Active vs. Passive Conservative Treatment for Sciatica (Part 3 of 3)

Previously, treatment for low-back pain consisted of bed rest or passive treatment methods. Now more studies are pointing to the benefits of staying active with pain thresholds. The word “active” is a double entendre though: not only does it mean more exercise, it also means that patients take an active role in their treatment by “taking responsibility in the treatment process” (1). Researchers in a recent study wrote that in active conservative treatment, “the treatment provider has a new role as ‘coach’ for the patient, instead of being the person who is expected to provide a cure.”

Using this approach, the researchers compared two methods of active conservative treatment for severe sciatica that included chiropractic care. ( Read more about their methods here). All the patients improved significantly within the 8 week study. At the one year follow up, 91% reported feeling better or much better.

Conservative treatment generally refers to anything that isn’t surgical, but within this definition exists a wide variety of treatments and methods. Researchers pointed out though that not all conservative treatments are the same and that “some conservative treatments are clearly more efficacious than others.” In the case of this study, patients who completed symptom-targeted exercises achieved better outcomes than patients did more general exercises. The researchers wrote that their study combined with results from other studies demonstrates that the appropriate type of active conservative treatment may be more effective than surgery for treating sciatica. (Read more about comparing conservative treatment to sciatica here).

Albert, HB and C. Manniche. “The efficacy of systematic active conservative treatment for patients with severe sciatica.: A single-blind randomized clinical controlled trial.” Spine (April 2011). doi: 10.1097/BRS.0b013e31821ace7f.