Dr. Stephen Kaufman

Denver, CO.

(303) 756-956


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Sciatica and Lumbar Disc Pain: An Effective Approach  

Abstract: A new approach to the problem of sciatica and lumbar disc pain is described, with some illustrative case histories. The treatment described is non invasive, very safe, cost effective, and extremely effective, in this author's experience. It does not involve chiropractic manipulation.  

( No attempt here will be made to describe the various diagnoses leading to sciatica. A patient with this problem should of course seek help from a competent physician to rule out any serious causes such as fracture, tumors, etc. The techniques here are applicable to idiopathic, non pathological syndromes. It is assumed any serious illness has already been excluded after a thorough work-up.)


   There are many different theories regarding the cause and treatment of low back pain. Every structure in the low back has been implicated by one author or another. The prolotherapists feel that lax ligaments are the culprits, while mainstream chiropractors feel the problems lie in malposition or fixation of the vertebrae of the spine. Old time osteopaths laid more emphasis on the sacroileac joints of the pelvis, as do current SacroOccipital Technique chiropractors. Deep tissue  and myofascial therapists attend primarily to the muscles. Acupuncturists may feel there is a problem in the energy fields of the meridian system, although some forms of acupuncture focus on the gross physical structures, especially the muscles and ligaments.  Neurosurgeons favor the  vertebral discs as an etiologic agent. The family practitioner M.D. generally prescribes pain killers and thus avoids the question of causation.

   Naturopaths and Ayurvedic practitioners may feel the problem stems from the digestive tract and might prescribe appropriate dietary and detoxification  measures. Nutritionists would seek to supply the nutrients that normally make up healthy connective tissue . Physical therapists might address appropriate exercises to stretch, strengthen , and stimulate the area. Of course, there is considerable overlap and any particular practitioner might use a combination of these approaches.

   When I was in chiropractic school in 1975, we were taught very detailed anatomy and physiology. We learned the structures of the low back in great detail and were given some tools to deal with low back pain, with an emphasis on chiropractic spinal manipulation. When I began my internship, and later my practice, I of course treated many patients with varying types of low back pain. I found that although some responded very well to manipulation , many more did not.

   Out of necessity I learned many more techniques for dealing with the low back and pelvis. I observed from the beginning of my practice that sciatica was often a different breed of duck than garden variety low back pain. While it would usually respond to treatment, it took much longer than  other low back pain. In my colleagues' patients as well as my own, sciatica was much harder to help. In the extensive reading and post graduate training that I did, it seemed that most teachers and doctors agreed with me . Sciatica is often a very resistant, difficult condition to treat.

   As I garnered training in one technique after another, the magic bullet for sciatica seemed to elude me. There were definitely many patients with sciatica that did get well. There were definitely many instances of dramatic cures and pain relief. Acupuncture especially was very useful. All of the procedures that I mentioned in the first paragraph do help sciatic patients at one time or another. Nevertheless my results with sciatica were always less than with other types of low back pain. It just took much longer.  I would silently cringe when a new patient would come in with that symptom.

   In the late 1980's I made a series of almost accidental observations which led to the discovery of an effective protocol for sciatica and most other disc problems. I noticed as I added new techniques that patient's sciaticas would start getting better in  two or three  visits.  I now see results very rapidly; in fact, I expect them.

   I had a well dressed patient named Chevy, a 35 year old male art dealer who had been in a severe auto accident. After three months, treatment had eliminated all of his low back and neck pain, but he still had a constant sciatica. I referred him to a neurosurgeon, who  wanted to do surgery , and did not feel any further chiropractic care would be helpful. Both the patient and I felt this was a poor choice. As I was reexamining him, I happened to test his ileocecal valve through the usual Applied Kinesiological methods. Finding it to be slightly inflamed, I treated it accordingly. (The patient had no abdominal or digestive symptoms whatsoever.) To my surprise, at his next visit the patient reported that the sciatica had totally disappeared immediately after that treatment. I knew this patient for several more years and he never had a recurrence of sciatic pain.

   The ileocecal valve (ICV)  is well known among Applied Kinesiologists as a potential source of involvement in low back problems but usually there are digestive symptoms accompanying ICV involvement. This patient had neither digestive nor low back complaints. Just sciatica. I made the ICV a priority part of my sciatic and lumbar disc work-up.

   I had always had a preference for low force chiropractic adjustment techniques. In 1988 I began to search for alternate ways to align the spine. I wanted to develop a way to align the spine that would stop pain, restore range of motion, and be completely gentle, without any possibility of hurting. It would work more quickly , last longer, and give better pain relief than my previous techniques. In the process of developing this method, I noticed that patient's sciaticas  would clear  up in record time. This was completely unexpected to me.  

Method for Treatment of Sciatica and Lumbar Disc Problems  

   There are a large number of techniques that I currently use in this condition, and they are always tailored to the individual's needs as well as their tolerance. Many people abhor needles, and choose not to have acupuncture. Acupressure , which is often as successful as needle treatment, does not work as well for sciatica. Nevertheless , the following procedures more than make up for it. Any one individual may need some or all of these procedures. The need is determined by the examining doctor who hopefully is proficient in these procedures. Even the home care alone may work in some cases.

1) The sacroileac joint is corrected according to the Category One or Two blocking system of Sacro Occipital Technique (SOT). In most cases a sciatic patient has a Category Two and is placed on the SOT  wedges face up for one minute. In this case manual muscle testing will usually show a weakness of the sartorius and gracilis muscles on the side of the patient's short leg. Strengthening these with acupressure on their tendons and lymphatic points will  greatly help to stabilize the sacroileac joint.

2)  The other muscles of the pelvis and low back need to be tested and strengthened in the same way, including the psoas, piriformis, gluteus medius, tensor fascia lata, gluteus maximus, adductors,  and hamstrings. The testing and strengthening procedures are described in Walther (1)  and Thie (2).

3) Areas of  malposition (subluxation) and fixation of the lower spine are gently corrected in the following manner. The doctor's thumb is placed on the left side of the lower vertebrae (e.g., S1) and the right side of the next vertebrae up (e.g.  L5). Very light pressure is applied to separate the two vertebrae. This is than continued up the spine (L5 and L4, L4 and L3, etc). to about T8. This is than reversed at right S1 and left L5, etc. up the spine again. Very light pressure is used .

4) The side of possible disc compression of L5-S1 or L4-L5 is determined and light traction is applied only by hand on that side. None of this should be painful to the patient! It should all be very comfortable.

5) If the patient has trouble bending forward, apophyseal glide techniques as described by Mulligan  (3)  may be applied . The doctor's thumb or palm lightly presses the L5 spinous forward and superior as the patient slowly flexes forward. This is done very gently and slowly , to patient's comfort. If done correctly, the patient will usually show a substantial  improvement in range of motion.

6) As mentioned, the ileocecal valve needs to be examined and treated , usually by  very light touch or reflex stimulation.

7) The doctor will consider treating acupuncture points B54, B60, K5, GB 30, and local points on the SI joint and lumbar sacrospinalis muscles.

8) Some patients have an upper cervical or occipital problem that occasionally will produce dramatic improvement in sciatica, when corrected.

9) Abdominal massage, or Hara treatment, as described in Matsumoto and Birch (5) is often helpful. Basically, pressure on trigger points on the patient's abdomen is applied to tolerance. Be very careful with this technique around the appendix area, on the right side of the patient's lower abdomen! Apply only tolerable pressure, never painful!

10 ) Now for the part most of my readers will understand! The patient should apply a blue ice  pack over the sacroileac joint and lumbosacral area on the side of the  sciatica, and go for a walk for 12 minutes.  Walk with the ice in place. Don't sit, walk with the ice pack over the SI joint. (Of course, place a paper towel between the ice pack and the skin). No more than 12 minutes. This can be done 2-3 times a day. This is enormously helpful, sometimes unbelievably so.

11) Supportive nutrition includes 400 IU of Vitamin E and one to 4 grams a day of Vitamin C (as calcium or sodium ascorbate ), to bowel tolerance. Glucosamine sulfate at 1500 mgs. a day is helpful longterm for improving the function of the joints in the lower back. It often gives pain relief in chronic lower back pain. Vitamin B1 100 mgs. three times a day, and B12, one sublingual lozenge three times a day, may reduce nerve irritation.


Case Histories and Discussion   

   Ted was a 45 year old male with a history of several months of intractable pain  and numbness in his left foot. He had slight back pain. This came on after he hurt his back moving furniture, but the back pain had almost stopped. His HMO had x-rayed his foot, done EMG testing on his foot, done blood panels, and performed an MRI ( on….his foot!) They never examined his back. After several months of increasing pain in spite of excessive pain medication, I examined him in my office. I diagnosed a lumbar disc lesion and a discontinuous sciatica. Within two or three  visits his foot was pain free and he was of his pain medication and able to sleep again, for the first time in months. The numbness took longer to clear up.

   Bob had constant sciatica for 59 years (!), since an injury in Europe in World War 2. It had interfered with his sleep for most of the past century. Previous medical care had been limited to pain killers and recommendation for surgery. At 78, x rays showed severe degenerative joint disease of the lower lumbar vertebrae. His sciatic pain completely disappeared after the second treatment, although his back pain took longer to resolve.

    Terry had had sciatica constantly for over a year when she was first treated, in spite of having seen several other chiropractors and acupuncturists. It took several weeks,  but her pain eventually  resolved and never returned.

    Phil was a very active cyclist who had fractured his femur  in an accident two years previously. He had constant sciatica and low back pain, necessitating pain medication to sleep at night, although he still did not sleep well.

   Although many people show improvement after a one or two treatments, most people will require longer  care to see and maintain results.     


Chronic Severe Foot Pain                                               August 27, 2002       

I finally went to see Dr. Kaufman after searching over 2 months for a doctor that could diagnose and treat the chronic pain I was experiencing in my foot.  I had been unable to sleep much for several months, and even with the pain medication that other doctors had prescribed, I was hardly able to function.    No only was Dr. Kaufman able to diagnose my problem on the first visit, he was able to treat the cause of the problem so successfully (sciatica??) that within a couple of weeks I was no longer taking pain medication.  I was also sleeping well and functioning in my normal daily routine.      Thanks for your help Dr. Kaufman.  I only wish I had come to see you sooner.                              Charlie Dancoster

Lower back , right hip, sciatic pain                                                                    

In early August I injured my lower back and fractured my right hip. I had sciatic pain that ran the length of my right leg and into my foot. Because of this pain I was unable to sleep and was having trouble standing for any prolonged periods. I begin treatment with Dr. Kaufman on August 20, 2002. For the first time in several weeks I was able to sleep the entire night without the aid of pain pills.                  Because of my hobby of BMX racing, I was not able have follow-up visit until 9-12-2002, at this time I still had some pain however greatly reduced and usually brought on by my riding. Since that visit the sciatic pain has not returned. I have maintained weekly visits for pain in my hip and have made great progress in this area as well.   Because of Dr. Kaufman’s treatment I have been able to sleep better, work has been more comfortable and my racing has return to my pre injury level.                    Bill Jacob            10/2/02 


Dr. Stephen J. Kaufman, D. C. , is a practicing chiropractor in Denver, Colorado. He has practiced chiropractic, applied kinesiology, myofascial and trigger point therapies, acupuncture, acupressure, Thought Field Therapy, yoga, and cranial osteopathy since 1978. He has developed many new techniques in soft tissue therapy and has published over 75 professional papers. He can be reached at (303) 756-9567.  2693 South Niagara St. ,Denver, CO., 80224.


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