Dr. Stephen Kaufman
and Lumbar Disc Pain: An Effective Approach
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
( 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.)
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.
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.
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.
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.
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
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
I now see results very rapidly; in fact, I expect them.
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.
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.
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.
for Treatment of Sciatica and Lumbar Disc Problems
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.
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
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
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.
Histories and Discussion
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.
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.
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.
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.
many people show improvement after a one or two treatments, most people will
require longer care to see and
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
back , right hip, sciatic pain
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.
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.