When a patient walks into your clinic after a car accident complaining of radiating back pain, numbness, or limited mobility, one of your first clinical suspicions may be a herniated disc. As a chiropractor, you know how disruptive—and often misunderstood—these injuries can be. From a legal and medical standpoint, herniated discs play a central role in personal injury claims, and the treatment pathway chosen can dramatically influence not only the patient’s outcome, but also the value of their case. The tension between conservative chiropractic treatment and surgical intervention is a topic both providers and legal professionals must navigate carefully.
Understanding the Injury
A herniated disc occurs when the nucleus pulposus (the gel-like center of the spinal disc) protrudes through the outer annulus fibrosus, often impinging on nearby nerves. The most common locations are the lumbar and cervical spine, regions frequently affected in car accidents due to whiplash, seatbelt pressure, or torsional forces.
Symptoms may include:
- Localized or radiating pain
- Numbness or tingling
- Muscle weakness
- Limited range of motion
MRI imaging is typically used to confirm the diagnosis, but your initial evaluation, orthopedic testing, and clinical notes are essential for identifying the need for further diagnostics.
The Chiropractic Pathway: Conservative but Powerful
Many patients with herniated discs benefit from non-invasive care, particularly in the early stages. Chiropractic treatment may include spinal adjustments, decompression therapy, soft tissue techniques, and rehabilitative exercises. This conservative approach appeals to many patients who want to avoid surgical risks and long-term opioid use.
From a legal perspective, conservative care also shows the court or insurance carrier that the patient attempted to manage their injury with the least invasive means first. It establishes a record of pain, functional impairment, and good faith efforts to recover without surgical escalation.
Your role as a chiropractor is not only to treat, but to document. Detailed SOAP notes, objective measures, and treatment timelines are critical in establishing the legitimacy and severity of the injury in court or settlement negotiations.
When Surgical Intervention Becomes Necessary
Not all disc herniations respond to conservative care. In cases where symptoms persist beyond 6–12 weeks, or neurological deficits worsen, surgical consultation may become appropriate. Procedures like microdiscectomy or spinal fusion may be considered, especially when there is evidence of nerve compression or spinal instability.
From a legal standpoint, surgical intervention often increases the perceived seriousness of the injury. It raises both the value of the claim and the level of scrutiny from defense attorneys. Questions will arise: Was surgery necessary? Were conservative options exhausted? Were the symptoms truly related to the accident?
This is where your chiropractic records become invaluable. If you provided care prior to the surgical referral, your documentation will help prove that surgery wasn’t a first resort, but a medically appropriate escalation of care. It helps refute arguments that the surgery was unnecessary or unrelated to the crash.
Collaborative Care and Legal Success
In many cases, the best outcomes—both medically and legally—come from a multidisciplinary approach. Chiropractors, pain management physicians, orthopedic surgeons, and physical therapists can work together to guide the patient from diagnosis to resolution.
