This is near and dear to my heart as I have yet again dodged the surgery bullet with full blown sciatica in
my good leg associated (initially) with loss of reflexes, an inability to heel or toe walk and muscle
strength loss which would have made me an immediate surgical candidate. Four months of chiropractic
care and I am neurologically intact with no real pain working on strength and stability . . . all those things
I would have had to do post surgically without the potential risk of adverse reactions (including death)
from general anesthesia and the potential neurological complications or failed back complications that
surgery risks!
Sciatica (Leg Pain) & Lumbar Disc Herniation; Surgery vs Chiropractic Care
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According to a group at Mayo Clinic.com (2010), "Sciatica refers to pain that radiates along the path of
the sciatic nerve and its branches — from your back down your buttock and leg. The sciatic nerve is the
longest nerve in your body. It runs from your spinal cord to your buttock and hip area and down the
back of each leg. Sciatica is a symptom, not a disorder (this means that while you may have sciatica
there is an underlying cause called the condition or disorder, that you must treat). The radiating pain of
sciatica signals another problem involving the nerve, such as a herniated disk"
(http://www.mayoclinic.com/health/Â sciatica/DS00516).
Sciatica symptoms include: Pain "…likely to occur along a path from your low back to your buttock and
the back of your thigh and calf. Numbness or muscle weakness along the nerve pathway in your leg or
foot. In some cases, you may have pain in one part of your leg and numbness in another. Tingling or a
pins-and-needles feeling, often in your toes or part of your foot. A loss of bladder or bowel control. This
is a sign of cauda equina syndrome, a serious condition that requires emergency care" (Mayo Clinic
Staff), 2010, http://www.mayoclinic.com/health/sciatica/DS00516/DSECTION=symptoms ).
A prime symptom of sciatica is leg pain in conjunction with herniated discs. Â When a person experiences
trauma and the forces are directed at the spine and disc the pressure on the inside of the disc increases
(like stepping on a tomato) and the internal jelly like material of the disc creates pressure from the
inside out. It tears the outer ligament layers (like cracking the skin of the tomato) causing the internal
material to go beyond the outer boundaries of the disc. This has often been misnamed a ‘slipped disc’
although the disc doesn’t really slip or slide, it is torn from trauma allowing the internal material to
escape.
Conversely, a bulging disc, which gets confused with a herniated disc, is a degenerative "wear and tear
scenario" that occurs over time with the annulus fibrosis degenerating. This can also be a "risk factor"
allowing the disc to herniate with less trauma due to the degeneration or thinning of the disc walls.
Lifetime prevalence of a herniated disc has been estimated to be 35% in men and 45% in woman and it
has been estimated that 90% of all leg pain secondary to herniated discs occurs at either the L4-5 or L5-
S1 levels. It has also been reported that the average duration of symptoms is 55.9 weeks, underscoring
the critical necessity for finding a viable solution for these patients"
(http://www.uschirodirectory.com/index.php/patient-information/item/235-herniated-discs-radiating-
pain-and-chiropractic).
In 2010, McMorland, Suter, Casha, du Plessis, and Hurlbert looked at the data on the approximately
250,000 patients a year who undergo elective lumbar discectomy (spinal surgery) for the treatment of
low back disc issues in the United States. The researchers did a comparative randomized clinical study
comparing spinal microdiscectomy (surgery) performed by neurosurgeons to non-operative
manipulative treatments (chiropractic adjustments) performed by chiropractors. They compared quality
of life and disabilities of the patients in the study.
This study was limited to patients with distinct one-sided lumbar disc herniations associated with one
sided radicular (leg) pain. The lumbar herniations were confirmed on MRI.  Based upon the authors’
review of available MRI studies, the patients participating in the study were all initially considered
surgical candidates.
Both the surgical and chiropractic groups reported no new neurological problems and had minor post-
treatment soreness. Â Of the 60% of the patients who underwent chiropractic care all reported successful
outcome while the 40% who tried chiropractic and still required surgery also all reported successful
outcomes. Of those patients choosing surgery as the primary means of treatment, 15% reported a failed
surgical outcome who then chose chiropractic as a secondary choice. Of those 15% with failed surgeries,
all were reported to have performed worse in clinical outcomes.
While it is clear that an accurate diagnosis could dictate that many patients require immediate
surgery, many also do not. The above study indicates that a conservative non-operative approach of
chiropractic care prevented 60% from surgery. While a larger study would give us more information,
based upon the outcomes, cost factors and potential increased risks of surgery, it was concluded that
chiropractic is a viable, first line treatment option.
These studies along with many others conclude that a drug-free approach of chiropractic care is one of
the best solutions for patients even with surgical lumbar discs and sciatic pain.
1. Mayo Clinic Staff. (2010, April 22). Sciatica, Definition. MayoClinic.com, Retrieved
from,http://www.mayoclinic.com/health/sciatica/DS00516
2. Mayo Clinic Staff. (2010, April 22). Sciatica, Symptoms. MayoClinic.com, Retrieved
fromhttp://www.mayoclinic.com/health/sciatica/DS00516/DSECTION=symptoms
3. Studin, M. (2010). Herniated discs, radiating pain and chiropractic. US Chiropractic Directory.Retrieved
from http://www.uschirodirectory.com/index.php/patient-information/item/235-herniated-discs-
radiating-pain-and-chiropractic
4. McMorland, G., Suter, E., Casha, S., du Plessis, S. J., & Hurlbert, R. J. (2010). Manipulation or
microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and
Physiological Therapeutics, 33 (8), 576-584
