Expert: J.R. Strecker, B.S., D.C. - 5/8/2008

Question
I have Sacroiliac Joint syndrome with Sciatica and also have a right hip and pelvis rotation.
Recently went to a chiropractor that stated I have stage 1 and can be fixed with 24 treatments. To me that seems like an awful lot of visits for stage 1 of anything.....am I wrong? I have heard of people going to get "adjusted" but typically with 4-6 visits.
I do not have pain on a daily basis and have learned to live "ignore" the pain when I do have it. I am wondering if it is even worth it to seek treatment.  any suggestions would be most helpful thanks.

Answer
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Hello K.,

I'm sorry to hear about your problem.  I'm not here to judge and say a certain doctor is wrong.  But from my experience, I usually can clear up a sciatica problem with 3-6 adjustments IF adjustments are going to fix it.  If the sciatica has not been fixed after that many treatments, it should feel a lot better.  After 1-2 months of treatment, if there are still symptoms, standard protocol is to refer the patient for further imaging studies or to a medical doctor for management/co-management.  I would say if a chiropractor knows 24 is the magic number to fix a problem, it sounds like he/she might be looking into a crystal ball.  If that is the case, he/she is hopefully going to cover some corrective or maintenance care in those 24 visits.  In other words, the sciatica may clear in fewer treatments, but if he/she wants you to continue treatment it is because he/she wants you to become a wellness patient.  Here's my advice, get another opinion.  Again, I'm not saying your first chiropractor is wrong, but it's a free world, and you're always welcome to get a second and third opinion.  Because you have sciatica, you may be required to have an x-ray.  If the first chiropractor took x-rays, ask for them, and then take them to your second, third, etc... opinion.  There is nothing wrong with the chiropractor lending you the x-rays.  Lastly, simple adjustments alone may not fix the problem.  It's best if you go to a chiropractor that addresses the mechanical causes for the sciatica.  In other words, you need a diagnosis.  Is it a disc bulge?  Is it piriformis syndrome?  Is it facet syndrome?  There are certain exercises you need to be doing for some of these conditions -- not just adjutments.  Plus, you'll get better much faster if you do any necessary exercises.  I've consulted patients, given them the proper exercises, never adjusted them, and seen their sciatica completely resolve (and that was after they left a chiropractor they were seeing 3x/week for six months).  Your safest bet is to find a chiropractic orthopedist in your area.  These chiropractors have a stronger scientific background.  They will have the initials FACO or DACBO after the "D.C." initials.  Again, I'm not here to say your first chiropractor does not know what he/she is doing.  But you expressed concern in your question, and if you are concerned by the information you've been given, then go get additional opinions from other chiropractors.  And keep in mind, you may be lucky enough to have a chiropractor clear your sciatica up with just one adjustment, but occasionally extra treatments may be needed to help prevent additional occurences of your sciatica.  One option you could explore is trying to spread your 24 treatments out over the course of a year as a preventative measure.  But really, there is a great deal of flexibility when it comes to managing the chiropractic patient and your chiropractic care should be a fair treatment agreement that makes sense to the you.  So though I can't say if your chiropractor is right or wrong, I hope my answer helps clear things up for you a bit.

Best of luck!

Dr. J.R. Strecker, D.C.