One of the most common and feared back issues is sciatica. Its symptoms include back and hip pain with pain that radiates into the individuals leg. Where many patients have confusion with sciatica or its definition, is the term “radiating pain”. Sciatica is a deep pain that is often hard for the patient to describe. Some patients will state the leg pain is deep to the bone or just the whole leg hurts and aches. The term radiates often gives patients the misconception that the pain shoots or is off and on. This may be the case for some patients but the vast majority just state the leg hurts. Patients will also state that the pain in the leg moves around or changes during the day. Often the pain is just in the back of the patient’s leg.
The most common cause of sciatica is nerve root impingement. It is important to note there several things can impinge or irritate a nerve. Degenerative or bulging disc are the most common cause. Secondly to this can be conditions known as piriformis syndrome or just inflammation in the facet joints. However a recent study showed that 16% of patients with sciatica had no nerve root impingement visible on an MRI.(1)
For treatment of sciatica the cause or etiology of the pain is foremost of importance. A good history taken by the chiropractor and a focused examination often give the Chiropractor the information that leads to a proper diagnosis. Orthopedic testing is very important in making the determination of the etiology of the sciatica. Straight leg raise and Slump test are two of the more common test. These orthopedic exams are simple and quick to perform in the clinical setting. Deep tendon reflexes and the ability for the patient to walk on his or her heels and toes also give information to the extent of the nerve damage, if any, and the location of the impingement. MRI and weight bearing x-rays are also very helpful. However, sometimes a short amount of conservative treatment is utilized to see if the sciatica resolves without the need for more expensive testing. If a patient is able to walk on his or her heels, both legs are strong and have similar circumference, and the patient is not losing control of urine or bowel control, conservative care is warranted.If a patient has a progressive neurological deficit, this means the legs is getting weaker and smaller and the patient is losing control of bowel or urine. An MRI and neuro-surgical consult is warranted.
Chiropractic care for sciatica is very beneficial and cost effective. At Moreland Chiropractic Clinic we use several different methods of chiropractic adjustment that benefit the patient. Man y patient’s benefit from side posture diversified chiropractic adjustments, other from Cox or decompression types of adjustments.
Home care is crucial in getting the patient better overall. Exercises to strengthen the patient’s core are at the fore front. Utilizing ice at home helps as well. It is important to get the patient as actively involved in their care as possible.
Sciatica should not be scary and can be dealt with utilizing chiropractic care quickly, efficiently and with minimal cost. If you or a family member is suffering from sciatica it is time to stop fighting it and get to work and fixing it.
Call Moreland Chiropractic Clinic in Rolla MO at 573-364-8086.
David J. Moreland, DC, CCSP, CME
Chiropractor Rolla MO 65401