Tag Archives: leg pain

Sciatica

Our Symptom of the Week this week.

Many people have sciatica, you may have heard someone say, “my sciatica is acting up.”  Sciatica is actually a description of the symptoms experienced when the sciatic nerve or it’s roots become irritated.

Sciatic NerveIt is a group of sciatic pain syndromes.  Sciatica is kind of the Thoracic Outlet Syndrome of the lower limbs.  The tingling, numbness or pain can go from your low back all the way down the leg, or it can be fairly mild and just be in your back.

Your sciatic nerve is actually a large bundle of nerves from your low back that travels through your pelvis, out through the sciatic notch and between the piriformis muscle and the other deep hip rotating muscles.  When this nerve bundle becomes irritated or “pinched” pain ensues and can be present any where the nerve goes.

Sciatic Pain

Sciatic Pain

The actual diagnosis of Sciatica would mean that the nerves are “pinched’ at the nerve root specifically due to a spinal condition.  Degeneration, disc herniation, joint dysfunction, inflammation, etc. may cause this.  However the nerve can be “pinched” in places other than the spine.  Though they are technically termed pseudo sciatica there is nothing pseudo about the pain.  The only real difference is where the nerve gets irritated.

Piriformis Syndrome can cause similar symptoms to sciatica because the same kind of thing is happening.  The sciatic nerve travels through the muscles, if they are abnormally tight then the nerve can become “pinched” and cause sciatica.

Sacroiliac Joint Pain is another diagnosis that can cause pain similar to sciatica.  Though the nerve does not actually pass through the sacroiliac (SI) joint it does travel close enough that problems in this area may affect the nerve.  Problems in the SI joint its self can also cause symptoms that mimic sciatica in that there can be pain all the way down the leg.

The cause of your sciatic pain is very important because it dictates how it should be treated.  Your chiropractor is trained to correctly diagnose and treat the causes of these painful syndromes.  Many treatments may be effectively utilized by your chiropractor, from manipulation to decompression to physiotherapy and exercises.  You can do many things at home to help to.

Piriformis Stretch

Piriformis Stretch

Piriformis stretches are useful, and even if the symptoms are not due to your piriformis it may be tight and adding to the problem.  Talk to your chiropractor if you are having sciatica.

Lumbar Disc Herniation

Blown disc, slipped disc, herniated disc, bulging disc, etc.  There are many names for a vertibral disc herniation.  This is a hard subject to keep short.  I will attempt to just give basic, simplified information to limit the length of this post.

A disc herniation has various levels as with most injuries.  The worse the herniation the more complicated the symptoms and the treatment.  Most herniations can be resolved and respond well to conservative care such as chiropractic.  In fact most herniations will resolve on their own in 6 months, but no one wants to wait 6 months for their back pain to go away.  With chiropractic treatment the symptoms are often reduced to less than 50% in 6 weeks or less, and can at times be resolved completely in as little as 3 months.

Disc herniations can happen to anyone and they don’t have to just be in the low back.  They can happen due to constant pressure of poor posture, sudden pressure due to trauma, weakened muscles and ligaments or weaknesses you’ve had since birth.

Some of the signs that you may have a herniation are: a sudden onset of low back and possibly leg pain that can go all the way down the leg.  The pain is usually described as a sharp or shooting pain and increases with bending forward, (although this direction of bending is typical it is not universal) or pressure increases such as coughing, sneezing or having a bowel movement.

Image from Spine Universe

Image from Spine Universe

Treatment for disc herniations are many,  the ultimate goal is to get the disc to reabsorb back in.  To understand any treatment you must understand the nature of an intervertebral disc.  (video) It’s kind of like a Jelly donut.  If you squeeze a jelly donut the jelly comes out.  If you only do it a little bit and then take the pressure off the jelly will kind of suck back in.  If you relieve the pressure and the damage isn’t too severe the disc will suck it’s nucleus back in and repair with time.  This is called decompression.  It can be accomplished many ways, and there is still debate as to which method is best.

The big problem with disc herniations is that often the pain is too severe to receive treatment.  So, the initial goal is to reduce pain enough to be able to be treatment.  The sooner you can get up and moving around the better the prognosis is going to be, even though there is severe pain. Some pain control techniques are cold packs, electric stim, mechanical spinal decompression, and if required pain medication.

The next goal is to centralize the pain.  Many patients worry when their back starts to hurt worse, but if the pain is coming out of the legs and centering around the pain generator it is a good thing.  Centralizing the pain means that we are relieving the pressure on the nerve.  After the pain is centralized, treatment becomes more normal and regular.

Once you’ve had a disc herniation you may be predisposed to injury in the future, therefore it is essential that you begin some form of core strengthening routine to build up your muscles so that they can protect from future injury.

Disc herniations can be very painful and can interrupt your life for quite some time.  The good news is that with chiropractic care you can often avoid surgery and be back to normal again relatively quickly.

More info…