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A Winning Treatment for 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 20 percent those with sciatica experience symptoms for more than six weeks. Fortunately, new evidence published this year in an international medical journal, The Spine Journal, identifies an effective treatment for this debilitating condition.
Medical doctors recently published the results of a study involving sciatica treatment. In the high quality study, 102 patients with acute back pain and sciatica with disc protrusion were randomized to active and simulated manipulation. Treatments were administered 5 days per week by experienced chiropractors for up to 4 weeks.
Results of the study were dramatic. Chiropractic care delivered a significant pain reduction benefit compared with simulated manipulation, and no patient experienced an adverse event. These impressive findings have important implications for the treatment of sciatica. Practitioners managing patients with acute back pain and sciatica with protruding discs should consider chiropractic care as a first option.
Dr. Scott Swanson is a chiropractor in Outer Sunset District of San Francisco specializing in the treatment of non-surgical spinal conditions. Call 415-566-7134 for additional information.
February 2010
To X-ray or Not to X-ray? 
Patients with a brief history of back pain frequently request an x-ray to determine the cause of their pain and to make sure it is nothing serious. While an x-ray might seem helpful, is it? Does it benefit the patient or simply expose him to risks?
Research studies confirm that x-rays are not necessary for most patients with a recent incident of low back pain and have generally been overused. A complete medical history and physical examination can usually identify any dangerous conditions that may be associated with back pain.
There are a couple major reasons why x-ray offers little value for patients with a recent attack of back pain. First, a lot back pain comes from ligaments and muscles that cannot be seen on an x-ray. Second, as we get older, the bones of the back change due to normal wear. On an x-ray, these normal changes can be mistakenly identified as the cause of back pain. Given these limitations, x-ray seldom provides information useful to treatment.
Aside from its lack of benefit, x-ray exposes patients to potentially harmful radiation. Medical health physicists have noted that low-back x-rays expose sex organs to large doses of ionizing radiation (many times greater than that associated with a chest x-ray). Pregnant women have been warned for decades to avoid x-rays because of the potential harm to the fetus. Although the precise effects of x-ray radiation remain uncertain, it is linked to serious risks, including cancer and death.
Another concern with x-ray is the financial cost. The US government recently estimated that the average cost for two low back x-rays is about $150. That means the overall cost of low back x-rays in America is nearly $1 billion every year -- most of which is estimated to be an unnecessary expense.
While x-ray generally is not helpful for assessing back pain, it may be necessary when a patient’s symptoms indicate a more serious condition requiring further assessment. For example, if a patient had a severe spinal trauma, a doctor might want to investigate the possibility of spinal fracture.
The advice for patients is to avoid x-rays unless there is a compelling reason for their use. Talk openly with your doctor about your specific condition and possible alternative means of diagnosis.
Dr. Scott Swanson is a chiropractor in Outer Sunset District of San Francisco specializing in the treatment of non-surgical spinal conditions. Call 415-566-7134 for additional information.
December 2009
