Chiropractic/Rehabilitative management of post-surgical disc herniation: a retrospective case report.

ObjectiveTo discuss management of postsurgical lumbar disc herniation using a program of chiropractic manipulation and an active rehabilitation program.Clinical featuresThe patient was a 54-year-old Caucasian male with a history of acute low back pain and left sciatic pain down the left posterior thigh and lateral calf and numbness in the dorsum of the left foot. Prior medical intervention included treatment with steroid anti-inflammatory drugs and lumbar microdiscectomy surgery, with incomplete resolution of his symptoms. The patient was unable to walk without pain or return to normal activities of daily living. He was antalgic in flexion. His lumbar range of motion was restricted in flexion and extension. He exhibited a positive straight leg raise and exhibited foot drop on the left.Intervention and outcomeThe treatment plan and intervention consisted of patient education on proper posture and proper bending and lifting techniques. Rehabilitative exercise began in the office and progressed to home based therapy and exercises. He noticed a decrease in his signs and symptoms after seven visits. Active rehabilitation was continued with the goal of returning lumbar spinal extensor strength. He was released to home therapy and supportive chiropractic care with continued positive response.ConclusionManagement of postsurgical lumbar disc herniation with chiropractic and active rehabilitation is discussed. Spinal deconditioning and a weakness of the lumbar spinal extensor muscles appeared to be related to the patient's symptoms. Patient education on proper posture, proper lifting techniques, core stabilization exercises, active strengthening exercise and chiropractic manipulation appeared effective in this case.