Chiropractic Spinal Manipulative Therapy for Acute Sciatica Secondary to Lumbar Disc Herniation

Vancouver General Hospital

Status: Unknown

Conditions: Lumbar Disc Herniation; Acute Sciatica

Treatments: Other: Usual Care; Other: Chiropractic Spinal Manipulative Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT01552486

1R21AT006773-01A1

Details and patient eligibility

About

Comparisons of surgical and non-operative treatment of patients with acute sciatica secondary to lumbar intervertebral disc herniation (AS/LDH) have shown no appreciable difference in outcome. The composition of the non-operative treatment of this patient population remains poorly defined. Spinal manipulative therapy (SMT) has demonstrated value in the treatment of AS/LDH. Recent preliminary studies suggest that SMT provides therapeutic benefit through the modulation of in vivo inflammatory mediators. This feasibility study will define the key experimental variables required to conduct a large multicentre study that will clarify the biological and clinical outcomes of SMT in the treatment of patients with AS/LDH.

Enrollment: 40 patients

Sex: All

Ages: 19 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• chief complaint of sciatica rather than lower back pain
• pain of up to 6 months' duration
• a McCulloch criteria score of 5/5 (two clinical symptoms and two clinical signs of sciatica, and diagnostic imaging confirming the presence of a herniated nucleus pulposus contacting a spinal nerve root at the appropriate level)
• fluency in spoken and written English to ensure subjects understand the content of questionnaires and consent

Exclusion criteria

• progressive neurological deficit
• spinal fracture
• spinal tumor
• spinal infection
• spinal nerve root motor score of less than 4/5
• spinal stenosis that is not attributable to a herniated disc
• any other significant spinal ailment or local or generalized co-morbidity ailment that could affect outcomes independently of SMT ( e.g. seronegative spondyloarthropathy, malignancy).

Trial design

40 participants in 2 patient groups

Chiropractic Spinal Manipulative Therapy

Experimental group

Treatment:

Other: Chiropractic Spinal Manipulative Therapy

Usual Care

Other group

Treatment:

Other: Usual Care