Can a Chiropractor Help a Herniated Disc? What the Research Says

If you've just been told you have a herniated disc, you're probably dealing with two things at once: real pain, and a lot of questions. Will this heal on its own? Do I need surgery? Is it even safe to see a chiropractor with a disc injury?

I've been asked these questions for nearly 50 years in practice, and I've treated thousands of patients with disc problems here in Sioux Falls. My answer is honest: for many people, yes, chiropractic care can help a herniated disc. It isn't the right answer for everyone, and I'll tell you exactly when it isn't. But the research on conservative, non-surgical care is more encouraging than most people expect.

Let me walk you through what the studies actually show, why the type of chiropractic care matters so much with a disc injury, and how we approach herniated discs at Back Specialists.

The Short Answer

Most herniated discs improve without surgery. Medical guidelines recommend starting with conservative, non-drug care for most back pain. Chiropractic care is one of those conservative options, and studies of patients with MRI-confirmed disc herniations show a large majority reporting meaningful improvement.

The catch is that not all chiropractic care is the same. When a disc is irritated and the surrounding muscles are guarding, the last thing it needs is twisting or forceful cracking. That's why I've built my entire practice around the gentle, precise Activator Method.

What a Herniated Disc Actually Is

Your spine has cushioning discs between each vertebra. Each disc has a tough outer ring and a softer, gel-like center. A herniation happens when part of that inner material pushes through a weakened spot in the outer ring. If it presses on or irritates a nearby nerve, you can feel pain, numbness, tingling, or weakness that travels down an arm or leg.

Herniated discs are often confused with bulging discs, but they are not the same thing. I explain the difference in detail in Herniated Disc vs. Bulging Disc: What's the Difference?

In the lower back, a herniated disc is one of the most common causes of sciatica. In the neck, it can cause pain, numbness, or weakness into the shoulder, arm, and hand.

What the Research Says

I want to be careful here. Plenty of websites overstate what chiropractic can do. I'd rather give you the evidence straight and let you decide.

Most Herniated Discs Improve on Their Own Over Time

This surprises a lot of patients. A 2015 systematic review published in Clinical Rehabilitation (Chiu et al.) looked at how often lumbar disc herniations shrink or disappear without surgery. The overall rate of spontaneous regression was about two out of three. The larger, more severe herniations, the ones that look the scariest on an MRI, actually had the highest rates of regression.

That matters because it means the goal of conservative care is often to reduce pain, protect function, and support the body while this natural healing process happens.

Surgery and Conservative Care Often End Up in Similar Places

Two of the most cited studies on this question are the Weber study (Spine, 1983) and the Spine Patient Outcomes Research Trial, known as SPORT (JAMA, 2006).

Weber found that surgical patients did somewhat better at one year, but by the four and ten year marks, the difference between surgical and non-surgical patients was no longer significant. SPORT found that patients in both the surgical and non-surgical groups improved substantially over two years.

Surgery absolutely has its place, and I'll cover that below. But for many patients without serious neurological signs, starting conservatively is a reasonable, well-supported choice. I cover this decision in more depth in Considering Back Surgery? Try Chiropractic First.

Chiropractic Care for MRI-Confirmed Disc Herniations

A 2014 study in the Journal of Manipulative and Physiological Therapeutics (Leemann et al.) followed 148 patients with MRI-confirmed lumbar disc herniations who received chiropractic care. About 90% of patients reported clinically relevant improvement at three months, and 88% at one year. Importantly, this included patients with chronic symptoms, not just new injuries, and no serious adverse events were reported.

This was an observational study, not a randomized trial, so it can't prove chiropractic care alone caused the improvement. But it's meaningful evidence that chiropractic care for disc herniation is both well tolerated and associated with strong outcomes.

Medical Guidelines Recommend Starting Conservatively

In 2017, the American College of Physicians published guidelines in the Annals of Internal Medicine recommending that most patients with low back pain begin with non-drug, non-surgical treatments, with chiropractic care among the recommended options. Medications and more invasive procedures are generally reserved for when conservative care hasn't helped.

An MRI Doesn't Always Explain Your Pain

A 2015 review in the American Journal of Neuroradiology (Brinjikji et al.) looked at spinal MRIs in people with no back pain at all. Disc bulges and protrusions were extremely common, and they became more common with age. Many people walking around Sioux Falls today have disc findings on an MRI and feel perfectly fine.

That's why I never treat an MRI report alone. I treat the person in front of me, and I use a careful exam to figure out what is actually driving their symptoms.

Where the Activator Method Fits

The Activator Method is the most widely researched instrument-assisted chiropractic technique in the world, and it is Medicare-approved. In fairness, large randomized trials looking specifically at the Activator Method for disc herniation are limited, and much of the published work is case reports and smaller studies. What the broader research does support is that conservative care works for most disc patients, and that gentle approaches are well tolerated. The Activator Method gives us a way to deliver that care precisely, without adding stress to an already irritated disc.

Why Gentle Matters When a Disc Is Injured

When a disc herniates, the muscles around it tighten up to protect the area. That guarding is your body's way of saying, "Don't move this." Twisting the spine or forcing a joint through that protective tension is exactly what a lot of disc patients fear, and honestly, it's the reason many of them avoided chiropractors for years.

The Activator Method works differently. It's a gentle, instrument-assisted, low-force adjustment. There's no twisting, no cracking, and no high-velocity manipulation. The instrument delivers a quick, precise impulse to a specific point on the spine. It fires faster than muscles can react, so your body doesn't have time to tense up against it.

For disc patients, that combination of precision and low force is the whole point. We can address how the spine is moving without loading the injured disc. Many of my patients tell me their first adjustment was nothing like what they expected, and I hear it often: "That's it?"

How Back Specialists Handles a Herniated Disc

A Thorough Exam and Imaging Review

Every disc case starts with a detailed history and exam. We check reflexes, strength, sensation, and how your symptoms respond to specific tests. If you have an MRI or X-rays, bring them. I've completed more than 1,700 hours of post-graduate training in X-ray, and I review imaging personally.

Precise Activator Adjustments

Both my son, Dr. Sean Hagen, and I are Advanced Proficiency Rated in the Activator Method, the highest credential available through Activator Methods International. I'm one of only five doctors in the Sioux Empire with that rating, and together Sean and I are the only father-son Advanced Proficiency Rated Activator team in the region. Back Specialists is the only 100% Activator Method clinic in Sioux Falls. Every adjustment we give uses this approach.

Honest Progress Tracking

We re-check your symptoms and neurological signs as care progresses. If things are improving, great. If they aren't improving the way they should, I'll tell you, and we'll talk about what comes next. That might mean additional imaging or a referral to a specialist.

Working With Your Medical Team

Many of my disc patients are also seeing their primary care provider, a physical medicine doctor, or a spine surgeon. I'm happy to coordinate. Good disc care is a team effort, and I have no interest in being the only voice in your recovery.

People sometimes ask why I'm still doing this after nearly 50 years. The answer hasn't changed: "I wanted to be the guy who provided relief, one person at a time. I wake up every day thankful that I have been blessed with my health and am still thrilled to drive to work and care for my patient family."

When a Chiropractor Is Not the Right Answer

We're not the right fit for everyone, and that's especially true with disc injuries. Please seek emergency medical care right away if you have:

• Loss of bladder or bowel control, or new difficulty urinating

• Numbness in the groin, inner thighs, or buttocks (sometimes called "saddle" numbness)

• Rapidly worsening weakness in a leg or foot, such as foot drop

• Back pain with fever, unexplained weight loss, or a history of cancer

These can signal serious conditions such as cauda equina syndrome that need immediate medical attention and sometimes urgent surgery. If I see any of these signs during an exam, I'll refer you out the same day. Knowing when not to treat is part of being a good chiropractor. I wrote more about this in Chiropractic Red Flags.

If You're Considering Surgery, or You've Already Had One

Some patients come to me after a surgeon has said surgery is an option but not urgent. In those cases, a trial of conservative care first often makes sense, and many of those patients never end up needing the operation.

Other patients come to me after surgery, still hurting. Unfortunately, this is common enough that it has a name: Failed Back Surgery Syndrome. Post-surgical spines are exactly the kind of complex cases where a gentle, low-force approach matters most. Twisting a spine that has been fused or operated on is not something I would ever do, and with the Activator Method, it's never part of the equation.

If that's where you are, read Why Am I Still in Pain After Back Surgery? You may have more options than you've been told.

Herniated Discs After Car Accidents and Work Injuries

Disc injuries are common after car accidents and on-the-job injuries. A disc can be damaged in a rear-end collision or while lifting on the job, and symptoms sometimes don't show up for days.

I've completed the Whiplash Masters Program along with post-graduate training in cervical trauma, accident reconstruction, personal injury, and AMA impairment rating. We document injuries thoroughly, work with attorneys, and we know the claims process cold. We accept PIP, MedPay, at-fault liability, and Workers' Compensation. Learn more on our whiplash and auto accident page and our work injury page.

Frequently Asked Questions

Can a chiropractor put a herniated disc back in place?

No, and I'd be cautious of anyone who says they can. A disc isn't something that pops in and out. What chiropractic care can do is improve how the spinal segments around the disc move, reduce irritation, and support your body while the disc heals, which research shows most herniations do over time.

Is it safe to see a chiropractor with a herniated disc?

For most patients without emergency warning signs, yes. The Activator Method is gentle and low-force, with no twisting or cracking, which makes it well suited to irritated discs. A thorough exam comes first, and if anything suggests you need a different kind of care, I'll refer you.

How long does it take to feel better?

It varies with the size and location of the herniation, how long you've had symptoms, and your overall health. Many patients notice changes within the first few weeks, while full recovery can take longer. I'll give you an honest estimate after your exam and adjust it based on how you respond.

Do I need an MRI before I come in?

Not necessarily. Many patients start care without one. If your exam shows significant neurological signs, or you aren't improving as expected, I'll recommend imaging. If you already have an MRI, bring the report and images to your first visit.

Can you help a herniated disc in the neck?

Yes. We treat both cervical (neck) and lumbar (low back) disc herniations. Neck disc problems often cause pain, numbness, or tingling into the shoulder, arm, or hand. Learn more on our neck pain page and our low back pain page.

Does insurance cover chiropractic care for a herniated disc?

In many cases, yes. We're in-network with Avera, Sanford, BCBS, DakotaCare, Wellmark, Medicare Part B, and ChiroHealth USA. The Activator Method is Medicare-approved. For coverage questions, call our office at 605-361-1700 or visit our insurance information page.

Find Out if Gentle Activator Care Is Right for Your Disc

A herniated disc diagnosis doesn't automatically mean surgery, and it doesn't mean you have to live with the pain. The research supports starting conservatively, and our approach is built for exactly the kind of spine that needs a gentle touch.

If you're in Sioux Falls and want an honest opinion about whether we can help, I'd be glad to meet you. If we're not the right fit, I'll tell you that too.

Schedule your new patient visit with Dr. Bruce Jon Hagen or Dr. Sean Hagen, or call us at 605-361-1700.

Back Specialists, 5109 S Crossing Place, Suite 1, Sioux Falls, SD 57108