Health Tips | Feb 02 | Disc Herniations & Manipulation
Should patients with confirmed herniated lumbar disks causing leg pain have a trial of spinal manipulation before surgery? A study in the Journal of Manipulative and Physiological Therapeutics randomized patients who failed three months of standard conservative medical treatment, into two groups. The first group received a trial of spinal manipulation for 8 weeks. The second group was treated with micro-diskectomy. Both groups had overall improvement with treatment. The most interesting finding was 60% of patients treated with spinal manipulation improved to the same degree as those that underwent surgery. The patients were followed for 52 weeks after treatment. The remaining 40% of patients that did not respond to a trial of spinal manipulation underwent surgical intervention and had excellent outcomes. This randomized clinical trial would suggest spinal manipulation be provided before surgery in patients that failed 3 months of non-operative medical management.
McMorland G, Suter E, Casha S, et al. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manip Physio Ther 2010