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- ""New England Journal of Medicine"; A Comparison of Physical Therapy, Chiropractic Manipulation and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain; Cherkin, DC, Deyo, RA, et al; Oct 1998; Vol 339, 15
- ""New England Journal of Medicine"; A Comparison of Physical Therapy, Chiropractic Manipulation and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain; Cherkin, DC, Deyo, RA, et al; Oct 1998; Vol 339, 15
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Chiropractics Vs. Physical Therapy for Sciatica
Although similar in their drug-free, nonsurgical approaches to care, chiropractic and physical therapy have distinguishing differences. Both approaches have unique benefits and some limitations. Chiropractic focuses more on joint manipulation and physical therapy focuses more on muscles 3. Sciatica involves inflammation of the sciatic nerve and can be caused by either joint or muscle problems.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Physical Therapy
Physical therapy or PT is available in both hospital and clinical settings. Although state regulations vary, many states require you to see your doctor to get a referral to see a physical therapist. Even after your doctor does your initial examination and makes the referral, the physical therapist will do an additional evaluation to develop a treatment plan. Later stages of treatment include exercises for aerobic capacity, strengthening, flexibility and increased range of motion.
- Physical therapy or PT is available in both hospital and clinical settings.
Chiropractic
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The unique contribution made by chiropractic is a focus on joint manipulation, also called an chiropractic adjustment. Chiropractors are considered primary care providers and are seen without a referral from your doctor. After an initial case history and physical examination, which frequently includes X-ray or MRI studies, a treatment plan is developed. Chiropractors seek to reduce joint restriction by making adjustments to the joints by delivering an adjustive thrust to unlock restriction. Improved joint motion reduces inflammation and improves range of motion.
- The unique contribution made by chiropractic is a focus on joint manipulation, also called an chiropractic adjustment.
- Chiropractors seek to reduce joint restriction by making adjustments to the joints by delivering an adjustive thrust to unlock restriction.
Comparisons
In a 1998 study published in the "New England Journal of Medicine," researchers at the University of Washington found both approaches showed benefit in initial pain management. However, they found that long-term results at the one year mark were only slightly better than a group who received only education about self management.
Final Considerations
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You may not have to choose as most chiropractors include some physical therapy in their treatment plans and many physical therapists do some joint mobilization. Most trials have looked for long-term changes after only relatively short-term treatment of one or two months. Longer periods of treatment or learning to self manage may produce longer control.
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References
- SpineUniverse.com; Physical Therapy to Relieve Sciatica; Kamiah A. Walker; Dec 2009
- SpineUniverse.com; Chiropractic Treatment of Sciatica; Susan Spinasanta; Apr 2010
- ""New England Journal of Medicine"; A Comparison of Physical Therapy, Chiropractic Manipulation and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain; Cherkin, DC, Deyo, RA, et al; Oct 1998; Vol 339, 15
- FoundHealth.com; Low Back Pain and Sciatica and Chiropractic; S. Showalter;
- Henderson CN. The basis for spinal manipulation: Chiropractic perspective of indications and theory. Journal of Electromyography and Kinesiology. 2012 Oct;22(5):632-42. doi:10.1016/j.jelekin.2012.03.008
- American Chiropractic Association. About chiropractic.
- National Center for Complementary and Integrative Health. Spinal manipulation: What you need to know. Updated July 2019.
- Blanchette MA, Stochkendahl MJ, Borges da silva R, Boruff J, Harrison P, Bussières A. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: A systematic review of pragmatic studies. PLoS ONE. 2016;11(8):e0160037. doi:10.1371/journal.pone.0160037
- Swait G, Finch R. What are the risks of manual treatment of the spine? A scoping review for clinicians. Chiropr Man Therap. 2017;25:37. doi:10.1186/s12998-017-0168-5
- Peter J. Miller, Alessandra S. Poggetti. Qualitative study on chiropractic patients’ personal perception of the audible release and cavitation. Clinical Chiropractic, 2011;14(1). doi:0.1016/j.clch.2011.01.002.
- Rubinstein SM, van Middelkoop M, Assendelft WJ, et al. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews. 2011;(2):CD008112. doi:10.1097/BRS.0b013e3182197fe1
Writer Bio
Greg Cooper began writing in 2007 with his book "The Reasonable Radical." He completed undergraduate work at West Virginia University and received his Doctor of Chiropractic from Sherman College. Cooper taught spinal manipulation in orthopedic hospitals in China and was part of a sports medicine team for the 1992 Olympic trials.