Chiropractic Treatment More Effective Than Epidural Injections For Sciatica

Should I get an epidural injection or try chiropractic treatments for my sciatica pain?

This is a question I hear quite often. A recent study sheds light on the answer.

In a new study from the Journal of Manual and Physiological Therapeutics, researchers from Switzerland compared the effects of chiropractic spinal manipulative therapy (SMT) and epidural nerve root injections (NRI). The study included 102 with symptomatic, MRI-confirmed lumbar disc herniation who were treated with either SMT or NRI.

After one month of treatment, both groups experienced significant improvements. Of the patients under chiropractic care, 76.5% said they were “much better” or  “better” compared to 62.7% of NRI patients. Sixty percent of chiropractic patients had a significant reduction in pain compared to 53% of NRI patients. These slight differences were not statistically significant.

While none of the chiropractic patients received surgery, three of the NRI patients eventually opted for an operation.

Since the treatments were considered equally effective, the cost analysis became even more important for comparing both treatments, the researchers pointed out.  On average, one month of chiropractic adjustments was less expensive than NRI ($558 vs. $729). Their analysis included only the “minimum cost” of NRIs, and did not take into account other costs that are frequently tacked on like additional consultations with clinicians, multiple injections, or possible surgery. Additionally, treatment cost for chiropractic patients may have been slightly higher than normal since they were required to receive an MRI to be in the study. Many chiropractic patients do not receive MRI because imaging guidelines do not recommend MRIs for patients with lumbar disc herniation in most cases. In contrast, MRIs are typically performed before injections or other more invasive procedures.

By Kevin Fielden