Sciatica Treatment: Surgery or Chiropractic?

Sciatica, the word and diagnosis every patient seems to know. Sciatica simply refers to the symptoms of pain, weakness or tingling in the legs as a result of compression or injury to the sciatic nerve. In two previous posts “Sciatica – Surgery Not Included” and “Sciatica – Part II” I discussed in more detail the diagnosis of sciatica. Today, I want to discuss the results of a study that compares head-to-head chiropractic manipulation and surgical microdiskectomy for the treatment of sciatica.

The study took 40 patients who had confirmed herniated discs on MRI and significant pain radiating into the legs for more than 3 months. The patients also had to have tried 3 months of conservative treatment including pain medication, physical therapy, massage therapy, and/or acupuncture before being accepted into the study. Then the group of 40 was split into two groups, 20 received chiropractic manipulation and the other 20 received surgical microdiskectomy.

The results? 60% of the patients in the chiropractic group had positive outcomes equivalent to those who underwent the surgery. A follow-up one year later showed these same patients continued to have positive results. The other 40% that did not have improvement in their condition, subsequently underwent surgery with positive outcomes.

What does this mean? If you try chiropractic manipulation before electing for surgery, you have a 60% chance of alleviating your sciatica without the use of surgery. And if it is successful the odds are that even a year later you will continue to have positive results. Additionally, if after trying chiropractic manipulation you do not have positive results, this does not effect your odds of having a successful outcome with surgery. Many people have been concerned that chiropractic treatment might worsen their condition and as a result make a surgical intervention less successful, but this is not true as determined by this study.

One interesting fact I found from the study was when the study was explained to the potential patients, a significant number refused to participate because they had never been told that chiropractic manipulation was an option before. They were upset that their medical doctors did not inform them of this potentially helpful therapy. They then elected to receive chiropractic manipulation for the opportunity to avoid surgery.

This is so true of the medical model. The majority of medical doctors do attempt some form of conservative treatment prior to sending a patient to surgery. However, this same majority rarely utilizes chiropractic as one of their conservative treatment options. Hopefully this study will begin to shed some light on the reality that chiropractic is a very viable, successful, conservative and cost effective treatment for sciatica resulting form a herniated disc.