title: Chiropractic treatment of lumbar spine synovial cysts: a report of two cases.
abstract: OBJECTIVE
  To present the treatment of low back and radicular pain due to synovial cysts of the lumbar spine including chiropractic distraction manipulation and physiological therapeutic care.
  
  
  METHODS
  Two patients (71-year-old man and 59-year-old woman) with magnetic resonance imaging (MRI)-diagnosed large synovial cysts at the L3 through L4 and L4 through L5 vertebral levels, respectively, had lower extremity pain, numbness, and tingling of the respective L4 and L5 dermatomes.
  
  
  RESULTS
  Chiropractic distraction manipulation was performed at the level of the synovial cyst. The manipulation was performed daily until 50% pain relief was attained, followed by diminished frequency of care. Physiotherapy included positive galvanism, iontophoresis, tetanizing electrical stimulation, stabilization exercises, and home cryotherapy. The male patient's pain was reduced by 50% in 14 days and 100% at 60 days. Range of motion of the thoracolumbar spine increased, walking distance increased from 1 to 2 blocks to 1 mile without pain, and repeat MRI showed reduced size of the cyst. The female patient, under the same treatment regimen, was pain free in 6 weeks.
  
  
  CONCLUSIONS
  Chiropractic distraction manipulation and physiological therapeutic care relieved 2 patients with low back and radicular pain attributed to MRI-confirmed synovial cysts of the lumbar spine. This treatment may be an initial conservative treatment option for synovial cysts with careful patient monitoring for progressive neurologic deficit which would necessitate surgery. Distraction manipulation may be a safe and effective conservative treatment of synovial cyst causing radicular pain; further data collection of clinical outcomes is warranted.
authors.affiliation: National University of Health Sciences, Lombard, IL, USA. jcox200@comcast.net
authors.forename: James M
authors.initials: JM
authors.lastname: Cox
authors.forename: James M
authors.initials: JM
authors.lastname: Cox
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D008159:Lumbar Vertebrae; D008297:Male; D026882:Manipulation, Chiropractic; D008875:Middle Aged; D013122:Spinal Diseases / Q000150:complications / Q000628:therapy*; D013581:Synovial Cyst / Q000150:complications / Q000628:therapy*