Archive for Chronic Pain
Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica – which can include pain, tingling, numbness and muscle weakness – is really a symptom indicating an underlying problem, not a diagnosis in and of itself. This article will explore in detail the findings of a recent controlled study comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches.
The study discussed here was conducted by the National Spine Center in Alberta Canada and published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics. The 40 study participants all had sciatica lasting over 3 months which had not responded to treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or acupuncture. They had all been referred by their primary care physicians to spinal surgeons who had deemed them appropriate surgery candidates.
Instead of having all the patient proceed with surgery, they were split into two groups – one group to undergo a surgical microdiscectomy and the other group to be treated with standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the results they obtained from their assigned method, the patients were allowed to switch to the other treatment plan after 3 months.)
So what happened? Both groups made significant improvements over baseline scores – meaning that they saw noticeable improvements whereas previous approaches had failed. A full 60% of the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if they underwent surgery. And, after 1 year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their primary care physicians and accepted as surgical candidates by the neurosurgeon could actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting, anesthesia and ER time.
There is one paragraph in the results section of this study that is easy to overlook, but incredibly important. There were originally 120 candidates of which 60 met the study criteria and were asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal manipulation as an alternative to surgery! They didn’t want to participate in the study and be randomly placed in the surgery group without first trying the spinal manipulation! This is incredibly telling. Not only does it demonstrate that there is still a lot of education about chiropractic that needs to happen among the public and among primary care providers, it also demonstrates that people understand the risks and costs of surgery and want to exhaust other possibilities first.
This was the first study to ever look at people who had failed traditional medical management of sciatica. Currently most patients that fail ‘conservative care’ are referred for a surgical evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term outcomes with chiropractic.
It’s 2 am and the crying has only gotten progressively worse across the past hour. You are pacing the downstairs hallway trying anything to soothe your inconsolable 10-month old so that your 5 and 8 year old kids can get some sleep upstairs. Your plan is to call the doctor’s office the moment they open – seven hours from now!
Although your infant cannot tell you what is wrong, your intuition says it is another middle ear infection. The statistics would suggest that your hunch is probably right. Earaches are the #1 reason for visits to the pediatrician’s office. As a parent, that probably comes as no surprise. But, you may be surprised to learn that both the American Academy of Pediatrics and the Academy of Family Physicians recommend a “watchful waiting” or “wait and see” approach to acute ear infections. Research published in the prestigious Journal of the American Medical Association demonstrated that there was no difference in fever, otalgia (pain) or number of future visits between kids that were given an antibiotic prescription and those that were not. As it turns out, antibiotics only outperform the body’s own immune system in a handful of cases.
At the same time, numerous studies of manipulative therapies including chiropractic care have shown remarkable results without the side effects of antibiotics. A groundbreaking 1997 study of 332 kids ages 27 days to 5 years indicted a strong correlation between chiropractic adjustment and the resolution of otitis media (the technical term for a middle ear ache). Just to highlight one finding – there were 104 kids in the group classified as having ‘chronic’ otitis media. This group of kids got 5 chiropractic adjustments each. Across the next six months the recurrence rate among this group was only 16%!
Let’s put that data into more human terms. That means that 84% of these kids classified as having chronic ear infections went six months without having another one after just 5 adjustments. A full half year devoid of screaming in the middle of the night, lost sleep and anguish of watching your child suffer for 84% of the parents.
The prior study published in a chiropractic journal spurred further research into the uses of chiropractic care for acute and chronic ear infections. The critical questions was – how would chiropractic fare head-to-head with standard pediatric care? A 2003 study published in a pediatric medicine journal comparing children receiving manipulative therapy and those receiving standard pediatric care, found that those who received manipulative therapy had fewer episodes of Acute Otitis Media (AOM), fewer surgical procedures and had higher rates of normal tympanograms.
This amazing news for parents has been validated and confirmed numerous times since then. The International Chiropractic Pediatric Association (ICPA) even maintains a webpage of all the published research studies done on children’s ear infections and the role of chiropractic care in treatment and prevention. The last time I looked there where 25 separate studies listed. You can view the full list at: http://icpa4kids.org/Chiropractic-Research/Ear-Infection-Otitis-Media/
All this data and research is great, but at the end of the day what matters to parents is getting their own child out of pain and on a path to a success in school, sports and life without the constant interruption of ear infections. Don’t spend another sleepless night pacing the halls with a screaming toddler in your arms. Call us now and make an appointment for a consultation.
Don’t wait until another ear infection strikes. Prevention is always the better option. Besides, when your child is in pain, your anxiety level as a parent goes way up. We want you to be able to ask all your questions and get all the facts at your own pace and not feel pressured to make a decision or start treatment because your child is screaming. Of course, if your child does have current symptoms, we want to see both of you as soon as possible.