Sciatica Clinical Trial
Official title:
A Pilot Study of Chiropractic Prone Distraction for Subacute Back Pain With Sciatica
Back pain is a major cause of disability in the United States. The lifetime prevalence of
low back pain is estimated at 60-90%. Back pain has conservatively been estimated to involve
total direct and indirect costs of over $25 billion annually in lost wages, treatment, and
related issues. These losses clearly extend to the active duty population cared for by
military health care facilities.
Chiropractic medicine is characterized by the use of a number of physical manipulations and
mobilization techniques, which can be used singly or in combination to treat a variety of
medical conditions. Although basic clinical practice guidelines for Chiropractic have been
developed, few studies have rigorously compared techniques and their outcomes for specific
conditions. Fewer still have sought to correlate treatment modality with both anatomical
effect and clinical outcome.
Throughout the military, Chiropractic care is available only to active duty personnel and
only at a limited number of medical treatment facilities. At National Naval Medical Center,
it is a well-established treatment option, where the full array of techniques is employed,
primarily for painful conditions, and most often for back pain. This study seeks to clarify
the mechanisms of action and efficacy of one specific treatment option, prone distraction,
for the relief of subacute sciatica due to radiographically confirmed herniated disc, and to
compare it to side-posture manipulation and standard medical management.
Prone lumbar distraction utilizes a specialized table with motorized continual motion
distraction. This table has multiple mechanical articulations that can be used to place
patients in a wide variety of positions. Patients being treated with continuous motion
distraction are placed prone with the table positioned for maximum comfort and
centralization of symptoms.
Side posture manipulation is a widely practiced, standard chiropractic technique, which has
been shown to provide considerable clinical improvement for patients with sciatica. Low-
grade oscillatory stresses are performed within the physiological range of normal joint
motion. The hip, pelvis and lumbar spine are rotated forward with manual pressure while a
counter rotation of the chest and thoracic spine is applied.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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