By Dr. Boris Nektalov, DNM, DC, Chiropractor & Enzyme Nutrition Specialist · Nektalov Chiropractic & Wellness, Forest Hills, Queens NY
Published: June 1, 2026 · Last reviewed: June 1, 2026
The Question Every Back Pain Patient in Queens Should Ask First
When a doctor recommends spinal surgery or injections, most patients assume conservative options have already been exhausted. Many haven't been.
If you are searching for a back pain chiropractor in Forest Hills or lower back pain relief in Queens, NY, this article explains what conservative chiropractic care is, how it compares to invasive procedures, and what national research says about spinal surgery rates — so you can make an informed decision about your own health.
What Is Conservative Chiropractic Care?
Conservative care refers to non-surgical, non-invasive treatment approaches that allow the body to heal naturally. In a chiropractic setting, conservative care typically includes:
- Chiropractic spinal adjustments
- Spinal decompression therapy
- Corrective exercise and postural rehabilitation
- Soft tissue therapy
- Nutritional and enzyme-based anti-inflammatory support
- Patient education and lifestyle counseling
Conservative care is considered the first-line standard of care for most musculoskeletal conditions, including disc herniations, sciatica, chronic back pain, and whiplash injuries, according to guidelines from the American College of Physicians and the Global Spine Care Initiative.
What the Research Says About Unnecessary Spinal Surgery
This is not a fringe concern — it is backed by national data and court records. A peer-reviewed analysis reported by Axios found that Medicare spent billions of dollars over a three-year period on spinal surgeries classified as "low-value" or potentially unnecessary. Researchers identified enormous variation in surgical rates between hospitals in the same region — a pattern that suggests local financial incentives, not patient need, may drive some surgical recommendations.
Separately, reports highlighting allegations of unnecessary spinal surgeries tied to personal injury litigation networks describe lien-based payment arrangements and high-value settlement strategies that can create financial incentives to escalate care rather than resolve it conservatively. Courts and state regulators are increasingly scrutinizing these models.
What this means for patients in Forest Hills, Queens: If you have been told surgery is your only option — especially following a car accident, slip and fall, or personal injury — it is worth asking whether conservative care has truly been given a full opportunity to work.
High-Volume Multidisciplinary Clinics: What Patients Should Understand
Multidisciplinary clinics can provide excellent care. Many do. But patients deserve to understand how volume-based business models can influence clinical decision-making. When a clinic sees 150 to 200 patients per day, the structural reality is:
- Time per patient is compressed. Deep evaluation becomes difficult at scale.
- Generalized treatment protocols replace individualized assessment.
- Provider continuity is limited. Patients often rotate between multiple providers without a primary relationship.
- Revenue depends on procedures. Imaging, injections, and surgery generate significantly more revenue than conservative rehabilitation.
None of this means a large clinic is operating improperly. But it does mean that financial incentives exist — and patients should be aware of them.
"Healthcare should never feel rushed. It should never feel like you are being pushed down an assembly line." — Dr. Boris Nektalov, DC
Conservative Care vs. Invasive Procedures: A Side-by-Side Comparison
| Factor | Conservative Chiropractic Care | Injections / Spinal Surgery |
|---|---|---|
| Invasiveness | None | Moderate to high |
| Recovery time | Minimal | Weeks to months |
| Risk of complications | Very low | Variable; surgery carries real risk |
| Addresses root cause | Yes, when done correctly | Often symptomatic only |
| Appropriate as first step | Yes, for most conditions | No — should follow failed conservative care |
| Long-term outcomes | Strong for disc, sciatica, posture | Variable; re-operation rates exist |
| Cost | Lower | Significantly higher |
When Is Spinal Surgery Actually Necessary?
Surgery is not always avoidable — and at Nektalov Chiropractic & Wellness, we will always tell you honestly when we believe you need it.
Conditions that may require surgical evaluation include:
- Severe neurological deficits (foot drop, loss of bladder/bowel control)
- Spinal fractures or structural instability
- Tumors or infections involving the spine
- Cauda equina syndrome (a medical emergency)
- Progressive neurological deterioration that is not responding to conservative care
If any of these apply to you, we will refer you immediately. Our goal is not to avoid surgery at all costs — it is to make sure conservative care is fully and properly explored before surgery is considered.
What Conditions Respond Well to Conservative Chiropractic Treatment?
Many of the most common reasons patients search for a sciatica chiropractor in Forest Hills or herniated disc treatment in Queens, NY are conditions that research supports treating conservatively first:
Disc Herniations and Bulges
Studies show that the majority of lumbar disc herniations improve with conservative care within 6 to 12 weeks. Chiropractic adjustments, spinal decompression therapy, and rehabilitative exercise can reduce pressure on the disc and surrounding nerve tissue.
Sciatica
Sciatica — radiating leg pain caused by nerve compression — often resolves with conservative care. Spinal decompression, targeted adjustments, and postural correction are highly effective approaches.
Chronic Low Back Pain
The American College of Physicians recommends spinal manipulation as a first-line treatment for acute and chronic low back pain before pharmacological or surgical options are considered.
Post-Accident Injuries (Whiplash, Soft Tissue)
Patients injured in car accidents frequently benefit from prompt conservative care to reduce inflammation, restore range of motion, and prevent chronic pain patterns from setting in. See our guide on car accident injury recovery.
Postural Instability and Muscle Imbalance
Many patients with chronic neck and back pain have underlying postural dysfunction that surgery cannot address. Corrective chiropractic care and rehabilitative exercise can produce lasting improvement.
The Gut-Inflammation-Pain Connection: Our Whole-Body Approach
At Nektalov Chiropractic & Wellness, we take a systems-based view of health. Patients searching for nutrition and chiropractic wellness in Queens are often surprised to learn how directly chronic inflammation — often driven by gut dysfunction — contributes to musculoskeletal pain.
Dr. Nektalov is both a licensed chiropractor and an enzyme nutrition specialist. Our approach integrates enzyme nutrition therapy, gut health evaluation, and nutritional counseling to reduce inflammatory triggers that slow musculoskeletal recovery. The nervous system, digestive system, immune system, and musculoskeletal system operate as an integrated whole.
Our Approach at Nektalov Chiropractic & Wellness, Forest Hills Queens
Every new patient at our office receives:
- A detailed intake and history review — we listen before we act
- Full spinal examination — postural analysis, range of motion, orthopedic and neurological testing
- Digital imaging when clinically indicated — so treatment is based on your actual anatomy
- A transparent conversation about findings, options, and what we believe is in your best interest
- An individualized care plan — not a protocol designed for volume throughput
We do not operate on a production quota. We operate on the principle that your spine is not a business model.
If You Have Been Told Surgery Is Your Only Option — Get a Second Opinion First
Before consenting to injections, pain management procedures, or spinal surgery, consider whether you have truly exhausted conservative options with a provider who has the time and commitment to apply them properly.
Many patients who come to us initially searched for the best chiropractor in Forest Hills Queens, herniated disc treatment Queens NY, neck pain chiropractor Forest Hills, spinal decompression therapy Queens, or lower back pain relief Queens NY. They were not just looking for pain relief. They were looking for honest guidance. That is exactly what we are here to provide.
Contact our office to schedule a comprehensive evaluation, or book online.
Serving Forest Hills, Rego Park, Kew Gardens, Jackson Heights, and surrounding Queens communities · 108-50 71st Ave, Forest Hills, NY 11375 · (718) 275-9000
Frequently asked questions
Should I try chiropractic care before surgery for a herniated disc?
Yes — in most cases, clinical guidelines recommend a trial of conservative care, including chiropractic, physical therapy, and pain management before surgery is considered. Studies show that a significant percentage of herniated disc cases resolve without surgical intervention.
Can a chiropractor in Forest Hills help with sciatica?
Yes. Chiropractic adjustments and spinal decompression therapy are among the most studied conservative treatments for sciatica caused by disc herniation or lumbar nerve compression. Many patients experience significant relief without injections or surgery.
Is spinal decompression therapy safe?
Spinal decompression is a non-invasive, traction-based therapy that gently reduces pressure within spinal discs. It is generally considered safe for patients with disc herniations, disc bulges, degenerative disc disease, and sciatica. It is not appropriate for patients with certain fractures, implants, or instability — which is why evaluation comes first.
How do I know if a clinic's treatment recommendation is financially motivated?
Ask whether conservative care has been tried first and for how long. Ask what the expected outcome of conservative treatment would be before considering surgery. Seek a second opinion from a provider who specializes in conservative care and has no financial stake in surgical outcomes.
What makes Nektalov Chiropractic & Wellness different from a high-volume multidisciplinary clinic?
We see a limited number of patients each day to ensure every individual receives thorough, individualized attention. Dr. Nektalov personally oversees all patient care. We do not have in-house surgery referral incentives. Our model is built around long-term patient outcomes, not procedure volume.
Do you treat car accident injuries in Queens?
Yes. We treat patients injured in auto accidents and provide documentation appropriate for personal injury cases. Our focus is always on your recovery — not on maximizing the value of a claim.
This article is intended for informational purposes. It does not constitute medical advice. Patients with emergent symptoms including loss of bladder or bowel control, severe or rapidly progressing neurological deficits, or suspected spinal fracture should seek emergency medical evaluation immediately.