NSD Therapy® Indications: How Suitability Is Assessed
A diagnosis or scan finding does not automatically indicate an NSD Therapy® procedure. Suitability depends on your symptoms, examination, health history and the particular option being discussed.
What Does an Indication Mean?
An indication is a clinical reason to consider a particular procedure. It must be weighed against that procedure’s evidence, risks, alternatives and your goals. It is not a promise that the procedure will work.
I developed NSD Therapy® to coordinate chiropractic, physiotherapy and rehabilitation in a non-invasive care plan. I had people with spinal disc, facet joint and spinal canal concerns in mind, including those seeking options after previous care or surgery. That purpose does not automatically make the method, every component or a particular device suitable for an individual.
I also had older adults in mind who are exploring non-invasive options because invasive procedures present additional concerns. Blood-thinning medication, cardiovascular conditions and other health issues are part of the individual review; difficulty undergoing surgery does not establish suitability for NSD Therapy®.
Each case is carefully reviewed. Findings, previous procedures and contraindications determine which components may be considered, modified or left out. Read the method overview and component guide for the program’s intended scope.
The official MyChiro guide (opens in a new tab) explains the broader program. This page focuses on the questions that connect a proposed procedure to an individual assessment.
What Your Symptoms and Scan Can Tell Us
A report describes findings on an image. The clinical discussion also needs to account for where your symptoms are, when they started, what changes them, whether sensation or strength has changed, and which activities are difficult. A finding can be relevant without explaining every symptom.
I use the history and examination together rather than selecting a procedure from an MRI term alone. Existing reports and images can be useful when they relate to the problem being assessed. Further imaging is not automatic. For low-back pain with or without sciatica, NICE recommends considering imaging in specialist care only when the result is likely to change management. Read NICE NG59 on assessment and imaging (opens in a new tab).
Improvement in pain or movement does not, by itself, prove disc rehydration or structural repair. Ask what outcome a proposed procedure is intended to change and how that outcome will be assessed.
Questions About Each Proposed Component
Before agreeing to a plan, ask:
- What specific problem or activity limitation is this component intended to address?
- What evidence supports that purpose for someone with my presentation?
- Who will provide it, and what is that practitioner’s professional role?
- What risks, precautions, alternatives and costs apply?
- How will we decide whether to continue, change or stop?
Chiropractic, physiotherapy, exercise and equipment-based options have different purposes and limitations. Coordination does not establish that everyone needs all of them. An assessment may lead to one service, a combination, a modified plan, further investigation or referral.
Use the effectiveness discussion to ask about claims and the session-planning guide to prepare questions about review points and time commitments.
When Another Assessment Comes First
Previous surgery, implanted devices, bone health, pregnancy, medication and neurological findings can alter what is appropriate. Read the contraindications and safety-screening page. An assessment may identify a need for medical or specialist review before any component is considered.
Emergency warning signs
With back or leg symptoms, new numbness around the genitals or anus, new difficulty starting or passing urine, new bladder or bowel dysfunction, or new sexual dysfunction may indicate cauda equina syndrome. Go to an emergency department immediately. Do not wait for loss of continence, several signs together or a clinic appointment. Rapidly worsening leg weakness also needs urgent medical escalation. Pregnancy does not remove the need for emergency assessment when these signs occur. See NICE NG127, recommendation 1.7.3 (opens in a new tab).
Prepare for an Assessment Discussion
If previous care has not resolved the problem
This was one of the situations I had in mind when developing NSD Therapy®. For the next assessment, it helps to explain more than “physiotherapy did not work” or “I have already had surgery.” Prepare a short account of:
- What problem was being treated and what explanation you were given.
- Which procedures or exercises you actually received, and over what period.
- What changed during care, what lasted afterwards and any unwanted effects.
- Why the plan ended, including practical barriers such as travel, cost or difficulty with home exercises.
- For previous surgery, the operation and date, current restrictions and available specialist reports.
This history helps the clinician decide whether the same problem remains, whether the proposed approach differs meaningfully and whether another assessment is needed. Previous non-response does not prove that NSD Therapy® will succeed, and previous surgery does not automatically include or exclude every component.
Bring relevant reports, a current medication list and examples of activities you want to manage better. The two-center directory provides routine contact details. Urgent neurological changes need the medical route described above.
The MyChiro first-visit guide explains the assessment process.