Spinal Manipulation May Help You Avoid Surgery
By Hari Dass Khalsa, DC
Spinal surgery, called microdiscectomy, is not an uncommon procedure for patients with sciatica. Sciatica often starts suddenly with pain in your lower back that radiates down from your buttock to one thigh and into your leg. You may have pain when you sit, sneeze or cough. You may also feel weakness, “pins and needles,” numbness, or a burning or tingling sensation down your leg.
Sciatica symptoms may result from general wear and tear, plus any sudden pressure on a disc. Most commonly, this occurs when a protruding or herniated disc irritates the sciatic nerve. Sciatica is a major source of disability and impairment of daily living activities. About twenty percent of those with sciatica experience symptoms for more than six weeks.
The surgeon performing a microdiscectomy makes a small incision on the back and removes the offending disc tissue. Although the success rate is generally good in the short-term, long-term effects remain largely unknown. Additionally, some patients develop recurrent disc herniation, dural tear, nerve root damage, or bowel or bladder incontinence. Moreover, death and paralysis occur in about one per thousand operations.
Fortunately, new evidence published in a scientific periodical, Journal of Manipulative and Physiological Therapeutics, identifies an effective treatment for sciatica that reduces the need for spinal surgery. The research team was composed of three spinal neurosurgeons, a senior health care researcher and a chiropractor.
In this study, patients with chronic back pain and sciatica with disc herniation and having failed treatment with analgesics, physiotherapy, massage therapy, and/or acupuncture were randomized to spinal manipulation or surgical microdiscectomy. Spinal manipulations were administered by an experienced chiropractor for up to eight weeks. Surgery was performed by one of three experienced spinal neurosurgeons. Patients were allowed to cross over to the alternative procedure after three months.
Chiropractic spinal manipulation delivered a significant benefit. Sixty percent of patients with sciatica who other medical management had failed benefited from spinal manipulation to the same degree as if they underwent surgical intervention. Of the patients that failed spinal manipulation, subsequent surgical intervention conferred excellent outcomes.
Delay of the surgical procedure did not adversely affect outcomes. Additionally, a study by another medical team demonstrated that chiropractic spinal manipulation can deliver a large, clinically important pain reduction with no adverse events in a patient population with acute symptoms.
These impressive findings have important implications for the treatment of sciatica. Patients with symptomatic disc herniation failing medical management should first consider spinal manipulation. Practitioners managing patients with chronic back pain and sciatica with protruding discs should also consider chiropractic care as a first option.
Dr. Hari Dass Khalsa is a chiropractor specializing in the non-surgical treatment of spinal conditions with offices located in the Hawthorne District at 503.238.1032