Help for Sciatica
Question: Dear Dr. Harvey,
I have been suffering from sciatica for the past month. I have tried a number of different treatments but nothing has worked and the pain is getting worse. What is the Chiropractic approach?
Sciatica is a very common problem which usually results in some type of symptom down the leg. This condition is usually a result of an inflammation of the sciatic nerve, the longest and largest nerve in the body. It is composed of five smaller nerves that leave the spinal cord from lower (lumbar) spinal column, join together and then travel down the leg. It then divides into many smaller nerves that travel to the thigh, knee, calf, ankle, foot and toes.
People with "sciatica" suffer from a wide range of symptoms. Some people may have only mild pain, which travels down the back into the upper leg. It may feel like a dull ache or numbness. For others, the pain may be very severe and travel down the leg into the foot and toes. Many factors affect the pain of sciatica. Sitting for long periods of time or driving can increase the pain, as well as working out or running. Also twisting activities, especially golf and tennis, have a tendency to cause a flare-up in sciatica pain. For some, the pain may be in both legs or change from side to side. For a number of others, back pain may occur before the sciatica itself.
Sciatica can result in a number of different areas. The first place to look is the lower back (lumbar spine). A misaligned spine of one or more of the lumbar vertebra resulting in pressure on the nerve is common. This condition is known as a subluxation. There may be disc involvement. The disc is the pad between the vertebra. The disc may bulge to one side resulting in what many people call a "slipped disc," although disc herniation is a better way of describing this condition. Degeneration or arthritis of the spine can also irritate the sciatic nerve. Trauma such as car accidents or falls may also result in sciatica.
The medical approach to treatment varies. It may include using painkillers, muscle relaxers or anti-inflammatories. Traction, physical therapy or injections may also be used. In severe cases, surgery may be necessary.
The chiropractic approach to this condition varies. In our clinic, a complete history is taken to determine how the problem may have first started. Next, x-rays are taken and a complete exam is performed. These tests are reviewed and presented to the patient. Recommendations will vary according to the severity of the condition. With most, a series of adjustments to move the related vertebra back to a more normal position is helpful to reduce the pressure on the nerve. In some cases, the use of ultrasound and ice is all that is needed. In our clinic, we employ two full-time massage therapists who are trained in reducing the pain related to muscle spasms. The combination of adjustments and physical therapy has proven very successful in treating sciatica. In the most severe cases, where we find a spinal fracture or some type of pathology such as a tumor, we will be sure to refer you to the appropriate specialist.
Whatever the cause of your sciatica, it is important to seek the advice of your Chiropractor or Physician for treatment. Too many people wait, hoping the symptoms will just go away or get better by themselves. Usually, it is much easier to treat a problem when it first becomes noticeable. Too many people wait until they can't stand the pain anymore, then come in and want immediate relief.
In conclusion, it is important to seek treatment as soon as possible for symptoms associated with sciatica. Be sure the doctor of your choice performs a complete exam with x-rays, and explains their approach to treatment in detail. If you do not receive positive results, don't hesitate to seek a second opinion. If I may be of further help, please contact me at my clinic.
©2009 Dr. Harvey