What is the best option for sciatica treatment?
A recent study (JAMA November 2006) found that immediate surgery (Group 1) appeared to relieve pain, with most patients eventually recovering, but that there were no adverse repercussions from delaying having the diskectomy (Group 2). Patients who had prompt surgery often reported immediate relief, but patients in both groups reported marked improvements within three to six months. About 70% of the patients in the two groups said they had major improvement in their symptoms after 2 years.
These are the results of a large trial study involving 2,000 patients from 13 spine clinics in 22 states that took place over the course of two years comparing patients who had immediate surgery, to patients who delayed surgery.
Disk surgery is usually the last resort in relieving pain associated with sciatica. This is a pain that runs along the sciatic nerve, a large nerve extending from the lower back and down the back of each leg. One of the nerve roots is usually impinged by a ruptured disk. This pressure results in sharp, intense pains down the buttocks and leg. Sciatica usually affects only one side of the lower body. Dr. James Weinstein, a professor of Orthopedic Surgery at Dartmouth University who led the study, said that as many as a million Americans suffer from sciatica, and that an estimated 300,000 have surgery on a yearly basis to relieve the symptoms.
In addition to pain, sciatica sufferers may also experience numbness or muscle weakness along the nerve pathway in the leg or foot, as well as tingling or a ‘pins and needles’ feeling in the toes or part of the foot.
If the disk herniation is severe, the patient may experience a loss of bladder or bowel control. This is serious and a sign
of ‘cauda equina syndrome’, a rare but serious condition that requires immediate surgery.
To diagnose sciatica, the doctor will examine the low back, hips and legs for strength, flexibility and reflexes. A postural
evaluation is also necessary for leg length inequalities. X-ray, MRI, CT scans and nerve conduction studies are also required.
Back pain is made worse by:
• being overweight
• not exercising regularly (having weak back muscles)
• wearing high heels
• sleeping on a mattress that is too soft
• and sitting daily for extended periods.
There are a variety of treatment options for back pain/sciatica, but the main proven ones are simple to incorporate into
your lifestyle.
• Begin walking daily—at lunch time and in the evening. Walking is very beneficial for the entire body, especially the
low back muscles.
• If you have a soft mattress or one more than 7 years old, purchase a firm one for support, and sleep either on your
side or back.
• Drinking 6 glasses of water per day will help the muscles function better.
• Finally, specific exercises recommended by your Chiropractor to strengthen your low back will be very beneficial
for your back, posture and overall health.
By making these critical changes to your life, you’ll see significant improvement in your back pain and there will be no need for surgery.
