Sciatica, Low Back Pain and Chiropractic
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Many people have heard the term, Sciatica. Sciatica literally means inflammation of the Sciatic nerve. The Sciatic nerve is a large nerve that runs from the lower back, through the buttocks and then down the leg. It is a combination of all the spinal nerves in the lower back. Injury or swelling in any one single nerve can cause “Sciatica” and pain down the path of the nerve. Some people feel it in their toes, some in the knee and some just in the buttocks like something is jabbing them. The pain can come from many different sources, most commonly from the lower back. Treatment is generally targeted to the parts of the body that are creating the “pain down the leg”. These parts include the bones of the spine, the intervertebral discs or the muscles that lie over the top of the Sciatic Nerve.
A recent study in 2008 reviewed all the scientific research related to Chiropractic and lower back pain along with leg complaints, some of which went back to the 1980’s! The research related to lower back pain and leg pain is growing and showing the effectiveness of Chiropractic care and Sciatica. The authors reported “The purpose of this work is to provide a balanced interpretation of the literature to identify safe and effective treatment options in the care of patients with low back pain and related disorders.”1 The paper revealed the following information:
1. Acute Back Pain – there is evidence that the chiropractic adjustment has better short term efficacy than mobilization or diathermy (a physical therapy treatment that heats up the tissues).
2. Chronic Back Pain – the chiropractic adjustment combined with strengthening exercises was as effective at pain relief as Non-steroidal anti-inflammatory drugs (Ibuprofen) with exercise. They also stated there was fair evidence that the chiropractic adjustment was better than physical therapy and home exercise for reducing disability. There was evidence that the chiropractic adjustment improved outcomes more than general medical care or placebo in the short term and to physical therapy in the long-term.
“Patients overall were more satisfied and felt they were provided better explanations about their pain from practitioners who used manual therapy ”1 There were many research studies that were reviewed in this paper but here are some of the highlights.
“The group receiving manipulation [chiropractic adjustment] had a shorter treatment time and a more marked improvement. At 6 month follow-up, the manipulation [chiropractic adjustment] group showed better neuromotor system function and a better ability to continue employment. Disability was lower in the manipulation [chiropractic adjustment] group.” 4
“Outcomes from manipulation [chiropractic adjustment] were better for neurologic and motor function as well as disability”4
For the Sciatica patients…….
“For patients with LBP [low back pain] and restricted straight leg raise test [laying on your back, legs straight then having someone lift your straight leg in the air] manipulation [chiropractic adjustment] conferred highly significant relief, more than alternate interventions.” 2
“Coxhead et al included among their subjects patients who had at radiating pain at least to the buttocks. Interventions included traction, manipulation, exercise, and corset, using a factorial design. After 4 weeks of care, manipulation [chiropractic adjustment] showed a significant degree of benefit on one of the scales used to assess progress.” 3
“Manipulation [chiropractic adjustment] was reported to be superior to conventional therapy.”
Doctors of Chiropractic have been treating lower back pain with and without leg pain for a very long time. It is an extremely safe and effective approach to Sciatica. Pain down your leg should never be ignored and a Doctor of Chiropractic is trained to determine the cause.
1. Dana Lawrence DC MMedEd, William Meeker, DC, MPH, Richard Branson, DC, Gert Bronfort, DC, PhD, Jeff R. Cates DC, MS, Mitch Hass, DC, MA, Michael Haneline, DC, MPH, Marc Micozzi, MD PhD, William Updyke, DC, Robert Mootz, DC, John Triano, DC, PhD and Cheryl Hawk, DC, PhD. Chiropractic Management of Low Back Pain and Low Back Related Leg Complaints: A literature synthesis. J Manipulative Physiol Ther 2008;31:659-674.
2. Mathews JA, Mills SB, Jenkins VM, Grimes SM, Morkel MJ, Mathews W, Scott SM, Sittampalam Y. Back pain and sciatica: controlled trials of manipulation, traction, sclerosant and epidural injections. Br J Rheumatolo 1987:26416-23.
3. Coxhead CE, Inskip H, Meade TW, North WR, Troup JD. Multicenter trial of physiotherapy in the management of sciatic symptoms. Lancet 1981;1:1065-8.
4. Arkuszewski Z. The efficacy of manual treatment in low back pain: a clinical trial. Man Med 1986;2:68-71.
5. Nwuga VCB. Relative therapeutic efficacy of vertebral manipulation and conventional treatment in back pain management. Am J Phys Med 1982;61:273-8.