Herniated Disc Treatment in Clairemont
Bulging, herniated or pinched: the first visit pinpoints the level and the nerve involved, and care can begin that same visit. Call for a same-day time.
5.0 215 Google reviewsOffice hours Mon to Fri. Call ahead.
I have multiple herniated discs and hip arthritis and Yossi has helped me tremendously with both of those issues. Dr. Stein is a very good listener and is very attentive to patients' needs. Highly recommended!
Rick M.
Bulging, herniated, pinched: what the words mean
Each disc is a tough outer ring around a softer center, sitting directly in front of the nerves that leave the spine. The three words describe how far the center has pushed, and whether it has reached a nerve.
Bulging
The outer ring stretches and the disc spreads past its usual edge, shown dashed. Bulges turn up often on the scans of people with no back pain at all.
Herniated
The softer center pushes through a weak spot in the ring. It sounds severe, and many herniations never reach a nerve or cause symptoms.
Pinched nerve
The disc material reaches the nerve root beside it. That is when pain, numbness or tingling travels the nerve's path, into the leg from the low back or the arm from the neck.
Repeat-scan studies find that many herniations shrink over the following months as the body reabsorbs the material. The ones that pushed out furthest shrink most often. Care restores motion around the level and takes pressure off the nerve while that happens. More on pinched nerve versus herniated disc.
Sources: Brinjikji et al., American Journal of Neuroradiology, 2015, on disc findings in people without pain. Chiu et al., Clinical Rehabilitation, 2015, on how often herniations regress.
Low back or neck
Most herniations sit at one of two levels low in the back, or two levels midway down the neck. The nerve involved decides where you feel it.
Low backUsually L4–L5 or L5–S1
NeckUsually C5–C6 or C6–C7
Where you feel it
Where you feel itThe low back, often with pain, numbness or tingling down one leg, sometimes past the knee. Pain that travels the leg is covered on our sciatica page.
Where you feel itThe neck and the edge of the shoulder blade, often traveling down one arm into the hand.
What tends to sharpen it
What tends to sharpen itBending forward, lifting, a cough or a sneeze, and long stretches in a chair or behind the wheel.
What tends to sharpen itLooking up, or turning toward the painful side. Some people find resting a hand on top of the head eases the arm.
What the exam checks
What the exam checksReflexes at the knee and ankle, strength in the foot and toes, sensation along the leg, and how each lumbar level moves.
What the exam checksReflexes and grip in the arm, sensation in the hand, and how each neck level moves. More on numbness and tingling.
Dr. Stein helped me tremendously recover from a strained disc in my lower back. I highly recommend coming here.
Aaron P.
I had been dealing with a C7/C8 injury for about four months — constant numbness and tingling that radiated down my arms and into my hands. Dr. Stein's approach was not generic or rushed. He tailored care to what my body needed, and that consistent, personalized approach is what helped drive gradual and sustained improvement over time.
Joshua S.
Care matched to the level
Disc care is specific work. It targets the level involved, moves it in the direction it tolerates, and sets the intensity by how irritated the nerve is on the day.
- Gonstead adjustments
- Most adjustments here use the Gonstead method. Each one is aimed at a single segment, in a set direction, once the exam has located the level.
- Drop table adjustments
- A section of the table drops a short distance as the adjustment is given, so it takes less force to restore motion.
- Joint mobilization
- Slow, graded movement for a disc that is freshly irritated and an area that is guarded. It restores motion without asking more of the nerve than it can take.
- Active Release Technique (ART)
- Soft tissue work on the muscles that guard around a disc problem, such as the hip flexors and the long muscles beside the spine.
When a manual adjustment isn't the right fit for a level, the method changes to mobilization or an instrument instead.
Your first visit
Five parts, and most first visits run about twenty minutes.
History
Where it started, what sharpens it, what eases it, and any imaging or reports you already have.
Exam
Reflexes, strength, sensation and motion, level by level, to find which disc and which nerve are involved.
A plain explanation
What the exam shows, what care would involve, and roughly how often.
Care begins
When care is the right call, it starts at this visit, matched to what the exam found.
A plan for between visits
You leave knowing which positions ease it and which to avoid for now.
Before you call
Can a chiropractor help a herniated disc?
Conservative care is the usual first step for a herniated disc, and chiropractic is part of it. The North American Spine Society's clinical guideline lists spinal manipulation as an option for symptom relief when a lumbar disc irritates a nerve.
The exam decides whether your case fits. We've written more on herniated disc treatment without surgery.
Source: North American Spine Society clinical guideline, Kreiner et al., The Spine Journal, 2014.
Do I need an MRI first?
No. Bring any imaging or reports you already have. Guidelines generally reserve imaging for warning signs, or for symptoms that persist after several weeks of care. If your exam points that way, we'll tell you plainly.
What if it isn't something you should treat?
If the exam shows this isn't something we should be treating, there's no charge for the visit.
Some situations call for hospital-level evaluation first. If you're unsure, call and we'll help you route correctly.
What does it cost?
$150the first visit, including the exam and care when it's the right call
We don't bill insurance. HSA and FSA cards are accepted. Follow-up and membership rates are on our rates page.
Find out what the word means for you
Disc pain tends to set the terms: the careful way out of the car, the chair you've stopped sitting in. A first visit tells you which disc, which nerve, and what care would involve.
5450 F Clairemont Mesa Blvd, San Diego, CA 92117. Complimentary parking out front.
Office hoursPacific time
- Monday9 AM to 2 PM
- Tuesday1 PM to 6 PM
- Wednesday9 AM to 2 PM
- Thursday1 PM to 6 PM
- Friday9 AM to 1 PM
Closed Saturday and Sunday