Did you know that on Mayoclinic.com the treatments they recommend for sciatica are medications, physical therapy, and surgery? If you go to WebMD, they list the same treatments but add hot and cold packs, stretching and exercise. They also add “alternative therapies” and list yoga, biofeedback, massage and acupuncture.
Hopefully you noticed that Chiropractic was missing from both lists. Many of you reading this have been treated in our office for sciatica and know that I have had two-disc herniations, one treated surgically and one with non-surgical decompression. One study published Oct, 2010 Journal of Manipulative Physical Therapeutics found manipulation and microdiscectomies had the same outcome meaning both were effective 60% of the time, while another study in the Jun, 2016 Journal of Chiropractic Medicine found Chiropractic treatment on patients that previously had surgery and still had pain produced greater than 50% pain relief in 81%.
There are other types of manipulation such as non-surgical decompression, and flexion-distraction with great studies showing effectiveness. So why isn’t manipulation mentioned on either of the above-mentioned websites? While the relationship between the two professions has improved you can see that there is still prejudice against the Chiropractic profession and the public is who pays the price with mis-information, ineffective treatments, and opioid deaths.
What should you do if you have sciatica? In this order I recommend:
Self-care: exercise such as walking, swimming, and stretching will increase your blood-flow which can pump out the chemicals of inflammation around the nerve causing the pain. Hot and cold treatments, using moist heat such as a hot shower rather than a dry heating pad. Cold packs should only be used for 15 minutes at a time because longer can actually aggravate the problem.
According to the 2017 British Medical Journal Lower Back Pain treatment guidelines you should start with exercise and if that is not enough then manual therapy. Manual therapy is manipulation, so if you can’t alleviate your sciatica with exercise and temperature therapy then call your Doctor of Chiropractic.
The above-mentioned study comparing manipulation with surgery found those that did not respond to manipulation did better than average with surgery. This is why we tell patients chiropractic first, drugs second, surgery last. When a patient does not respond to my care, I refer them to their medical doctor to then start medication to take with their Chiropractic treatment.
If the combination of exercise, Chiropractic, and medication does not work only then do we consider a surgical consultation. I was in this position and responded well to my surgery because I had ruled out most of the problems that would not respond to surgery.
Having a doctor that is familiar with the different treatments available for your problem increases your chances of getting the right treatment at the right time. Call our office for a complimentary consultation.