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Dr. Brian Abelson DC

Sciatica Part 3: Conservative Treatment

Updated: Aug 17


Manual Therapy on the Hamstring Muscle

With a notable success rate of over 90% in reducing or eliminating pain and improving function, our approach to sciatica treatment combines the power of manual therapy with targeted exercises to deliver truly remarkable results.


Sciatica treatment is not just about relief; it’s about empowering you to take control of your health. By addressing the root causes of nerve irritation, supporting functional recovery, and preventing future episodes, our methods promote a proactive and positive approach to overall wellness. Let’s dive into the specifics of these highly effective conservative treatments.


Article Index:

 

Conservative Approaches to Sciatica

Opting for non-surgical methods to treat sciatica often involves a comprehensive approach that focuses on relieving pain and enhancing mobility. These treatments can be both effective and holistic, encompassing a range of approaches:


  • Motion Specific Release (MSR)—a highly effective, multimodal, and interdisciplinary treatment system. MSR is extremely successful in both reducing pain and improving function by integrating manual therapy, functional movement, and other specialized interventions tailored to individual needs. Additional methods may include massage, heat or cold applications, and various techniques to reduce muscle tension and encourage healing.

  • Functional Exercises: Under the guidance of a professional, patients engage in exercises specifically designed to strengthen back and core muscles, improve flexibility, and promote proper posture. These exercises are crucial for relieving pressure on the sciatic nerve and enhancing overall mobility.

  • Osseous Manipulation/Mobilization: These techniques involve precise adjustments and mobilizations of the spine and joints to improve alignment and increase joint mobility, thereby alleviating pressure on the sciatic nerve. Chiropractic adjustments or osteopathic manipulations can be particularly effective in improving joint function and reducing nerve compression.

  • Acupuncture/Acupressure: Utilizing Traditional Chinese Medicine (TCM) principles, specific points such as BL40 (Weizhong), GB30 (Huantiao), and BL60 (Kunlun) are targeted to reduce pain and inflammation associated with sciatica. These therapies involve inserting fine needles or applying pressure to stimulate these points, enhancing the body's natural healing processes.

  • Cortisone Injections: Healthcare providers may recommend these injections to reduce inflammation and pain significantly. This reduction in pain allows patients to tolerate manual therapy better and perform the necessary functional exercises.

  • Pain Medication: Over-the-counter pain relievers like acetaminophen or NSAIDs may be necessary to manage pain and inflammation. It’s essential to follow your physician's advice to determine what is best for your particular case, ensuring safe and effective pain management.

  • Lifestyle Modifications: Making specific changes such as maintaining proper posture, achieving a healthy weight, avoiding prolonged sitting or standing, and setting up an ergonomic workspace are essential in reducing spinal stress and preventing future episodes of sciatica. Incorporating regular physical activity, stretching routines, and mindfulness practices can support long-term spinal health.


 

Joint Manipulation/Mobilization


The human body's ability to move freely and without pain relies heavily on the health and integrity of its joints. When treating sciatica, it's essential to recognize that joints don’t function in isolation; they are part of a complex network where each joint influences others. An injury or dysfunction in one area can lead to compensatory biomechanical changes elsewhere in the body, often exacerbating sciatic pain.


For those suffering from sciatica, joint manipulation or mobilization can be critical in relieving pressure on the sciatic nerve by restoring proper joint function and alignment. By addressing these interconnected joints, healthcare practitioners can help reduce pain and improve overall mobility, supporting a more comprehensive recovery from sciatica.


Chiropractic Adjustment Demonstration Video

Adjustment Demonstration

Chiropractic adjustments are a powerful tool in managing chronic back pain and are especially beneficial for alleviating sciatica symptoms. These precise interventions help restore function to restricted joints and increase overall mobility, critical components of a well-functioning kinetic chain. Patients who incorporate regular chiropractic maintenance into their routine often experience better outcomes, as they maintain spinal health and prevent the recurrence of sciatic pain rather than waiting for acute episodes to seek treatment.



 

Motion-Specific Release


Motion Specific Release (MSR) is a comprehensive, multimodal treatment system that effectively addresses sciatica by combining osseous (joint) and myofascial (soft tissue) techniques with acupuncture and acupressure procedures. This dynamic, patient-centered approach recognizes the complex nature of sciatica, where nerve irritation or compression can stem from various interconnected musculoskeletal issues.


MSR is not a one-size-fits-all method but a personalized treatment considering each patient's unique medical history and clinical presentation. For sciatica, MSR targets the local sources of pain and the broader musculoskeletal imbalances contributing to sciatic symptoms. MSR provides a tailored approach to addressing the underlying causes of sciatica by restoring functional movement, alleviating pain, and enhancing overall mobility.


Sciatic Nerve Release Video
Click Image to Watch Video

Eliminate Your Sciatic Nerve Pain

In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures to alleviate sciatic nerve pain. Sciatica symptoms can arise from various issues such as disc herniation, foraminal stenosis, spinal stenosis, or nerve entrapment. Thankfully, most sciatica cases can be effectively managed without surgery, with no red flags.


Fascial Expansion: MSR Low Back Pain Protocol

In this video, Dr. Abelson, the Motion Specific Release (MSR) developer, demonstrates how fascial expansions are utilized in treating sciatica and low back pain. This approach combines a modern understanding of fascia, kinetic chain relationships, and the core principles of acupuncture and traditional Chinese medicine. This protocol effectively reduces pain and restores mobility by addressing the fascial restrictions that contribute to sciatic nerve compression.



 

Treatment Frequency for Sciatica


Tailored Approach: The frequency of treatment is customized according to the patient's pain levels, functional abilities, and response to therapy. Depending on individual schedules, patients can opt for two 15-minute sessions per week or one 30-minute session.


Acute Sciatica (2 to 4 weeks):

  • Frequency: 2 sessions per week.

  • Focus: Symptom relief, reducing inflammation, and preventing chronicity.

  • Note: In very acute cases, collaboration with a family practitioner may be necessary to prescribe medications or injections. This can help patients tolerate therapy, perform exercises, and get adequate rest.

Sub-Acute Sciatica (3 to 8 weeks):

  • Frequency: 1-2 session per week or bi-weekly.

  • Focus: Promote healing, restore function, and prevent the transition to chronic pain.


Chronic Sciatica:

  • Frequency: 1 session every 2-4 weeks as needed.

  • Focus: Maintenance care, managing ongoing symptoms, and enhancing self-management strategies.


Important Note: Combining manual therapy with a functional exercise program is significantly more effective than relying on either approach alone. Medications or injections should be considered adjuncts rather than primary treatments, as they offer minimal long-term benefits compared to comprehensive, non-invasive strategies.


 


Conclusion - Part 3

With a success rate of over 90% in reducing or eliminating pain and improving function, our approach to sciatica treatment emphasizes the importance of a comprehensive and individualized strategy. By integrating manual therapy, targeted exercises, and thoughtful lifestyle adjustments, we aim to address the root causes of sciatica, support functional recovery, and prevent future episodes.


In the next part of this series, "Sciatica Part 4 - Exercise and Activities of Daily Living (ADL)," we will explore how specific exercises and daily activities can be tailored to support your recovery and maintain long-term spinal health. By adopting these proactive measures, patients can continue to build on the progress made through conservative treatment, ensuring a sustained improvement in quality of life.




 

References - Part 3


  1. Snelling NJ. Spinal manipulation in patients with disc herniation: a critical review of risk and benefit. Int J Osteopath Med 2006;9:77–84.

  2. Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J 2006;6:131–137.

  3. Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther 2004;27:197–210.

  4. Lisi AJ, Holmes EJ, Ammendolia C. High-velocity low-amplitude spinal manipulation for symptomatic lumbar disk disease: a systematic review of the literature. J Manipulative Physiol Ther 2005;28:429–442.

  5. Akeson WH, Amiel D, Abel JF, et al. (1987). Effects of immobilization on joints. , 219, pp. 28-37.

  6. Woo SL, Matthews JV, Akeson WH, et al. (1975). Connective tissue response to immobility: correlative study of biomechanical and biochemical measurements of normal and immobilized rabbit knees. , 18(3), pp. 257-264.

  7. Coronado RA, Gay CW, Bialosky JE, et al. (2012). Changes in pain sensitivity following spinal manipulation: a systematic review and meta-analysis. , 22(5), pp. 752-767.

  8. Degenhardt BF, Darmani NA, Johnson JC, et al. (2007). Role of osteopathic manipulative treatment in altering pain biomarkers: a pilot study. , 107(9), pp. 387-400.

  9. Mitchell JH, and Schmidt RF. (1977). Cardiovascular reflex control by afferent fibers from skeletal muscle receptors. In: Shepherd JT, et al, eds, Handbook of physiology, Section 2, Vol. III, Part 2. Bethesda: American Physiological Society, pp. 623-658.

  10. Schleip R. (2003). Fascial plasticity— a new neurobiological explanation. Part 1. J Bodyw Mov Ther, 7(1), pp. 11-19.

  11. Van der Wal J. (2009). The architecture of the connective tissue in the musculoskeletal system: An often-overlooked functional parameter as to proprioception in the locomotor apparatus. In: Huijing PA, et al, eds. Fascia research II: Basic science and implications for conventional and complementary health care. Munich: Elsevier GmbH.

  12. Chen C, and Ingber D. (2007). Tensegrity and mechanoregulation: from skeleton to cytoskeleton. In: Findley T, and Schleip R, eds. Fascia research. Oxford: Elsevier, pp. 20-32.

  13. Findley T, and Schleip R. (2009). Introduction. In: Huijing PA, Hollander P, Findley TW, and Schleip R, eds. Fascia research II. Basic science and implications for conventional and complementary health care. München: Urban and Fischer.

  14. McGill, S.M. Ultimate back fitness and performance, Backfitpro Inc., Waterloo, Canada, 2004. ISBN 0-9736018-0-4. Fourth edition 2009.

  15. McGill, S.M. Low back disorders: Evidence based prevention and rehabilitation, Human Kinetics Publishers, Champaign, IL, U.S.A., 2002. ISBN 0-7360-4241-5, Second Edition, 2007.

  16. Lori A, Boyajian-O’ Neill, et al. Diagnosis and management of piriformis syndrome:an osteopathic approach. J Am Osteopath Assoc Nov 2008;108(11):657-664


 

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DR. BRIAN ABELSON DC. - The Author


Photo of Dr. Brian Abelson

Dr. Abelson is dedicated to using evidence-based practices to improve musculoskeletal health. At Kinetic Health in Calgary, Alberta, he combines the latest research with a compassionate, patient-focused approach. As the creator of the Motion Specific Release (MSR) Treatment Systems, he aims to educate and share techniques to benefit the broader healthcare community. His work continually emphasizes patient-centred care and advancing treatment methods.



 


MSR Instructor Mike Burton Smiling

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Integrating MSR into your practice can significantly enhance your clinical practice. The benefits we mentioned are only a few reasons for joining our MSR team.



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