Jeff LangmaidFounder, The Evidence Based Chiropractor

Disc Herniation? Surgery Isn’t First-Line Care

8 Apr 2026 · 1 min

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In this segment Jeff Langmaid addresses the common scenario of patients presenting with lumbar disc herniation and radiculopathy, often already having MRI evidence at L4‑L5 or L5‑S1 and prior medication use. He notes that despite many being told surgery may be needed, clinical guidelines recommend conservative, chiropractic/manual therapy as the first‑line approach for lumbar disc herniation with radiculopathy. He acknowledges that some patients recover more slowly under standard care and introduces emerging research exploring the combination of traditional manual therapy with functional magnetic stimulation (FMS) to potentially accelerate recovery.

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Each and every day you walk into your practice, I'm pretty sure you have patients coming in with disc herniations and radiculopathy, and some of them probably come in with MRIs already done that showcase to you very clearly at L4-L5, L5-S1, there's a disc herniation. Many of them probably have already tried medications. Many probably have already been told they might need surgery as the next step. But the interesting part is many of these individuals do not end up having surgery. In fact, clinical guidelines show that conservative care, chiropractic care, what you provide is the best first-line treatment for lumbar disc herniation with radiculopathy. But the big challenge is even with great care in your practice, some patients get better more slowly. And the researchers asked a very interesting question knowing this. Which is what happens if we combine traditional manual therapy with a newer technology called functional magnetic stimulation.