons. 2024)


  • Discectomy, also known as microdiscectomy, can be performed on the lumbar or cervical spine.
  • The surgeon accesses the affected disc through a small incision and removes portions of the disc. (American Academy of Orthopaedic Surgeons. 2022)

Artificial Disc Surgery

  • Another approach involves implanting an artificial disc.
  • This is most often used for hernia in the lower spine; the worn or damaged disc is removed, and a specialized prosthetic replaces the removed disc. (American Academy of Orthopaedic Surgeons. 2022)
  • This allows for more mobility.

The success of herniated disc surgery depends on different factors. Advances in minimally invasive techniques have significantly improved long-term outcomes, with one review finding that around 80% reported good—excellent results at a six-year follow-up. (George J. Dohrmann, Nassir Mansour 2015) However, there is the possibility of recurrence. About 20% to 25% of individuals with herniated lumbar discs experience re-herniation at some point. (American Academy of Neurological Surgeons. 2024)


  • Surgery for a herniated disc is specialized, and the costs depend on the scope and scale of the treatment.
  • The individual’s specific insurance plan also determines the expenses.
  • The typical costs of surgery range between $14,000 and $30,000. (Anna N A Tosteson et al., 2008)

Choosing Treatment

When choosing between chiropractic and surgery for a herniated disc, a number of factors can determine the decision, including:

  • Chiropractic is the less invasive nonsurgical option.
  • Chiropractic adjustments cannot help certain severe cases of herniated discs.
  • Chiropractic adjustments prevent the herniated disc from getting worse and ease symptoms.
  • Surgery provides pain and symptom relief faster than chiropractic or conservative treatment but requires significant recovery time and is expensive. (Anna N A Tosteson et al., 2008)
  • Surgery may not be appropriate for individuals with osteoarthritis or osteoporosis.

Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with surgery. Generally, surgery is only recommended when noninvasive methods haven’t been able to stop or manage the pain and symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.

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MedlinePlus.MedlinePlus. (2023). Chiropractic. Retrieved from

National Center for Complimentary and Integrative Health. (2019). Chiropractic: in depth. Retrieved from

Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society, 18(5), 866–879.

Dagenais, S., Brady, O., Haldeman, S., & Manga, P. (2015). A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC health services research, 15, 474.

American Academy of Orthopaedic Surgeons. (2022). Herniated disk in the lower back.–conditions/herniated-disk-in-the-lower-back/

American Academy of Neurological Surgeons. Surgeons, A. A. o. N. (2024). Herniated disc.

Dohrmann, G. J., & Mansour, N. (2015). Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 24(3), 285–290.

Tosteson, A. N., Skinner, J. S., Tosteson, T. D., Lurie, J. D., Andersson, G. B., Berven, S., Grove, M. R., Hanscom, B., Blood, E. A., & Weinstein, J. N. (2008). The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine, 33(19), 2108–2115.

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The information herein on "Managing Back Pain: Exploring Surgery and Chiropractic" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Dr. Alex Jimenez
Specialties: Stopping the PAIN! We Specialize in Treating Severe Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sports Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal Mobility, Posture Control, Deep Health Instruction, Integrative & Functional Medicine, Functional Fitness, Chronic Degenerative Disorder Treatment Protocols, and Structural Conditioning. We also integrate Wellness Nutrition, Wellness Detoxification Protocols and Functional Medicine for chronic musculoskeletal disorders. We use effective "Patient Focused Diet Plans", Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols, and the Premier "PUSH Functional Fitness System" to treat patients suffering from various injuries and health problems. Ultimately, I am here to serve my patients and community as a Chiropractor passionately restoring functional life and facilitating living through increased mobility. Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training, functional medicine, and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional & Integrative Nutrition, Agility & Mobility Fitness Training and Cross-Fit Rehabilitation Systems for all ages. As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises and advanced agility treatment options. We have teamed up with the cities' premier doctors, therapist and trainers in order to provide high-level competitive athletes the options to push themselves to their highest abilities within our facilities. We've been blessed to use our methods with thousands of El Pasoans over the last 3 decades allowing us to restore our patients' health and fitness while implementing researched non-surgical methods and functional wellness programs. Our programs are natural and use the body's ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living. With a bit of work, we can achieve optimal health together, no matter the age, ability or disability.