Do you have low back pain with pain down your leg? Called Sciatica, pain starts in the lower back, then radiates from there to include buttock pain, numbness, weakness, or pain in the leg even down to the foot. It sometimes includes pins and needs or tingling and difficulty moving and controlling your leg or foot. Some people describe “shooting pain” down the leg. It is often disabling from just the severity of the pain or because it is difficult to even stand up or walk. In most all cases the problems affect one side or the other but rarely both. Many people turn to pain medications but often need strong narcotic drugs to gain relief. These medications unfortunately addict some patients leading many commentators to criticize their widespread use in this country for back pain. Other than pain medications there are a couple of good options for relief to consider but we think that a new study, discussed below, shows Fairfax chiropractic treatment of Sciatica is clearly the better choice.
So What causes Sciatica?
The symptoms follow the path of the sciatic nerves, the huge nerve bundles in the body that serve most all the tissues and muscles of the buttock, thigh, leg, and foot. Between each pair of bones (the vertebrae) of your lower or “lumbar” spine, a nerve root exits through a small opening. Additional nerve roots exit from the sacrum immediately below the lumbar vertebrae. Each of your two sciatic nerves starts in the lower back as roughly 5 nerve roots – leaving your spinal cord on one side of the spine that join together to form one of your sciatic nerve bundles. There is a sciatic nerve on either side of the spine, one for each leg that extends all the way to your feet. Those nerve roots can get irritated or compressed by problems with the spine that press on one of those nerve roots. The most common cause is disc herniation or bulging of the rubbery disks between the vertebrae. Other causes include growths on the bones called bone spurs that decrease the size of the opening for the nerves, referred to as Spinal Stenosis, something common with aging. Discs can also shrink and lose their height with age allowing the bones to get closer together narrowing the opening for the nerve root.
Of the nerve roots that come together to form either sciatic nerve, the ones that cause the most problems are the L4 and L5 nerve roots (exiting below lumbar vertebrae 4 and 5) and the first sacral nerve roots, S1 directly below them. (S2 and S3 are the other main nerve roots that joint the sciatic nerves.) Since there are multiple nerve roots that can be involved, Sciatica affects a lot of people and the symptoms vary somewhat with the nerve root involved and may include pain in the leg along with numbness, tingling and weakness of the involved extremity .
The New Study
An interesting study just showed that Fairfax chiropractic spinal manipulations (what we usually call “adjustments”) were equally as effective as nerve root injections for sciatica patients. On both outcome measures the chiropractic patients actually did better than those getting the spinal injections but the differences were not large enough to be considered significant.
Within the traditional health care community, nerve root injections, also called epidural injections, are a well-established treatment for patients with low back pain radiating to the leg due to compression of a nerve root from disc herniation. Within the chiropractic community, spinal adjustments are recognized as highly effective for these as well but there has not been enough well done studies supporting this to convince their health care colleagues in the traditional medical field, so this is a welcome addition to the literature.
All the patients had disc herniation noted on magnetic resonance imaging (MRI) that matched their low back and leg pain symptoms. Before any treatment, all patients rated their pain on a 1-10 level scale. They rated their pain level again a month later and also rated their impression of their change from “much better” to “much worse” on a 7 point scale.
The spinal injections were imaging guided (fluoroscopy) so they could see the needle was guided to the relevant nerve. The patients received injections of both a steroid and a pain killing anesthetic. The patients receiving spinal adjustments received an average number of 11.2 adjustments over the one month.
Both groups were much improved with 76.5% of the chiropractic patients reporting being “much better” or “better” compared to 62.7% of the spinal injection patients. Pain was reduced 60% on average for the chiropractic group compared to 53% average pain reduction for the injection group. Getting worse was reported by only 2% of the chiropractic patients versus 5.9% of the injection patients and in both groups it was reported as only “slightly worse.”
None of the adjusted patients went on to need surgery but three of the patients getting injections went on to have surgery and three others needed a second injection after the 1 month study period. Then consider the cost of the treatments in the one month time. The chiropractic care cost less but that did not include the cost of the MRI that all the patients received at the beginning. Yet an MRI would not be recommended prior to non-invasive types of care for Sciatica like chiropractic, but is normal prior to invasive procedures like these spinal injections so the cost would be even higher under normal clinical conditions for the group getting the injections.
We think all this puts Fairfax chiropractic care as the better choice. If you get equally great results (if not better), spend less, and can have non-invasive conservative care rather than the inherent risks of invasive spinal injections, the choice would seem clear.
Sciatica is typically not the sort of thing you can just live with. It makes it hard to function, work or even walk so if you find yourself with pain in the low back radiating down the leg, don’t turn to drugs. We can help you, and according to this study, as well or better than more conventional injections.
Concept Chiropractic and Rehab has the expertise and experience with proven results in helping people of all ages and walks of life recover from Sciatica. We have been functionally improving the pain levels and quality of life of thousands of patients in Northern Virginia and Fairfax for over 10 years with consistency and success. Please don’t let your symptoms linger or think they will improve or disappear on their own. Contact our office today to get rid of your Sciatica and start achieving immediate results. Please call 703-573-5500703-573-5500 to set up an appointment.