Lower back pain continues to affect millions of Americans each year. Some estimates suggest that 75-85% of all Americans will experience lower back pain during their lifetime. Over the last twenty years, surgery for conditions that cause sciatica pain, a specific type of lower back pain, have risen more than 200%.[a] Because this condition affects the quality of life for so many individuals, it’s important to let people know that surgery is an option but not the only option. In this article I want to give a brief description of what sciatica pain is and then share some thoughts on a popular randomized study I came across. Finally, I will discuss the Surgical Alternative therapies we integrate into a tailored treatment plan to help alleviate the pain and restore daily function so that our clients can enjoy an active lifestyle.
The sciatic nerve is the longest nerve bundle in the human body. Beginning at the fourth lumbar, the confluence of anterior and posterior nerve fibers run through the buttocks and down the back of each leg. Sciatica is pain associated with compression, pressure or irritation to the roots of the sciatic nerve. Symptoms related to sciatica include radiating pain in the lower back, shooting pain down the buttock or back of the leg, burning or tingling sensation along the pathway of the nerve, and numbness or limited muscle control in the leg. Typically, pain is localized to one side. Again, sciatica only refers to symptoms. There are a wide variety of conditions that cause sciatica. Multiple lumbar-spine associated disorders including herniated disks, degenerative disks, spinal stenosis, and spondylolisthesis can affect the sciatic nerve resulting in sciatica. It is also important to point out that not all lower back pain is caused by irritation of the nerve; soft tissue damage or injury can also play a significant role therefor, proper diagnosis is imperative in order to form an effective treatment plan.
Now that we have defined what sciatica pain is let’s delve into the aforementioned findings. The study was published in The New England Journal of Medicine; titled Surgery versus Prolonged Conservative Treatment for Sciatica. Participants in the study suffered confirmed sciatica pain caused by herniated disks, with onset of symptoms experienced between six and twelve weeks. Subjects were randomly assigned to two groups, early surgery and conservative treatment. The early surgery group had the procedure done within two weeks while the conservative treatment group continued therapy up to sixteen weeks with the option to have surgery extended. Data from each treatment group was collected on three different dimensions: functional status, intensity of pain, and perception of general health, then compared after one year
As a therapeutic massage specialist who has helped clients find relief from sciatica pain, the results of the study did not surprise me. The rates of recovery on all three measures were nearly identical for both subject groups at the end of the one year follow up period. In other words, surgery did not improve the overall quality of recovery defined by the indicators mentioned above. While some benefits included a quicker rate of recovery from pain reported in the short term; the difference between the two groups in the level of pain diminished by week twenty-six. To me, the findings seemed to say two things; first, that there are different treatment paths that can achieve the same overall goal and secondly, people have the option to try non-invasive options before electing surgery.
Comparatively speaking, the only statistically significant benefit the study observed for early surgery was an increase in the rate of which the sciatica pain subsided. There is no question that this option could benefit someone who needed relief from debilitating pain immediately but many patients can find relief through other methods of treatment. For example, 16 of the 141 patients assigned to the early surgery group in this study recovered before surgery could be performed[b]. In addition, 61% of the conservative therapy group did not undergo surgery at all[c]. Remember, at the end of 1 year there were no differences in recovery between the two groups, an important note that should be emphasized to those faced with the option of surgery compared to alternative treatment methods. The point is that people are very diverse and each case is highly variable, so one treatment method will not work for everyone. Take time to learn the facts about each treatment option before charting a course to recovery.
As I mentioned before, surgery is a viable option for those dealing with intractable pain or for those who have exhausted all other treatment options. It is also important to recognize the benefits of surgical alternatives that have helped bring relief to individuals suffering from sciatica pain. We have helped hundreds of clients overcome the affliction of sciatica pain and return to happy, active, pain-free lifestyles through body and structural rebalancing techniques as well as therapeutic massage.
Our process is simple. In our first consultation we construct a pain profile which involves a description of symptoms the client is experiencing as well as visual observations to assess balance. Our goal is to verify that the pain the client describes matches what we are seeing. Our next step involves kinesiology testing to assess for structural or musculature weaknesses / imbalances that are responsible for the symptoms. Once we have gathered all the relevant data we can begin treatment sessions and allow the body to begin healing. Our results-oriented approach is always focused on helping our clients alleviate their pain, regain normal function and, through our holistic approach; support a happy, healthy, pain-free lifestyle!
Please contact Surgical Alternative-Rehabilitative and Therapeutic Massage Therapy with your questions regarding sciatica pain or other conditions of which we may be of assistance. We would love to hear from you via the web or other social media outlets. For an appointment please visit our website to use our interactive calendar feature or call us at (813) 948-6300.
[a]Vega P, Charles MD http://www.medscape.com/viewarticle/737594
[b] Peul, W. C., et al. (2007). Surgery versus Prolonged Conservative Treatment for Sciatica.
[c] Peul, W. C., et al. (2007). Surgery versus Prolonged Conservative Treatment for Sciatica.
 Peul, W. C., et al. (2007). Surgery versus Prolonged Conservative Treatment for Sciatica. The New England Journal of Medicine, 356(22), 2245-2256.