Abstract
Treating disc herniation with High Velocity Thrust (HVT) manipulations is something the osteopathic profession is currently very cautious about. HVT is often described as a contraindication to spinal manipulation on the principle that it would aggravate the symptoms by increasing the herniation. A more invasive alternative to osteopathy is imaging-guided nerve root injection. There is a fair amount of evidence around this procedure but a lack of placebo-controlled trials and a lack of evidence on the efficacy of using anaesthetics alone or adding corticosteroids.
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