Should you get a second opinion before back surgery?
Yes. Spinal surgery is not reversible and the recommendation to operate is not always the only option on the table. Getting a second opinion before you schedule anything costs you a few weeks and can change the entire outcome.
Listen, this is the single most important thing I tell people. Once a surgeon says the word surgery, most patients stop looking. They assume the decision has been made for them.
Jonathan is a patient of ours who did the opposite. He had sciatic pain running down his left leg. He had been through acupuncture. He had been through physical therapy. When he went to Kaiser, he was offered cortisone shots and told surgery was on the table. In his own words, he said hold on, before we do surgery I have got to look at all my options.
That pause is the whole thing. He did the research, found our office in Walnut Creek, and never had the operation.
Do cortisone shots actually fix sciatica?
Usually not, because a cortisone shot is a chemical solution for a physical problem. It reduces inflammation around an irritated nerve for a period of weeks. It does not move the disc material that is pressing on that nerve.
I am not against shots. When someone is in so much pain they cannot sleep or function, a shot can buy real relief and I am glad when it does.
But understand what it is and what it is not. If a disc has pushed out and is sitting on your nerve root, the shot quiets the alarm. The thing setting off the alarm is untouched. That is why so many patients get two or three shots with less relief each time.
Jonathan had already been through the standard sequence before he was offered shots. That sequence is what I call the conveyor belt: therapy, then injections, then a spot on the surgery schedule.
Why doesn’t acupuncture or physical therapy fix sciatic pain?
Because neither one targets the disc. Physical therapy strengthens and mobilizes the muscles around the spine. Acupuncture works on pain signaling and muscle tension. If the source of your sciatica is disc material compressing a nerve, the compression itself goes unaddressed.
This is not a knock on either. Both help plenty of people with plenty of conditions, and I refer patients for both. The problem is a matching problem.
Jonathan went through acupuncture. He went through physical therapy. He was doing everything he was told to do, in the right order, with real effort. The pain kept running down his left leg.
The missing factor is compression. Until the pressure inside the disc changes, the material has no reason to move off the nerve. You can build the strongest core in Contra Costa County and the disc does not care.
What is non-surgical spinal decompression?
It is a computer-controlled therapy that creates negative pressure inside a specific disc. You lie on your back in a harness while the table applies tension, holds, then releases, in repeating cycles. That pressure change is what draws the disc material back toward center and off the nerve.
Think about an airplane cabin at 10,000 feet. Change the pressure and everything inside changes with it. That is the mechanism, and it is why non-surgical spinal decompression does something that stretching and strengthening cannot.
There are three dials that decide whether it works. Number one, the angle, adjusted in 2.5 degree increments based on the disc level and the direction the material migrated. Number two, the weight. The textbook says 50% of body weight and I think that is flawed, way too aggressive. We start low and build. Number three, oscillation, the pull-and-relax accordion cycle that separates real decompression from generic traction.
Decompression tables are Ferraris. Incredible machines. But you have to know how to drive stick or you crash. Two patients on the same table with different settings get completely different results.
Is there proof that spinal decompression works?
Yes, and it is measured on MRI rather than on how a patient says they feel. Our peer-reviewed case series in the Journal of Contemporary Chiropractic documented herniation index reductions of 9.4%, 16.5%, 29.1%, and 29.5% on follow-up imaging, with all four patients fully recovered from pain and no surgery.
You can read the full paper here: Reduction of the Size of a Lumbar Disc Herniation Using Non-Surgical Spinal Decompression Combined With Chiropractic Care (Dudum J, Gatterman B. JCC. 2024;7(1):146-155).
In one of those cases the patient had 18 mm of disc material that had migrated up above the L2-L3 disc. On the follow-up scan that migrated fragment had reduced by 78% and was no longer visible in the region under the pedicle.
That is the part that matters to me. Not a satisfaction survey. Before-and-after MRIs, measured by a board-certified radiologist, showing what actually changed inside the spine.
How fast do patients feel relief from spinal decompression?
Many patients notice a difference in the first few weeks, and some notice it much sooner. Structural change on imaging takes longer than symptom relief, which is why the follow-up MRI comes months after treatment ends.
Jonathan’s line about it was that he woke up feeling great, and that he had not felt that good in a long time. Waking up is when people notice it first. Sciatica tends to be worst at night and first thing in the morning, so that is where change shows up earliest.
In our published protocol, patients completed 20 to 30 decompression sessions over 8 to 10 weeks, with follow-up MRI four to six months after treatment ended. Your plan depends on what your imaging shows.
I want to be straight with you about one thing. Patients like Jonathan are why I do this, and his result is his result. Yours depends on the size, type, and age of your disc lesion, which is why the MRI review comes before any promises.
When is back surgery actually necessary?
Some situations are surgical and should not wait. Loss of bowel or bladder control, numbness through the groin or saddle area, or rapidly progressing weakness in both legs are emergencies. Go to the emergency room, not to a chiropractor.
My mission is helping people avoid unnecessary spinal surgery. That word unnecessary carries the weight. There are operations that need to happen, and there are surgeons I trust and refer to.
What I push back on is the default sequence, where nobody addresses the compression before the operating room comes up. Roughly 25% of the patients in my program have already had spinal surgery. They come in because the surgery removed the material but never changed the pressure that pushed it out.
If you have red flag symptoms, get emergency care today. If you have sciatica that has dragged on through therapy and shots without progress, you have room to look at your options the way Jonathan did.
Where can I get a second opinion on sciatica in Walnut Creek, CA?
Dudum Chiropractic at 1900 Olympic Blvd, Suite 100, Walnut Creek, CA 94596 is a dedicated non-surgical spinal decompression center with 13 decompression tables and more than 50,000 treatments performed. We review your MRI, correlate it to your exam, and tell you honestly whether you are a candidate. Call (925) 300-3302.
We see patients from Walnut Creek, Lafayette, Concord, Pleasant Hill, Danville, Alamo, and across Contra Costa County and the East Bay. About 300 patients a week come through our doors, and some fly in from out of state.
Bring your imaging. If you have had an MRI in the last year, bring the disc or the report. If you have not had one, that is where we start, because an MRI report alone is misleading without an exam to correlate it to.
And if you are not a candidate, I will tell you that. The honest no is part of the job.
Quick questions, straight answers
Can sciatica be treated without surgery?
Often yes, when the sciatica comes from disc material compressing a nerve root and there are no emergency red flags. Non-surgical spinal decompression targets the compression directly, and our published case series documented measurable herniation reduction on follow-up MRI in all four patients without surgery.
How many cortisone shots is too many?
That is a question for the physician administering them, since limits depend on the injection type, location, and your overall health. What we see clinically is that relief tends to shorten with each successive shot, because the injection addresses inflammation rather than the disc material causing it.
Can I still do spinal decompression if surgery is already scheduled?
Many patients come to us in exactly that window. Talk to your surgeon about the timeline, bring us your imaging, and we will tell you whether decompression is a reasonable thing to try first. If your case is one that needs surgery, we will say so.
Does spinal decompression hurt?
Most patients describe it as a comfortable stretch rather than pain. Sensors reduce the tension when your muscles resist, which is what prevents the spasming people get on inversion tables. Sessions run 20 to 30 minutes.
Where can I get spinal decompression in Walnut Creek, CA?
Dudum Chiropractic, 1900 Olympic Blvd, Suite 100, Walnut Creek, CA 94596. Call (925) 300-3302 for an MRI review and candidacy evaluation. We also serve patients from Lafayette, Concord, Pleasant Hill, Danville, and throughout Contra Costa County.
If you’re dealing with sciatica or back pain and want to find out whether you’re a candidate for spinal decompression, contact us at Dudum Chiropractic in Walnut Creek or call (925) 300-3302. You deserve relief without spinal surgery.