Biomaterial Database

A series of consecutive cases of low back pain with radiating leg pain treated by chiropractors. 1995

P J Stern, and P Côté, and J D Cassidy

Department of Orthopaedics, Royal University Hospital, Saskatoon, Saskatchewan, Canada.

OBJECTIVE To report the clinical presentation and outcome of consecutive patients who received a course of nonoperative treatment, including manipulation, for low back and radiating leg pain. This review was conducted to generate hypotheses for a future clinical trial involving manipulation for the treatment of lumbar spine disk herniation. METHODS A case series of consecutive patients presenting to a postgraduate teaching chiropractic clinic between 1990 and 1993 was evaluated. Three thousand, five hundred and fifty-three charts were reviewed; in 71 of the cases, the patient had low back pain (LBP) with radiating leg pain clinically diagnosed as lumbar spine disk herniation. METHODS All outcome measures were extracted from the patients' charts. Subjective improvement reported by the patient, range of motion and nerve root tension signs were used to assess improvement. RESULTS Of the 59 patients who received a course of treatment, 90% reported improvement of their complaint. A subgroup analysis indicated that 75% of the patients that reported improvement of their conditions had an increase in straight leg raising (SLR) and lumbar range of motion. The maximum complication rate associated with this treatment approach was estimated to be 5% or less. A previous history of low back surgery was a statistically significant predictor of poor outcome. CONCLUSIONS Based on our results, we postulate that a course of nonoperative treatment including manipulation may be effective and safe for the treatment of back and radiating leg pain. This hypothesis remains to be tested in a prospective study.

UI	MeSH Term	Description	Entries
D007405	Intervertebral Disc Displacement	An INTERVERTEBRAL DISC in which the NUCLEUS PULPOSUS has protruded through surrounding ANNULUS FIBROSUS. This occurs most frequently in the lower lumbar region.	Disc Herniation,Disc Protrusion,Disc, Herniated,Disk Herniation,Disk Protrusion,Disk, Herniated,Intervertebral Disc Herniation,Intervertebral Disc Protrusion,Intervertebral Disk Displacement,Intervertebral Disk Herniation,Intervertebral Disk Protrusion,Prolapsed Disk,Protruded Disc,Protruded Disk,Slipped Disk,Disk Prolapse,Herniated Disc,Herniated Disk,Prolapsed Disc,Slipped Disc,Disc Displacement, Intervertebral,Disc Herniations,Disc Protrusion, Intervertebral,Disc Protrusions,Disc Protrusions, Intervertebral,Disc, Prolapsed,Disc, Protruded,Disc, Slipped,Discs, Protruded,Disk Displacement, Intervertebral,Disk Herniations,Disk Prolapses,Disk Protrusion, Intervertebral,Disk Protrusions,Disk, Prolapsed,Disk, Protruded,Disk, Slipped,Herniated Discs,Herniated Disks,Herniation, Disc,Herniation, Disk,Herniation, Intervertebral Disc,Herniation, Intervertebral Disk,Intervertebral Disc Displacements,Intervertebral Disc Herniations,Intervertebral Disc Protrusions,Intervertebral Disk Displacements,Intervertebral Disk Herniations,Intervertebral Disk Protrusions,Prolapse, Disk,Prolapsed Discs,Prolapsed Disks,Prolapses, Disk,Protruded Discs,Protruded Disks,Protrusion, Disc,Protrusion, Disk,Protrusion, Intervertebral Disc,Protrusion, Intervertebral Disk,Protrusions, Intervertebral Disk,Slipped Discs,Slipped Disks
D008159	Lumbar Vertebrae	VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE.	Vertebrae, Lumbar
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D002684	Chiropractic	An occupational discipline founded by D.D. Palmer in the 1890's based on the relationship of the spine to health and disease.
D005260	Female		Females
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D012585	Sciatica	A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of SCIATIC NEUROPATHY; RADICULOPATHY (involving the SPINAL NERVE ROOTS; L4, L5, S1, or S2, often associated with INTERVERTEBRAL DISK DISPLACEMENT); or lesions of the CAUDA EQUINA.	Neuralgia, Sciatic,Sciatic Neuralgia,Sciatica, Bilateral,Bilateral Sciatica,Bilateral Sciaticas,Neuralgias, Sciatic,Sciatic Neuralgias