Spinal Degeneration

Spinal degeneration refers to a gradual deterioration in the function of the spine. Aging, injury or trauma can all contribute to wearing down the cartilage discs between the vertebrae.

Four stages mark the degeneration of the spine:

Phase 1 is the stage in which the spine loses its balance. Nerves are affected and joints and discs begin to age more rapidly. At this point, response to spinal care is generally positive.

Phase 2 involves a much greater degree of decay. As discs narrow even further, changes in posture become more evident. There is more pain than at Phase 1, but significant improvement is possible with chiropractic care.

Phase 3 is marked by further imbalances in posture, more advanced nerve damage, and bone deformation. A permanent loss of height can occur and loss of energy is significant. Disabilities may become more noticeable along with mental and physical weakness. Some reversal of symptoms may be experienced with the correct chiropractic care.

Phase 4 involves severely limited motion. Serious nerve damage, permanent scar tissue, and fusion of the bones may become noticeable. Phase 4 shows a significant increase in pain levels, while mental and physical abilities are severely compromised. Although considered irreversible, some relief from the condition may be expected from the appropriate chiropractic care.

Sciatica Pain Relief: No drugs, No surgery!

Backaches are very common ailments affecting nearly 80% of adults at one time or another in their lives. Backaches can stem from compressed or herniated disks in the spine, muscle strains and a combination of these. Often times, excessive weight (especially abdominal weight) and improper lifting are to blame.

Sciatica and Piriformis Syndrome affect the sciatic nerve that begins at the sacrum and extends down both legs. In sciatica, the sciatic nerve is not being directly compressed, but the nerve roots at the base of the spine that connect with the sciatic nerve are being compressed. In piriformis syndrome, the piriformis muscle in the buttocks region is directly compressing the sciatic nerve.

In either case, the classic marker is shooting pain down one or both legs. Though surgery and drugs (anti-inflammatories and pain meds) are often used to treat back problems, there are other options. First, it is imperative that a person loses weight, strengthens abdominal muscles and learns to lift properly. This may be difficult, however, if pain is not relieved in another way.

This is where massage therapy for sciatica pain can enable a person to carry on with daily activities and begin the path towards weight loss and strengthening their body. Your massage therapist may begin by assessing the lower back and buttock area to see if the pain stems from compression in the lower back, sacral area or buttocks. They will then concentrate on the piriformis. At this point, the massage therapy will depend on your particular pain. Your therapist may use gentle vibrations or deep massage to relieve the pressure and pain.1

Your massage therapist can also give advice on exercises that you can do at home to relieve pain. For drug-free, surgery-free pain relief, contact a licensed massage therapist today!

1. Barrett C. Massage Therapy for Sciatica: How to Reduce Pain in the Sciatic Nerve

Exercise could help sciatica patients avoid surgery

Studies on the efficacy of surgery for sciatica have produced conflicting results. An estimated 5-10% of patients that undergo microdiscectomy suffer from recurrent disc herniation after the operation. For patients undergoing another common sciatica surgery, lumbar laminectomy, 20-30% do not experience significant improvements in pain and function. Surgeries for sciatica also carry the risks of nerve root damage, infections,cerebrospinal fluid leakage, and more.

Recent research suggests that many sciatica patients could avoid the risks of surgery with exercise and chiropractic therapies. In a study published earlier this year in the journal Spine, Danish researchers tested the efficacy of active conservative treatment in patients who would normally qualify for surgery.

Half of the patients were assigned to perform symptom-targeted exercises while the other half were assigned sham exercises. The latter were designed to increase blood circulation but did not specifically target back pain. Patients were also advised to stay as active as possible without aggravating their leg pain.

By the end of the eight-week treatment, both groups had statistically and clinically significant improvements in pain, global assessment, functional status, and vocational status. But those in the targeted exercise group experienced substantially better outcomes. Although this isn’t the first study linking exercise with improved outcomes in sciatica patients, the findings confirm that surgery is not the only option for treating severe sciatica.

Previous research has also shown that patients with sciatic pain who may normally qualify for surgery could benefit from chiropractic care. In a 201o study comparing chiropractic adjustment to microdiscectomy , 63% of patients experienced substantial improvements with chiropractic treatments.

Reference

Albert HB and Manniche C. The efficacy of systematic active conservative treatment for patients with severe sciatica: a single-blind, randomized, clinical, controlled trial. Spine 2012; 37(7):531-42.

Acupuncture better than drug for sciatica

Acupuncture could be better than a common drug for treating sciatica pain, a recent small study suggests. After three treatments, 57% of acupuncture patients were cured compared to just 27% of patients taking a common pain killer and 20% receiving alkaloid injections.

Researchers from China divided 90 sciatica patients into three groups receiving treatments of warming acupuncture, tablets of a common drug called Nimesulide, and injections of a plant-based alkaloid used as a natural anti-shock treatment. The researchers then measured patients initial pain thresholds. Acute and chronic pain tends to lower your overall pain threshold, or the level of pain you can tolerate. As expected, the sciatica patients had lower pain thresholds compared to 300 healthy participants tested. Over time as patients began to recover with treatment their pain thresholds crept upwards. But patients in the acupuncture group experienced more significant improvements; their pain threshold increased by 1.65 mA compared to 0.5 mA for the drug and 0.72 mA for the injection group.

Researchers pointed out that acupuncture could release chemicals that alter neurotransmitters to block the transmission of pain. They also suggested that the burning moxa used in warming acupuncture could dilate capillaries in the affected area and improve circulation to strengthen the analgesic effects of acupuncture.

Though previous research suggests that acupuncture can also relieve back and neck pain, this study suggests it could also be beneficial for patients with sciatica.

 

Reference 

Chen M, Wang P, Cheng G, et al. The warming acupuncture for treatment of sciatica in 30 cases. Journal of Traditional Chinese Medicine 2009; 29 (1): 50-3.

Drug-free Sciatica Treatment

Pain medication is frequently prescribed for patients with sciatica, but a new article from the prestigious British Medical Journal reveals that there may be little efficacy in this practice.

In the article, researchers reviewed 23 studies that compared placebo pills to various drugs typically prescribed for sciatica. In study after study, drugs were found to be no more effective than a placebo in relieving pain. Drugs also did not significantly help  radiating leg pain, one of the primary symptoms of sciatica. Though two drugs did reduce overall pain, it was unclear how effective they were in the long-term.

This led researchers to conclude that there is no clear evidence demonstrating the efficacy or tolerability of common pain medications prescribed for sciatica.

Chiropractic is a better approach to sciatica than drugs. A 2010 study found that chiropractic does not pose the same risks as surgery yet it is just as effective.

Call our office today for natural, effective treatment of sciatica.
McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics. 2010; 33(8): 576-584.
Pinto,Rafael Zambelli. Chris G Maher, Manuela L Ferreira, Paulo H Ferreira, Mark Hancock, Vinicius C Oliveira, Andrew J McLachlan, Bart Koes.Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis. British Medical Journal. 2012, February; 344:e497 doi: 10.1136/bmj.e497.

Drugs Ineffective for Sciatica Relief

The efficacy of common drugs for sciatica treatment has been called into question in a recent  literature review. Although there are consistent guidelines for prescribing medication for low-back pain, “this is not the case for sciatica.” To address this lack of clear guidelines, researchers analyzed the results of current literature on treatment for sciatica using non-sterodial anti-inflammatory drugs (NSAIDs).

After evaluating 23 studies, researchers concluded that there is no clear evidence demonstrating “favourable effects of NSAIDs, corticosteroids, antidepressants, or opioid analgesics in the immediate term [relief of pain] even compared with placebo.” That means that in many studies, drugs were no more effective than a placebo in relieving pain. Several drugs also did not significantly impact leg pain, one of the primary symptoms of sciatica. Though some NSAIDs and an anticonvulsant called gabapentin did reduce overall pain in the short term, the long-term effective  were unclear.

For long-lasting relief of sciatica pain, chiropractic care combined exercise may ultimately prove more effective by addressing the root cause of sciatic pain instead of simply easing symptoms.

Reference:

    Rafael Zambelli Pinto, Chris G Maher, Manuela L Ferreira, Paulo H Ferreira, Mark Hancock, Vinicius C Oliveira, Andrew J McLachlan, Bart Koes.”Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis.” British Medical Journal. 2012, February; 344:e497 doi: 10.1136/bmj.e497.

Spinal Manipulation as Effective as Surgery for Majority of Sciatica Patients

The pain condition sciatica is triggered when an injury or misalignment of the spine interferes with the nerves that run from the lower back down each leg. Often this interference is caused by a herniated disc. Patients suffering from sciatica whose symptoms don’t improve after initial treatment with painkillers are often recommended to undergo spinal decompression surgery, also known as microdiscectomy. Over 300,000 microdiscectomies are performed every year in the United States, but in 10-20% of cases, surgery does not relieve the original pain symptoms. Other patients opt to use the services of a chiropractor who performs spinal manipulation.

Researchers in Canada conducted a pilot clinical trial to compare the effects of surgery versus spinal manipulation on 40 patients with sciatica caused by lumbar disc herniation (LDH). Patients participating in the study had not seen improvement in their sciatica symptoms after at least 3 months of trying nonoperative health therapies, including lifestyle modification, massage, acupuncture, or painkillers. Half of the study participants were then randomly assigned to receive microdiscectomy surgery, while the other half went on to receive spinal manipulation. Patients from both groups attended six rehabilitation sessions after their assigned treatment. After 12 weeks, patients in both groups who were not satisfied with their results were given the option to switch treatment groups.

Among the patients who were assigned to the microdiscectomy group, 85% improved after the treatment. For those who received spinal manipulation, 60% saw clear improvement of their symptoms. The patients from this group who then opted for microdiscectomy saw the same improvement rates as those who initially had surgery, but this was not the case for those who opted for spinal decompression post-surgery.

The study findings suggest that that for more that half of people suffering from sciatica caused by a herniated disc, spinal manipulation will offer a noninvasive path to pain relief that is just as effective as surgery. Those patients who do not respond to chiropractic care will still have the option of surgery, and as the researchers conclude “the obvious risk and cost profile of operative care argues for serious physician and patient consideration of spinal manipulative therapy before surgical intervention.” This research can help inform treatment options for patients with sciatica—although spinal manipulation may not be effective for all patients, it is a viable and cost-effective alternative to consider before surgery.
McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics. 2010; 33(8): 576-584.

Chiropractic Speeds Sciatica Recovery

Many people with sciatica find the pain to be so debilitating that they are forced to miss work and social gatherings. Among patients with lower back pain, those with sciatica experience the highest level of disability.1 According to public health records in Norway, patients with sciatica are disabled for an average of 72 days a year.

A recent study offers hope to patients suffering from sciatica pain. The new research suggests that chiropractic treatments may speed sciatica recovery, enabling patients to return to work faster.2 The researchers evaluated 44 Norwegian workers who had visited the hospital with severe sciatic pain. Most of the participants had been experiencing pain for at least three weeks before visiting the hospital.

In the hospital, a chiropractor evaluated each patient’s posture, gait, range of motion, and palpation of the lumbar spine. The chiropractor then performed joint adjustments to the spine, in addition to other joints that had been injured as patients compensated for the pain. Soft tissue soreness was relieved with ice treatment. Patients received daily treatments while in the hospital, and then three times a week for a period of two weeks. Some patients also underwent additional follow-up treatments, but most did not receive more than 14 treatments.

Within 21 days, 91% of patients had returned to work full-time. An additional 2 patients were back at work part-time. The researchers concluded that the study demonstrates the potential benefit of chiropractic care for sciatica patients.

References

Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.

Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.