A SERIES OF CONSECUTIVE CASES OF LOW-BACK-PAIN WITH RADIATING LEG PAIN TREATED BY CHIROPRACTORS

Objective: To report the clinical presentation and outcome of consecut ive patients who received a course of nonoperative treatment, includin g manipulation, for low back and radiating leg pain. This review was c onducted to generate hypotheses for a future clinical trial involving manipulation for the treatment of lumbar spine disk herniation. Design : A case series of consecutive patients presenting to a postgraduate t eaching 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 pai n clinically diagnosed as lumbar spine disk herniation. Outcome measur es: All outcome measures were extracted from the patients' charts. Sub jective improvement reported by the patient, range of motion and nerve root tension signs were used to assess improvement. Results: Of the 5 9 patients who received a course of treatment, 90% reported improvemen t of their complaint. A subgroup analysis indicated that 75% of the pa tients that reported improvement of their conditions had an increase i n straight leg raising (SLR) and lumbar range of motion. The maximum c omplication rate associated with this treatment approach was estimated to be 5% or less. A previous history of low back surgery was a statis tically significant predictor of poor outcome. Conclusion: Based on ou r results, we postulate that a course of nonoperative treatment includ ing manipulation may be effective and safe for the treatment of back a nd radiating leg pain. This hypothesis remains to be tested in a prosp ective study.