Chiropractic care has always been regarded as highly effective for relieving backaches and headaches.

Inside you can read how chiropractic may be better than drugs for headaches and better than surgery for low back pain with sciatica (radiating pain from the back down the legs). Indeed surgery was found to be hardly better than just waiting and using conventional care. But chiropractic offers more than relief of back or head pain.

Chiropractic is about caring for the spine. All the nerves from the brain to all the other parts of the body run down the center of the spine in the spinal cord and branch off to the other parts of the body at each bone or vertebrae of the spine. The spine can affect these nerves and in turn, the nervous system affects just about every aspect of health from your immune response, to sensing pain, to controlling muscles and virtually every organ in the body. Because the spine so affects the nervous system, regular chiropractic spinal checkups should be a routine part of preventive health care just like getting your teeth cleaned and checked by the dentist prevents all sorts of more serious dental problems. Dentistry focuses on oral health. Chiropractic is all about spinal health. So don’t wait for a backache or headache. Get regular spinal checkups to protect your total health.

A major new and important study, published in the Journal of the American Medical Association, found that for back pain with radiating pain from lumbar disc herniation, patients recover almost equally well with or without surgery.1

In many cases it used to be thought that surgery was needed for this sort of condition and further that waiting for surgery could be harmful. But this study shows that not only is waiting almost as good as surgery, but most importantly, that there is no risk or significant harm in waiting, using non-surgical care instead, even in cases of severe sciatica.2

Sciatica is the name for low back pain that radiates from the low back out to the buttocks and down the leg. It is named for the rather large sciatic nerves that branch off from the spinal cord in your lower back and run down both legs to your feet. Compression of a sciatic nerve at the root where it branches off from the spinal cord can cause this radiating pain. Commonly this appears to be caused by a herniated disc, where the disc between the bones of the spine bulges out and pushes on the nerve. There can be other causes of sciatica like degenerative changes to the bone but as herniated discs are often seen in sciatica patients they often thought to be the culprit. Surgeons previously believed this required surgery to remove the bulging portion of the disc in order to relieve pressure on the sciatic nerve and relieve the pain. But it turns out that surgery is only effective some of the time and that the herniated disc is not always the problem. Indeed imaging studies often show herniated discs in patients with no related pain. Further patients with sciatica and herniated discs often get relief with conservative measures like chiropractic care yet subsequent imaging shows the herniation is still present.

In this new study there were 501 surgical candidates who had disc herniation and persistent radiating pain for six weeks or more, despite regular non-surgical care. They were randomly assigned to two groups. The surgery group received open discectomy, with removal of disc fragments and decompression of the nerve root. The second group got individualized usual care, which included physical therapy, home exercises, pain medications and a small group (36 or 11%) received chiropractic care. Outcomes were measured with standard pain and disability questionnaires taken at the beginning or baseline and then at follow-up of 6 weeks, 3 months, 6, month, 1 year, and 2 years.

Both groups showed strong improvements at each follow up period. While the surgical patients did slightly better in the raw numbers, there were no statistically significant differences.3 The researchers concluded, “there was little evidence of harm from either treatment.”4 Still on the surgery side there were complications during the initial surgery 5% of the time and 4% needed a second operation within the first year.

This study got a good deal of attention in the press and so an article in the New York Times noted that “many surgeons had long feared that waiting would cause severe harm but those fears were proved unfounded.”5 (emphasis ours)

The study got media attention because the researchers were well known, (the lead author in this study was editor of the prestigious medical journal Spine), the quality of the study was high, it had a two year follow up, and because it challenged much traditional thinking. The writers noted that that disc herniation is often seen on imaging when there are no symptoms and that there is a 15-fold variation in the rates of this surgery, discectomy, across various regions of the U.S., and so they wrote that this “raises questions regarding the appropriateness of some of these surgeries.”6
Our take on all this is that it is best to try conservative care first. This study did not attempt to compare surgery to chiropractic care. While a few of the non-surgery group did seek chiropractic care during the trial, almost 9 of 10 did not. Had this entire group had chiropractic care, we wonder if their results would have been far better than the surgical group. Some years ago a large study did show chiropractic care effective for sciatica cases where regular medical care like physiotherapy and drugs had not helped. Some 3,136 persons with low back and sciatic pain who had no positive results with standard medical care were given chiropractic care and over half had excellent results with no relapses and another 34% improved but had relapses that then responded well to additional chiropractic care. Only 15.2% had no significant improvement.7 So chiropractic care does work for sciatica, even with cases that failed with regular (non-surgical) medical care.

We think the most important finding of this study was that there is no harm in trying conservative care like chiropractic care first. Surgery on the spine is inherently dangerous, as any surgery is, to say nothing of the high costs and substantial recovery times that surgery entails. Chiropractic care is relatively inexpensive compared to surgery, has a fraction of the risk of most any surgery, and since there is no harm in waiting on surgery it seems obvious to try chiropractic care first if you suffer with sciatica. Patients can always opt for surgery later if they don’t get relief from conservative chiropractic care.

1. J. Weinstein, et al., “Surgical vs Nonoperative Treatment for Lumber Disk Herniation: The Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial,” November 22, 2006, JAMA, Vol. 296, pp. 2441-50, and “Observational Cohort, JAMA Vol. 296, pp; 2451-59 (as reported by D. Chapman-Smith, “Professional Notes,” January 2007, The Chiropractic Report, Harmony Printing, Toronto, Canada, Vol. 21, No. 1, pp. 1 & 4.)
2. D. Chapman-Smith, Ibid., p. 1.
3. Ibid., p. 4.
4. J. Weinstein, et al., Op. Cit. (as reported by D. Chapman-Smith, Ibid.)
5. New York Times, November 22, 2006, (as reported by D. Chapman-Smith, Ibid.)
6. J. Weinstein, et al., Op. Cit. (as reported by D. Chapman-Smith, Ibid.)
7. S. Nall, “The Role of Specific Manipulation Towards Alleviating Abnormalities in Body Mechanics and Restoration of Spinal Motion, 1982, Journal of Manipulative and Physiological Therapeutics, Vol. 5, pp. 11-15 (as reported by T. Koren, “Sciatica & Leg Pain,” 1991, Koren Publications. p. 5).

Many people today use prescription or over the counter drugs for headache relief. While treating a rare headache with aspirin or similar pain drugs may not do much harm, such pain medications can have serious and even deadly side effects when used repeatedly on a regular basis for recurring or chronic headaches. That is where chiropractic may be a better choice.

Different things can cause headaches. Even breathing toxic fumes can give you a headache. But many headaches arise from problems in the spine and particularly in the upper part of the neck where nerves that serve the head and face can easily be irritated by spinal problems in the neck causing pain in the head and face.1
Over the years various studies have reported that chiropractic care is often effective for tensions headaches as well as migraine. One study is particularly interesting in that it compared chiropractic care to a popular prescription drug often used to prevent tension headaches called Amitriptyline. The patients in this study had suffered with at least one headache per week over a period of three months or more. They had chronic headaches. The patients were divided into two groups. One would receive chiropractic care and the other would get the drug.

Both groups improved at similar rates from their baseline measures during 6 weeks of care. However, fully 82% of the group taking the drug suffered with side effects including dry mouth, drowsiness, or weight gain and five dropped out due to the severity of the side effects. In contrast only 4.3% of the chiropractic patients reported any side effects and these were only neck stiffness after the first chiropractic visit, which disappeared in all cases after the second week of care.2 The advantage for chiropractic care in side effects alone is significant enough but the real advantage of chiropractic care showed at follow-up four weeks after the care ended. The chiropractic group continued to enjoy a 42% reduction in headache frequency, a 32% reduction in headache intensity, a 30% reduction in pain medication usage, and a 16% improvement in functional health. The group given the drug however reverted back to their baseline values or was slightly worse in all outcome measures.3

This study illustrates that drugs for headaches often have negative side effects and no lasting value. The headaches came right back for the drug group. There is also an additional risk to taking drugs for headache in what some call the “rebound headache.”4 After long-term use the medication may give partial relief, but the headache returns as the medication wears off and is often more severe than the original headache.5 To treat it with drugs the patient will need more and more or the medication.6

Instead of subjecting yourself to risky drug treatments for your symptoms, try chiropractic. Call and make an appointment today, we can likely provide long term relief of your symptoms without the negative side effects of over-the-counter or prescription drugs.

1. C. Masarsky. “Headaches, Drugs, and Chiropractic.” July 30, 2005, Dynamic Chiropractic, Vol. 23, No. 16, p. 40-41.
2. P. Boline, et al., “Spinal Manipulation vs. Amitriptyline for the Treatment of Chronic Tension-type Headaches: A Randomized Clinical Trial,” March/April 1995, Journal of Manipulative and Physiological Therapeutics, Vol. 18, No. 3, p. 150.
3. Ibid.
4. D. Curl, “Chiropractic Aspects of Headache as a Somatovisceral Problem.” In C. Masarsky, M. Todres-Masarsky (eds), Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach. Churchhill Livingstone, New York, 2001, (As reported by C. Masarsky. “Headaches, Drugs, and Chiropractic,” July 30, 2005, Dynamic Chiropractic, Vol. 23, No. 16, p. 40-41).
5. Ibid.
6. Ibid.