Questions exists between the relationship of anatomical and paraphysiological circumstances of the pain and discomfort that exists in patients with low back pain and lower limb radiculopathy. A change in occupancy of the spinal canal by the intervertebral disc is the topic under investigation. The efficacy of chiropractic care in relation to any perceived changes in the intervertebral disc size and patient response was the focus of this investigation. An unblinded clinical trial was constructed to measure the objective and subjective patient response to chiropractic management of low back pain with associated lower limb radiculopathy. Thirty patients fulfilling the inclusion and exclusion criteria were included in the trial. No control groups were used. Two management groups containing 15 subjects each were created. One group received rotatory side posture adjustment to the lumbar spine. The other subject group received flexion distraction techniques on a McManis traction table. Patients were assessed using recognized neurological and orthopedic procedures. Numerical rating scale 101 and Oswestry back disability indices were used as subjective data capture tools. Computer tomographic images were obtained using an ELSCINT 2400 scanner. Multiple-level radiological examination was performed on each patient prior to initiation of treatment. Repeat investigation at the termination of treatment included noted pathological levels only. A 4-mm-slice width was used. Measurement of the percentage occupancy of the spinal canal by the intervertebral disc was performed on the ELSINT 2400 scanner. Captured data were statistically evaluated using parametric paired and unpaired t tests within the 95% confidence interval. Objective and subjective criteria for the measurement of patient discomfort showed statistically significant improvements for both treatment procedures. Neither procedure displayed statistically more favorable results for the management of the patient's symptomatology. Pathology involving the intervertebral discs was noted at the third, fourth, and fifth lumbar intervertebral disc levels. Lesions were most commonly noted at the fifth intervertebral disc levels. Thirty-eight intervertebral disc lesions displayed pathological changes prior to initiation of either management program. An increase in the percentage occupancy of the spinal canal by the intervertebral disc was recorded in 10 cases. Twenty levels showed decreased percentage occupancy. Critical values for percentage occupancy of the spinal canal at the fourth intervertebral disc were statistically evaluated to 0.008. At the fifth intervertebral disc, the percentage occupancy was calculated to 0.763 (t = 13; 0.05 to 1.1771). The mean percentage for the adjustment group pretreatment showed the intervertebral disc to occupy 30.98% of the spinal canal. Post-treatment examination revealed an occupancy of 26.29%. The mean percentage for the flexion-distraction group pretreatment showed the intervertebral disc to occupy 33.51% of the spinal canal. Post-treatment examination revealed occupancy of 29.28%. No statistically significant changes were noted in the percentage occupancy in the spinal canal by the intervertebral disc at any of the spinal levels examined. Reduction of the objective and subjective clinical presentation, without significant changes in the intervertebral disc to spinal canal ratio, leads to the conclusion that neither the presence nor the size of the intervertebral disc following lumbar spine radiological examination should be used as pathological indicators. Chiropractic examination of lumbar spine pain with radiculopathy has displayed positive qualities regarding its effectiveness and safety.

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