Sciatica is one of the most common symptoms patients come into my office for. It is also one of the most misunderstood symptoms. It is commonly confused with back pain, buttock pain or certain leg pain or combination . However, sciatica is a symptom, not a condition.
Here are some facts about Sciatica. Hope this helps those who have symptoms to distinguish them from similar ones and find out what options are available to resolve the symptoms and fix the cause by addressing the source of the symptoms as well.
Definition/Presentation of symptoms
Sciatica describes pain that radiates along the sciatic nerve. The sciatic nerve is the largest single nerve in the human body; it runs from each side of the lower spine through deep muscles in the buttock and back of the thigh, and all the way down to the foot.
The pain can be severe for some, for others it is infrequent and irritating, but has the potential to get worse. Sciatica usually affects only one side of the lower body, often radiating from the lower back down through the buttock and down the leg. Depending on which part of the sciatic nerve is affected, the pain may also extend into the foot or toes.
The most common causes of sciatica are usually pressure on the sciatic nerve from a disc protrusion or extrusion (also referred to as a herniated/ruptured disc, pinched nerve, slipped disk, etc.), degenerative disc disease, or spinal stenosis. The problem is diagnosed as a “radiculopathy”, meaning there is pressure or irritation on the radicular nerve (nerve root).
Any of the following sensations may occur with sciatica:
■ Pain, burning, or tingling down the leg and possibly into the foot ■ Weakness, numbness or difficulty moving the leg or foot ■ A constant pain on one side of the buttocks ■ A shooting pain that makes it difficult to stand up or stand up straight ■ Pain in the buttock or leg that is worse when sitting
Most cases of sciatica will get better with time and non-surgical care. However, some sciatica symptoms may indicate a potentially serious condition and require immediate medical attention:
. Pain affecting both legs may signal important pathology and should prompt a consultation with your doctor for evaluation.
. If weakness is present, the nerve may be damaged and it is very important to seek attention from a health care professional. If the nerve is compressed and the pain and symptoms are severe, surgery may be warranted.
. If there is bowel or bladder incontinence (inability to control the bowel or bladder) and/or progressive weakness or loss of sensation in the legs, the condition is serious and immediate emergency medical attention is appropriate.
Sciatica is a symptom and not a diagnosis. The term literally means that a patient has pain down the leg from
compression on the sciatic nerve. The clinical diagnosis determines the cause of the compression (such as a
disc protrusion). The vast majority of sciatic episodes heal themselves within 6 to 12 weeks with proper non-
surgical care. If the sciatica doesn’t get better on its own, various treatment options can be considered.
Treatment Options for Sciatica
Non-Surgical Treatment and Chiropractic Care for Sciatica There are a number of non-surgical treatment options available to help alleviate the pain and discomfort of sciatic pain that a chiropractor may recommend.
As we discussed last week, decompression may be the best choice, especially the patients is going through space occupying lesion such as disc herniation, bulging and/or protrusion or degenerative disc disease. Revisit the previous blog by clicking Here or visit our Spinal Decompression page
Chiropractic Adjustment (also called Chiropractic Manipulation)
Chiropractic adjustment focuses on improving spinal function and reducing pressure on the sciatic nerve roots to treat the underlying problems which may be causing the sciatica. Chiropractic adjustment is intended to increase spinal range of motion, decrease pain and inflammation, and improve overall physical functioning.
How a Chiropractic Adjustment Works
Chiropractic manipulation typically involves:
. A controlled, sudden force applied to a spinal segment to normalize motion and improve function. Adjustments may be performed using high velocity or low velocity techniques.
. Reducing joint restriction and restoring function allows the local inflammation and pain reflex responses to begin to subside.
. In some cases, an accompanying, audible release of gas (joint cavitation or cracking) that is caused by the release of oxygen, nitrogen, and carbon dioxide, may be heard. This is a phenomenon and has no known physiological effect but signifies that pressure was released from the joint.
. A relieving sensation is usually perceived. Less frequently, minor discomfort may occur (that usually lasts for only a short time duration) if the surrounding muscles are in spasm or tense.
Other chiropractic treatments may include joint mobilization and soft tissue therapies.
Exercise and Physical Therapy
Specific sciatica exercises may be recommended that is designed to provide relief from sciatic pain in the back and leg, and the exercises are specific to the cause of the sciatica. Exercises are also important to prevent the condition from worsening and to condition the body to prevent future sciatic pain. Common types of exercises for sciatica, regardless of the cause, include strengthening the core muscles (back, abdominal, hip and gluteus muscles), extension exercises, hamstring stretching, and low impact aerobic exercise.
Cold Laser Therapy
Cold Laser therapy also known as Low Level Laser Therapy (LLLT) can be effective on reducing inflammation in and around of inflamed tissues including muscles, tendons, ligaments and fibrocartilages (disc). For more details Click Here to be directed to our Cold Laser site.
For acute sciatica pain, heat and ice packs are quite often the first step to try for relief. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated.
Over-the-counter or prescription medications may be helpful in relieving sciatica pain. Non-steroidal anti- inflammatory drugs (NSAIDs) or oral steroids can reduce inflammation, which is often a cause of pain.
Other Sciatica Treatments
Chiropractors may employ the use of other therapies including ultrasound, electrotherapy/TENS, acupuncture, various forms of traction, massage therapy and other techniques, depending on the specific cause of the sciatica.
Beyond Non-Surgical Care
As appropriate, a chiropractor may include other health care professionals in the patient’s sciatica treatment plan, such as a physical therapist, physiatrist, or osteopathic physician. If the sciatica pain is severe or has not improved within a reasonable timeframe, a chiropractor may refer the patient for an epidural steroid injection or a surgery consult.
For more information, call us at 303-750-3000 or visit www.AuroraChiroPlus.com