Sciatica - Four Main
Causes, How a Chiropractor Can Help
Sciatic pain refers to burning, tingling, or a deep
dull aching toothache-like pain radiating from the low back and buttock down
the back of one or both thighs, and into the legs or foot. Sometimes it can
feel like being zapped by an electric shock over and over again. This extremely common condition, which has
four main causes, can be treated many different ways by close to a dozen different types of doctors. For some, sciatic pain can be completely debilitating affecting regular day-to-day activities while others, the pain is so severe, they become bed ridden for awhile. Fortunately, the
chiropractic care we offer at Chiropractic Orthopedic Group can correct all
four major causes of sciatica.
Oh Great,
Not Sciatica Again!
The sciatic nerve is the largest and longest nerve
in the body. It runs from deep inside the pelvis through the hip area and
buttocks and then finds its way down the back of each leg branching into
smaller nerves along the way.
The term “sciatica” refers to the inflammation of
this nerve and the pain that radiates along its pathway. Sciatica may feel like
a leg cramp or as numbness, burning or a pins-and-needles sensation or severe
electric shocks.
The pain can also be excruciatingly painful with a piercing
or stabbing quality to it. In one study of patients with chronic pain, sciatica
sufferers endured “significantly higher”
pain scores and limitation in activities of daily living than any other group,
(J Manipulative Physiol Ther 2002;25:162-7).
Where it
Comes From
Although sciatic pain is generally in the buttocks
and legs, it’s best to know the root cause of sciatica is often due to a compression
of the sciatic nerve root, which is the beginning of the sciatic nerve as it
exits the spinal cord in the low back.
Nerve root compression is frequently the result of
one of two conditions: vertebral subluxation (fixation or misalignment of spinal
bones) or a sacroiliac subluxation (misalignment of pelvic bones) or a sacral
fixation. When the spinal or pelvic bones are even slightly out of place,
spinal movement is restricted, which in turn irritates the muscles, discs and
the nerve root — causing inflammation and pain.
The other two main causes of sciatic nerve compression
are herniated spinal discs and piriformis syndrome (inflammation of the
piriformis muscle in the buttocks).
Often, more than one of these four causes occur
simultaneously, so it’s crucial to identify and address all factors as soon as
possible. The good news is that research shows that skillful chiropractic care alleviates
all four of the most common causes of sciatic pain.
Vertebral
Subluxations, Sacroiliac, and Sacral Subluxations
With the correct manual orthopedic care both
vertebral and sacroiliac subluxations can be corrected combined with
specialized home exercises. These maneuvers,
which are safe and effective, successfully realign and normalize mobility
between spinal and pelvic bones.
One analysis followed 44- patients with acute
low-back pain and sciatica, which kept them from working. All the study participants were evaluated by
orthopedic surgeons and underwent X-rays, computerized tomography (CT) and
magnetic resonance imaging (MRI). No pathology was found and the physicians
could not determine the cause of the patients’ discomfort.
Next, the patients received a chiropractic
examination. All were determined to have a vertebral subluxation involving the
spine affecting the low back. They also suffered from sacroiliac subluxations. Each patient then received chiropractic care.
According to the study results, “All but two patients returned to work. The
period of sick leave among the patients was reduced by two thirds as compared
with that associated with conventional medical treatment.” (J ManipulativePhysiol Ther 2007;30:135-9.)
Another study enrolled 2,945 patients with sciatica
and low-back pain, of which 268 patients suffered chronic low-back pain and
radiating pain below the knee.
These patients received either medical care or
chiropractic care for the correction of vertebral and sacroiliac subluxations.
Researchers assessed the participant’s satisfaction with care and low-back
status via multiple questionnaires at various intervals of their treatment.
From these questionnaires when comparing
chiropractic vs. medical care the people with chronic low-back pain and
radiating pain below the knee “noted an
advantage when it came to their long-term outcome and improvement.”
Over 55- percent of the chiropractic group employed
such strategies as exercise and self-care education to reduce their symptoms.
The medical care group was far more likely to choose bed rest. They were also
significantly more likely to rely on family and friends for help, (JManipulative Physiol Ther 2001;24:543-51).
Herniated
Discs
The spinal discs, which are sandwiched cushions between
each vertebra, can also put pressure on the sciatic nerve root.
These intervertebral (between vertebrae) discs give
the spine its flexibility and act as shock absorbers between each of the 24 movable
spinal bones. The outer layer of each disc is tough and fibrous like the radial
belts of a tire, while the inside material is spongy and jelly like.
If discs degenerate or are subject to trauma, the
soft center may bulge to one side through a crack or breech in the fibrous
outer layers. This condition is known as a bulged or herniated disc.
Sciatic pain ensues as the nerve root becomes
trapped against the spinal canal by the disc bulge. The good news is that
research shows how chiropractic care can help sciatica caused by “slipped” or
prolapsed discs.
One analysis of 154- patients with sciatic pain
found that those with disk-related magnetic resonance imaging (MRI) findings
were likely to recover following chiropractic care, (J Manipulative Physiol Ther2007;30:135-9).
Another study, performed in Italy, included 64- men
and 38- women ranging in age from 19- to 63- years of age. This patient group had acute back pain and
sciatica with herniated discs (“disc protrusion”).
Only 53- of these patients received chiropractic
adjustments, while 49- underwent sham or “simulated” spinal adjustments.
Chiropractors performed the adjustments or
simulated adjustments five days per week. The number of sessions depended on
pain relief, but was limited to 20 total visits. Patients were assessed at admission and again
at 15, 30, 45, 90 and 180 days. At each visit, the chiropractors used standard
techniques to assess pain levels and improvement.
So, what was good news? Patients receiving genuine chiropractic
adjustments enjoyed significant improvement in pain severity and duration
beyond what patients undergoing simulated adjustments experienced, (Spine J2006;6:131-7).
In another study, a 23-year-old woman suffered from
chronic, unremitting symptoms of lower back pain and left-leg pain. After
receiving chiropractic care “the patient responded well with a complete
resolution of her symptoms and a restoration of her lumbar lordosis
[over- exaggeration of the low back curve (or swayback)].” (J ManipulativePhysiol Ther 2004;27:579.)
Is it the Piriformis or Gluteus Complex?
The piriformis and other deep gluteal complex muscles
extend along both sides of the lower back and buttocks. Sciatic nerves travel beneath
the piriformis and gluteal muscles on their way from the spine to the back of
each leg.
Piriformis syndrome occurs when the muscle becomes
inflamed, forcing pressure on the sciatic nerve and squeezing it against the
bones of the pelvis.
We employ a variety of all-natural interventions
for piriformis syndrome and gluteal complex pain that often times mimics the
same excruciating pain as a herniated disc. This combination approach is highly
effective.
One case study conducted by researchers at the
University of Quebec looked at a 19-year-old patient who developed piriformis
syndrome and sciatica following a football injury. He received chiropractic
care for three months, during which time his condition completely resolved. and
he remained pain-free five months later, (J Manipulative Physiol Ther2006;29:486-91).
The
Things That Don’t Work
Unlike chiropractic care, research shows that
traditional medical care for sciatica is often not very effective.
For instance, one study of 183- sciatic pain patients
found that bed rest was no more effective than “watchful waiting.” After 12- weeks, patients who were assigned to
bed rest had no more improvement than those who were in a “watchful waiting”
group. Researchers concluded that there was “no
evidence that bed rest is an effective treatment for sciatica.” (NEJM1999;340:418.)
Another standard treatment involves masking the
pain with continual doses of non-steroidal anti-inflammatory drugs (NSAIDs),
such as prescription painkillers or over-the-counter drugs like aspirin, Advil,
Motrin and Aleve. Although these drugs may seem benign, overuse is linked to
chronic headaches and migraines, gastrointestinal problems, heartburn and
ulcers.
In addition, these drugs don’t cure sciatica. One
study compared chiropractic care for sciatica to bed rest, massage, electrical
muscle stimulation, non-steroidal anti-inflammatory drugs (NSAIDs) and a muscle
relaxant. Patients in the chiropractic care group experienced significant reduction
in the length of care, faster improvement from symptoms, less disability at
work and fewer missed work days, compared with all other groups, (Ann Swiss
Chiro Assoc 1989;9:133).
Help Is
On Its Way
If you currently have back or leg pain, it’s important
not to self-diagnose yourself. The
origin may lie in the sciatic nerve root or may be related to another cause, unrelated
to the sciatic nerve and pose a much more serious medical problem.
My advice? Schedule
an appointment right away to discover the underlying problem. We’re committed
to identifying the root causes and obstacles to wellness, rather than masking
symptoms with unnecessary medication or surgery. Pain is the body’s natural way
of signaling distress; let us help you pinpoint the true cause.
Bless and Be Blessed ALWAYS…
