Surgery or Chiropractic for Chronic Sciatica Sufferers?
Pain coming from compression or irritation of the sciaticnerve is called sciatica. Sciatica which can include pain, tingling, numbnessand muscle weakness is really a symptom indicating an underlying problem, nota diagnosis in and of itself. This article will explore in detail the findingsof a recent controlled study comparing spinal manipulation (chiropractic) andsurgery for people whose sciatica did not respond to traditional medical treatmentapproaches.
The study discussed here was conducted by the National Spine Centerin Alberta Canada and published in October of 2010 in the Journal ofManipulative and Physiological Therapeutics.The 40 study participants all had sciatica lasting over 3 months which had notresponded to treatment with pain medications, lifestyle modifications, physicaltherapy, massage therapy or acupuncture. They had all been referred by theirprimary care physicians to spinal surgeons who had deemed them appropriate surgerycandidates.
Instead of having all the patient proceed with surgery, theywere split into two groups one group to undergo a surgical microdiscectomyand the other group to be treated with standardized chiropractic spinalmanipulation by a single chiropractor. (If not satisfied with the results theyobtained from their assigned method, the patients were allowed to switch to theother treatment plan after 3 months.)
So what happened? Both groups made significant improvementsover baseline scores meaning that theysaw noticeable improvements whereas previous approaches had failed. A full 60%of the study participants benefitted from chiropractic spinal manipulation tothe SAME degree as if they underwent surgery. And, after 1 year there was nodifference in outcome success based on the treatment method. That means that a full 60% of peoplereferred for surgery by their primary care physicians and accepted as surgicalcandidates by the neurosurgeon could actually get similar results with chiropractic.That is a lot of potentially unnecessary cutting, anesthesia and ER time.
There is one paragraph in the results section of this studythat is easy to overlook, but incredibly important. There were originally 120candidates of which 60 met the study criteria and were asked to participate. Ofthese 60, 20 refused. Why? Because they had never been offered spinalmanipulation as an alternative to surgery! They didnt want to participate inthe study and be randomly placed in the surgery group without first trying thespinal manipulation! This is incredibly telling. Not only does it demonstratethat there is still a lot of education about chiropractic that needs to happenamong the public and among primary care providers, it also demonstrates thatpeople understand the risks and costs of surgery and want to exhaust otherpossibilities first.
This was the first study to ever look at people who hadfailed traditional medical management of sciatica. Currently most patients thatfail conservative care are referred for a surgical evaluation. Now we knowthat 60% of these folks could avoid surgery and get similar long-term outcomeswith chiropractic.
Please share this article with anyone considering surgeryfor sciatica.
 McMorland G, Suter E, Casha S, du Plessis SJ,Hurlbert RJ., Manipulation or microdiskectomy for sciatica? A prospectiverandomized clinical study. J Manipulative Physiol Ther. 2010; Oct;33(8):576-84.