What Is the Best Treatment for a Herniated Disc Without Surgery? – Mira Mesa, CA

Do You Really Need Surgery for a Herniated Disc?

This is probably the question I hear more than any other when someone walks into the office with an MRI showing a herniated disc.

“Do I need surgery?”

The answer is often no.

That doesn't mean surgery is never necessary. It absolutely is in certain situations. But seeing the words “disc herniation” on an MRI does not automatically mean you need an operation.

I have looked at thousands of spinal MRIs over the years, and two people can have what sounds like the same diagnosis on paper and be dealing with completely different problems.

One person may have an L5-S1 herniation with mild back pain and no neurological symptoms.

Another may have a similar-looking disc injury but can barely sit, has burning pain into the calf and foot, is sleeping two hours at a time, and is beginning to notice weakness.

Those are not the same patient.

And they shouldn't automatically receive the same treatment.

That is why the first step is figuring out what is really going on.

Start With a No-Charge Consultation With Dr. Cassidy Boelk, DC

Patients from Mira Mesa can schedule a No-Charge, No-Obligation Consultation at The Spinal Decompression & Chiropractic Center of San Diego.

If you have an MRI, bring it.

I prefer looking at the actual MRI images whenever possible rather than only reading the radiology report.

If you don't have an MRI yet, that's okay. You do not need one just to come in and talk with me.

During the consultation we will go through things like:

• Where the pain started

• Where the symptoms travel

• Whether you have numbness, tingling, burning, or weakness

• What happens when you sit

• What happens when you walk

• Whether driving makes it worse

• Whether coughing or sneezing increases the pain

• What treatment you have already tried

• Whether you've had previous spinal surgery

• Your MRI or X-rays, if you have them

• Whether the imaging actually matches what you're feeling

• Whether I think additional evaluation or imaging is needed

• Whether Non-Surgical Spinal Decompression makes sense for your condition

Sometimes I tell someone they look like a very good candidate.

Sometimes I tell them I need more information first.

And sometimes I tell them decompression is not what I would recommend.

That's the point of the consultation.

It isn't supposed to be a sales appointment.

Call 619-298-0800 to schedule.

You can also call or text 619-884-8298.

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

www.SanDiegoBackCare.com

Live 24/7 Answering Service
Hablamos Español

Amanda Was Already Being Sent for Injections and a Surgical Evaluation

Amanda's case is a good example of why I think patients should understand their options before assuming surgery is the only path left.

Her MRI showed an extruded disc pressing on the L5 nerve.

⭐⭐⭐⭐⭐ Amanda — San Diego, CA

“Last year, I spent three months constantly going back and forth between doctor’s appointments and urgent care. The pain was unbearable—I was taking medication regularly just to get through the day. Getting out of bed was excruciating, and walking or standing felt like torture. Every step filled me with dread.

In December, my doctor finally ordered an MRI. That’s when I learned I had an extruded disc pressing on my L5 nerve, which affects the leg and foot. My doctor scheduled two follow-up appointments: one for pain management (spinal injections), and another to evaluate me for surgery.

Then I discovered spinal decompression therapy. I was thrilled to find a non-invasive alternative. I never ended up needing either of those appointments.

Now, I’m walking regularly, standing up straight—something I couldn’t do before. When I first sought help, I was so hunched over that I had to use a cane just to move forward. Because of the pain, I hadn’t exercised in months. But now, I’m doing a program called 75 hard which requires not one but 2 45-minute workouts per day, and I've even gotten back to lifting weights!

I’m so thankful I found this place. It’s conveniently located near my work, which makes it easy to fit sessions into my lunch break. Dr. Boelk and the staff are incredibly friendly and polite—it’s always a pleasure to come in.

The environment is so relaxing that I look forward to each visit. I truly thank God for leading me to this alternative. It’s made such a difference in my life.”

— Amanda, San Diego, CA

Her result is obviously her result. Nobody should read one testimonial and assume they will respond exactly the same way.

What I do think her story shows is that even a significant disc injury does not automatically mean surgery is your only choice.

So What Is the Best Nonsurgical Treatment?

There really isn't one.

And I would be cautious of anyone who tells you there is.

I've treated spinal problems for more than 22 years, and the longer I've done this, the less interested I've become in trying to force every patient into the same treatment plan.

Sometimes the best treatment is simply giving the injury time to settle down.

Sometimes physical therapy is exactly what the patient needs.

Sometimes medication helps someone get through the acute inflammatory phase.

Sometimes an epidural injection makes sense.

Sometimes decompression is a very reasonable option.

And yes, sometimes surgery is the correct answer.

The real question isn't:

“What is the best treatment for a herniated disc?”

It is:

“What is the best treatment for this herniated disc in this patient?”

That is a much better question.

One Thing I Pay Close Attention to: Where the Symptoms Go

A lot of people focus on how much their back hurts.

I pay just as much attention to where the symptoms travel.

If pain stays mostly in the low back, that tells me one thing.

If it starts in the buttock and runs down the outside of the leg into the foot, that tells me something different.

If there is numbness in a particular area of the foot or weakness in a particular muscle group, that becomes even more useful.

Nerves are fairly predictable.

When a certain lumbar nerve is irritated, there are patterns we commonly see.

That is why somebody can have relatively mild low-back pain but absolutely miserable leg pain.

The painful leg isn't necessarily where the problem started.

The nerve may be getting irritated much higher up at the spine.

Another Big Clue: Sitting

People with significant disc-related sciatica will sometimes tell me they feel better walking than sitting.

They may be able to walk around the neighborhood but can't sit through dinner.

Or they are okay standing at work but the drive home is brutal.

That gets my attention.

Sitting changes the position of the lumbar spine and places a different type of load on the discs.

Long drives can be particularly bad because you add vibration, hip flexion, and very little opportunity to change position.

One simple thing you can do if sitting is aggravating your leg pain is to stop staying in one position for hours at a time.

Get up.

Walk around.

Change position.

And be careful about aggressively stretching the hamstring just because the back of your leg feels tight.

Sometimes what feels like a tight hamstring is actually an irritated sciatic nerve, and yanking on it over and over isn't always helpful.

What About Physical Therapy?

I'm a big believer in rehabilitation.

The spine ultimately has to get stronger.

No matter what gets somebody out of pain, the long-term goal should be returning that person to normal movement.

Sitting.

Standing.

Lifting.

Walking.

Traveling.

Working.

Exercising.

Playing golf.

Surfing.

Whatever they want to get back to.

Where I sometimes see patients get frustrated is when they are trying to strengthen through an extremely irritated disc and nerve problem.

If every exercise flares the leg pain for the next 24 hours, we may need to calm the problem down first.

Then rehabilitation becomes much more productive.

It isn't always an either/or decision between decompression and rehab.

For the right patient, they can be different parts of the same process.

Where the DRX9000 Fits In

For patients who qualify, I use Non-Surgical Spinal Decompression with the DRX9000.

We exclusively use DRX9000 systems in our San Diego office.

The purpose of treatment is to apply controlled decompressive forces to the involved area of the spine while carefully monitoring how the patient responds.

But here's something I think patients should understand:

The machine itself is not the whole treatment.

I don't believe you simply put every L4-L5 herniation on the same setting.

I consider:

• The disc level

• Where the herniation is located

• The patient's body size

• Where the symptoms travel

• Treatment angle

• Starting force

• Patient positioning

• Previous response

• How irritated the nerve is

• How the patient is progressing

Those things matter.

I also want to know what the MRI looks like and whether I believe the patient should be treated at all.

“After the First Two Decompression Sessions My Sciatic Pain Was Gone”

Abel came to the office after an accident with severe low-back problems and sciatic pain running down one leg.

⭐⭐⭐⭐⭐ Abel T. — San Diego, CA

“I had really bad back problems to the point I couldn’t sleep, also had pain radiating along the sciatic nerve which ran down one leg from the lower back—caused by an accident.

I came in and talked to Dr. Cassidy about my back problems. He evaluated me and mentioned I was a good candidate for this treatment. After the first 2 decompression sessions my sciatic pain was gone and we were able to work on the root of the problem. I did a total of 24 sessions, after which I was able to start rehabilitation training to strengthen my core.

The office is super nice and the staff’s customer service is above and beyond.

Back and neck issues are horrible to live with—trust me, I know firsthand. I gained weight, took pain killers, went into depression, and had major anxiety. I’m over it now—feeling better, walking, sleeping well, and starting to have a better social life as well.

The experience for me has been nothing but excellent. Dr. Cassidy Boelk is hands down amazing—super glad I came here.”

— Abel T., San Diego, CA

I like Abel's story because it also illustrates something that is important in our office.

The goal wasn't to keep him dependent on passive treatment forever.

Once he was doing better, rehabilitation and strengthening became part of getting him back to normal life.

Why Patients From Mira Mesa Come to See Dr. Cassidy James Boelk, DC

My practice has become very specialized over the years.

I spend a large part of my day evaluating people with:

• Herniated discs

• Bulging discs

• Sciatica

• Degenerative disc disease

• Foraminal stenosis

• Spinal stenosis

• Chronic neck pain

• Chronic low-back pain

• Radiating arm or leg symptoms

My background includes:

• Certified Spinal Decompression Doctor

• Certified Pain-Free Performance Specialist

• More than 22 years of clinical experience

• More than 100,000 spinal decompression treatments performed

• Founder of the Non-Surgical Spinal Decompression Training Academy

• Founding Member of the American Spinal Decompression Society

• Member of the International Disc Education Association

• California X-Ray Radiation Supervisor & Operator

I also train other doctors in Non-Surgical Spinal Decompression protocols and techniques.

But some of the way I practice also comes from being on the patient side of this myself.

I suffered a significant low-back injury when I was younger and have dealt with both neck and back injuries over the years.

I've spent thousands of hours working on my own rehabilitation as well as helping patients get back from theirs.

That changes your perspective.

You start thinking less about what somebody's MRI is called and more about how you're going to get that person back to doing the things they care about.

Seven DRX9000 Systems in Our San Diego Office

Our office has:

• 4 lumbar DRX9000 systems

• 3 cervical DRX9000C systems

Seven total.

We use them every day.

This isn't something we added as an occasional service on the side.

Non-Surgical Spinal Decompression has been one of the primary focuses of the practice for years.

That kind of repetition matters.

You learn a lot when you have treated more than 100,000 sessions and seen how different patients respond.

You also learn when to say no.

Patients Come From Much Farther Away Than Mira Mesa

Most Mira Mesa patients have a pretty easy drive to our Kearny Mesa office.

Some of our patients travel considerably farther.

We've had patients come from other parts of California, other states, Mexico, Canada, Spain, and the United Kingdom.

Lisa travels from the UK.

⭐⭐⭐⭐⭐ Lisa S. — United Kingdom

“I travel from the UK to see Dr Boelk and his wonderful team . I have 3 bulging disc and one is touching the nerve. I have the spinal decompression treatment and it really helps keep me in my active life . I will not go to anyone else for back treatment, this place is number one and they genuinely care about their patients.”

— Lisa S., United Kingdom

Here Is the Part That Matters Just as Much: Not Everyone Gets Accepted

I wish decompression worked for everybody.

It doesn't.

More importantly, there are some people I simply should not put on a decompression table.

Examples can include certain cases involving:

• Unstable spondylolisthesis

• An unhealed spinal fracture

• Significant osteoporosis

• Abdominal aortic aneurysm

• Pregnancy for lumbar treatment

• Certain cancers

• Certain spinal hardware at the treatment level

• Progressive neurological weakness

• Cauda equina syndrome

There are also cases that don't fall neatly onto a checklist where I simply don't like what I'm seeing.

That may mean ordering additional imaging.

It may mean sending the patient back to their medical doctor.

It may mean getting a neurological or surgical opinion.

That isn't treatment failure.

That's doing what is safest for the patient.

One Patient Came All the Way From Tucson — And I Recommended Surgery

Jeff J. is a perfect example.

He found our office online and traveled from Tucson hoping there might be a nonsurgical option.

After reviewing his situation, that isn't what we decided.

⭐⭐⭐⭐⭐ Jeff J. — Tucson, AZ

“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”

— Jeff J., Tucson, AZ

I think that review says as much about how we run the practice as a review from somebody who had a great treatment result.

Jeff traveled all that way.

I still wasn't going to recommend decompression if I didn't believe it was right for him.

When I Would Not Wait Around With a Herniated Disc

There are a few symptoms where I would want someone evaluated medically right away.

These include:

• Loss of bowel or bladder control

• New difficulty urinating

• Numbness around the groin or saddle area

• Rapidly progressing muscle weakness

• Sudden loss of control of a leg

Those symptoms can represent significant neurological involvement.

That is not a “let's try a few decompression sessions and see what happens” situation.

Get evaluated.

What Should You Do If You Live in Mira Mesa and Want to Avoid Surgery?

Start by getting a better understanding of what is actually going on.

If you already have an MRI, bring the images.

If you've already tried physical therapy, injections, chiropractic care, medication, acupuncture, or anything else, tell me what happened.

If sitting hurts, tell me.

If walking helps, tell me.

If your foot is numb, tell me exactly where.

Those details matter.

Then we can have a real conversation about your options.

Maybe Non-Surgical Spinal Decompression makes sense.

Maybe something else makes more sense.

Either way, you should leave understanding your condition better than when you walked in.

Schedule a No-Charge, No-Obligation Consultation

The Spinal Decompression & Chiropractic Center of San Diego

5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

Call: 619-298-0800

Call or Text: 619-884-8298

www.SanDiegoBackCare.com

Live 24/7 Answering Service

Hablamos Español

Patients from Mira Mesa, Sorrento Valley, Miramar, University City, Rancho Peñasquitos, Scripps Ranch, and throughout San Diego County are welcome to schedule.

There is no obligation to begin treatment.

The first step is simply finding out what you're dealing with and whether Non-Surgical Spinal Decompression is something I believe you should consider.

— Dr. Cassidy James Boelk, DC
Certified Spinal Decompression Doctor
Certified Pain-Free Performance Specialist
Founder, Non-Surgical Spinal Decompression Training Academy

Patient testimonials describe individual experiences. Results vary and no specific outcome can be guaranteed.