What's Best For Low Back Pain & Sciatica?

Low back pain and sciatica can be very frustrating and totally suck the enjoyment out of life.

Usually pain will resolve over time, typically 10 to 12 weeks. But for some, the pain either doesn't go away or keeps flaring up.

When pain persists for longer than 3 months, it's termed as "chronic". How to resolve chronic back pain and sciatica is always a hot topic of discussion.

Will a recent study published in 2023 shed any new light on which treatment will work best for low back pain and sciatica - spinal manipulation vs mobilisation?

Let's dive in......

The study recruited 40 patients diagnosed with disc herniation and radiculopathy (sciatic pain) lasting longer than 3 months. 

They were randomly split into 2x groups of 20 receiving one of the treatments below:

1. Spinal manipulation
2. Spinal mobilisation

Both groups also received a neurodynamic mobilisation technique immediately after spinal manipulation or mobilisation.

Each group was treated for 30 mins twice a week for 12 weeks by 2 experienced physiotherapists who swapped groups midway through to reduce bias.

They were all then given a standard home protocol to follow for 40 weeks.

Their reported back pain, leg pain, activity limitation, sciatica 'bothersomeness', sciatica frequency, functional mobility, quality of life, and overall effect of changes were measured at 6, 12, 26 and 52 weeks.

Results

• At the end of the 12 week treatment period 100% of the mobilisation group experienced an improvement in their symptoms compared to only 60% of the group receiving spinal manipulation.
• At the end of the 52 weeks, the mobilisation group generally improved more than the spinal manipulation group.

Caveats

This study does have some important limitations which should be considered when looking at these results:

• It was a small study with 40 participants. It would be interesting to see if these results can be replicated in a larger group.
• There was no control group (ie. a group having no treatment) for comparison
• Neurodynamic mobilisation was included in both the mobilisation and spinal manipulation groups. Therefore we don't know how effective mobilisation and manipulation are on their own.
• The researchers did not account for other factors that influence chronic pain eg. a participant's lifestyle, beliefs about back pain, social environment and socioeconomic status.

What can we learn from the results of this study?

I think the number 1 takeaway is that chronic pain is complex, and there isn't a one size fits all treatment protocol.

Invasive procedures such as surgery and epidural injections often improve pain faster but long-term outcomes are the same as more conservative treatments.

This latest study adds to the body of evidence that there isn't one magic treatment that will cure chronic back pain and sciatica.

I believe this is because chronic pain is complex with many factors involved.

1. Treating structure through manipulation helps somewhat. 
2. Mobilising the spine helps somewhat,
3. Calming down the sciatic nerve with neurodynamic mobilisation helps somewhat.
4. Leaving it alone and letting time heal helps somewhat.

But this isn't much consolation when you can't work or do the activities you enjoy because you're in pain.

This is why The Befriend Your Body (BYB) Method is NOT a 1 size fits all approach, and it doesn't just address one area, like only structure or only mobility.

Through gentle movement explorations The BYB Method enables you to feel how your body responds to movement, what triggers muscle tension for you and how to balance your body so it can work as Nature designed.

The BYB Method shows you how to self regulate your nervous system to reduce tension, and teaches you a simple yet often overlooked mindset shift that will transform how you think about your body and movement.

When you learn The BYB Method you'll learn how to adjust your structure, how to feel when your body comes out of balance and how to restore equilibrium and stability for yourself at home.

It doesn't replace traditional soft tissue and manual therapy if you're already in treatment, but it will complement these techniques so the results stick around for longer and longer.

The BYB Method is also effective on it's own as a stand alone home pain relief protocol.

NEXT STEPS

1) Make this the year you find freedom from persistent or recurring pain and muscle tension with The BYB Method workshop retreat.

Read about the upcoming workshop retreat and the results class members have gained from The BYB Method, some of them life changing, in their own words HERE.

8.5 hours of live tuition including 2x deeply relaxing sound bath experiences, with an optional 30 days of 1:1 personal coaching support to help fast track your results.

We'll bust some of the most common industry myths that are keeping you stuck in pain, and what to do instead to get out of pain. 

Read all the details about this event HERE.

2) You can also:

• Book into a Stretch, Yoga or Pilates class with me - these are a good introduction to The BYB Method and to take the first steps to your pain-free body.
• Attend a mind-body retreat - these are deeply relaxing, fun, social small group experiences typically held in various locations within easy reach of Worthing, West Sussex. The next retreat is  on Sunday 24th March. Click HERE for all the details.
• Subscribe HERE to receive "The Movement Chronicle", a weekly e-newsletter delivering mobility and pain reduction tips directly into your inbox every Monday morning,

If you would like support with managing pain or an injury please reach out to me on any of these channels:

• Email at norma.pearson1@ntlworld.com
• DM me on Facebook Messenger 
• WhatsApp message to 07801 867361.

Study Link

Musa Sani Danazumi, Jibril Mohammed Nuhu, Shehu Usman Ibrahim, Mubarak Abubakar Falke, Salim Abubakar Rufai, Usman Garba Abdu, Isa Abubakar Adamu, Musbahu Hamisu Usman, Abah Daniel Frederic & Abdulsalam Mohammed Yakasai (2023) Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial, Journal of Manual & Manipulative Therapy, 31:6, 408-420, DOI: 10.1080/10669817.2023.2192975