Posts for tag: Sciatica
Sciatica (or sciatic neuritis) is a set of symptoms arising from the compression or irritation of the sciatic nerves or nerve roots. It is experienced as pain in the lower back and buttocks, and sometimes in the legs and feet, and may be accompanied by tingling sensations or numbness, muscle weakness and restricted leg movement. The pain may be felt to "travel" down the leg, and is commonly felt only on one side of the body.
If you suffer from sciatica, it is important to remember the term "set of symptoms." This means that it is a description of the effects, rather than a diagnosis or exact description of what causes them. Sciatica can be caused by several different conditions. For this reason it is important to see your chiropractor to get an accurate diagnosis to determine the actual cause of the symptoms in your case. Any treatment regime or set of prescribed exercises will depend on the exact nature of this diagnosis, and cannot be generalized.
Following an examination, your chiropractor may recommend a series of chiropractic manipulations to treat the underlying structural cause of the condition, but will also prescribe a series of exercises to relieve the pain by stretching tight muscles that may be contributing to it by maintaining pressure on the sciatic nerves. Exercise is often felt by the sciatica sufferer to be counter-intuitive, because the pain can be so severe that one is tempted to take painkillers and go to bed and rest until it subsides. But in reality one of the best forms of self-treatment is exercise, either in the form of walking or gentle stretching movements. The exercise will strengthen the muscle groups that support your lower spine and back, stimulate blood flow to the area to promote healing, and cause the production of endorphins, which are natural painkillers.
Exercises to relieve the symptoms of sciatica may vary, depending on the specific cause of the condition, but a few general observations can be made about them. Most sets of sciatica exercises involve strengthening the abdominal muscles, which better support the spine and keep it properly aligned when they are strong. Sciatica exercises also often include gentle stretching of the hamstring muscles. Once the initial sciatica pain has been treated via chiropractic manipulation or other means, walking is often a great form of self-treatment, because it contributes not only to healing by promoting blood flow but also strengthens the muscles that support the lower back.
In some cases, "press ups" (lying on your stomach and pressing your upper body up with your arms, similar to the chataranga or "up dog" pose in yoga) can be beneficial. "Curl ups" (lying on your back with your knees bent and gently curling the upper body up and holding the position for a few seconds) can also strengthen the abdominal muscles, and are easier than traditional "sit ups." Leg raises (lying on your back and gently lifting first one leg and then the other and holding it for a few seconds) can also be effective. If your sciatic pain is severe, you may find these and other exercises easier to perform in water.
With all sets of exercises used to treat the symptoms of sciatica and relive its pain, there are three things to remember. First, as mentioned above, don't start a generic set of these exercises without consulting a professional to determine the exact cause of your symptoms. Second, "easy does it." Don't strain or try to attain or hold any position that is uncomfortable for you. And third, be consistent; the benefits of exercise for sciatic pain depend on doing them regularly.
Walking upright on two feet has advantages, but it also puts intense pressure on the spine, as well as on other muscles and bones. Add to this improper sitting, lifting, or reaching -- and the normal wear and tear of working and playing -- and you have the perfect recipe for back pain. That's why back pain is the 2nd most common reason for visits to the doctor's office, outnumbered only by upper-respiratory infections. In fact, some experts say, as many as 80% of us will experience a back problem at some time in our lives.
Back injuries are a part of everyday life. They can cause a sharp pain or a dull ache and can be accompanied by a tingling, numbness, or burning sensation. You may also feel weakness, pain, or tingling in your pelvis and upper leg -- a condition known as sciatica. The spine is quite good at dealing with back injuries. Minor injuries usually heal within a day or two. Some pain, however, continues. What makes it last longer is not entirely understood, but researchers suspect that stress, mood changes, and the fear of further injury may prevent patients from being active and exacerbate the pain.
Tips for Back Pain Prevention:
- Maintain a healthy diet and weight.
- Remain active -- under the supervision of your doctor of chiropractic.
- Avoid prolonged inactivity or bed rest.
- Warm up or stretch before exercising or other physical activities, such as gardening.
- Maintain proper posture.
- Wear comfortable, low-heeled shoes.
- Sleep on a mattress of medium firmness to minimize any curve in your spine.
- Lift with your knees, keep the object close to your body, and do not twist when lifting.
- Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
- Work with your doctor of chiropractic to ensure that your workstation is ergonomically correct.
Chiropractic Treatment for Back Pain
If you experience back pain, consult your doctor of chiropractic. More than 30 million Americans sought chiropractic care last year alone. Past studies have indicated that consumers are very happy with the chiropractic care they receive.
With a thorough knowledge of the structure and functioning of the human body, doctors of chiropractic make diagnoses and take steps to correct problems using spinal adjustments, dietary and lifestyle advice, and other natural tools. Spinal manipulation -- the primary form of treatment performed by doctors of chiropractic -- is a recommended option for back pain treatment, rated as such by many state and workers' compensation guidelines.
Research has shown that manipulative therapy and spinal manipulation are not only safe and effective, but can cut costs and get workers back on the job faster than other treatments. A recent medical study has also pointed out that manual manipulation offers better short-term relief of chronic back pain than medication.2
When choosing a doctor of chiropractic:
Be sure the chiropractor has attended an accredited chiropractic college.
Make sure the chiropractor is licensed to practice in your state. After graduating from an accredited chiropractic college, doctors of chiropractic must pass rigorous state and national board exams before they can practice.
Talk to your friends, family, and co-workers. The best referrals often come from satisfied patients.
Talk to the doctor. The chiropractor should be willing to answer your questions and should talk freely with you about your concerns and course of treatment.
1. Vallfors B. Acute, subacute and chronic low back pain: Clinical symptoms, absenteeism and working environment. Scan J Rehab Med Suppl 1985;11:1-98.
2. Giles L, Muller R. Chronic spinal pain: A randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine 2003 July 15;28(14):1490-1502.Coming soon.
Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica – which can include pain, tingling, numbness and muscle weakness – is really a symptom indicating an underlying problem, not a diagnosis in and of itself. This article will explore in detail the findings of a recent controlled study comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches.
The study discussed here was conducted by the National Spine Center in Alberta Canada and published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics. The 40 study participants all had sciatica lasting over 3 months which had not responded to treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or acupuncture. They had all been referred by their primary care physicians to spinal surgeons who had deemed them appropriate surgery candidates.
Instead of having all the patient proceed with surgery, they were split into two groups – one group to undergo a surgical microdiscectomy and the other group to be treated with standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the results they obtained from their assigned method, the patients were allowed to switch to the other treatment plan after 3 months.)
So what happened? Both groups made significant improvements over baseline scores – meaning that they saw noticeable improvements whereas previous approaches had failed. A full 60% of the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if they underwent surgery. And, after 1 year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their primary care physicians and accepted as surgical candidates by the neurosurgeon could actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting, anesthesia and ER time.
There is one paragraph in the results section of this study that is easy to overlook, but incredibly important. There were originally 120 candidates of which 60 met the study criteria and were asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal manipulation as an alternative to surgery! They didn’t want to participate in the study and be randomly placed in the surgery group without first trying the spinal manipulation! This is incredibly telling. Not only does it demonstrate that there is still a lot of education about chiropractic that needs to happen among the public and among primary care providers, it also demonstrates that people understand the risks and costs of surgery and want to exhaust other possibilities first.
This was the first study to ever look at people who had failed traditional medical management of sciatica. Currently most patients that fail ‘conservative care’ are referred for a surgical evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term outcomes with chiropractic.
Please share this article with anyone considering surgery for sciatica.
McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ., Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010; Oct;33(8):576-84.
The New Way to Treat Herniated Discs Without Surgery
By Dr. James D. Edwards
If you’re suffering from a herniated disc and chiropractic adjustmentsor therapy have not yielded sufficient benefit, you should ask your doctor if you might be a candidate for spinal decompression therapy.
What is spinal decompression therapy?
It’s a nonsurgical, traction-based treatment for herniated or bulging discs in the neck and low back. Anyone who has back, neck, arm or leg pain caused by a degenerated or damaged disc may be helped by spinal decompression therapy.
Specific conditions that may be helped by this therapeutic procedure include herniated or bulging discs, spinal stenosis, sciatica, facet syndrome, spondylosis or even failed spinal surgery.
Many patients, some with magnetic resonance imaging (MRI)-documented disc herniations, have achieved “good” to “excellent” results after spinal decompression therapy.
The computerized traction head on the decompression table or machine is the key to the therapy’s effectiveness. The preprogrammed patterns for ramping up and down the amount of axial distraction eliminate muscle guarding and permit decompression to occur at the disc level. This creates a negative pressure within the disc, allowing the protruded or herniated portion to be pulled back within the normal confines of the disc, which permits healing to occur.
Your specific treatment plan will be determined by the doctor after your examination. Based on research and my clinical experience, the best results are achieved with 20 sessions over a six-week period. To reduce inflammation and assist the healing process, supporting structures sometimes are treated with passive therapies (ice/heat/muscle stimulation), chiropractic adjustments (when indicated) and/or active rehabilitation in order to strengthen the spinal musculature.
There are many spinal decompression systems in use today, most of which work equally well. The cost for 20 sessions can range from $1,000 to $5,000 or more. While this may seem like a lot, it is very reasonable, considering the cost and potential adverse outcomes associated with spine surgery.
Spinal decompression therapy has saved many people from spinal surgery. If you are suffering from a degenerated or herniated disc, I encourage you to explore safe and effective spinal decompression therapy before risking surgery. The rationale for treating a herniated disc without resorting to surgery has research support on its side: According to a recent study in the Journal of the American Medical Association,surgery is no more effective than non-invasive treatments, including chiropractic care, for patients with lumbar disc herniation causing sciatica.
Ask your doctor for more information about spinal decompression and if you might be a candidate. If your doctor does not yet offer spinal decompression therapy, they can help refer you to someone who does.
What Does It Mean?
Not familiar with some of the terminology in this article? Don’t worry: Here’s a brief explanation of what these terms mean in relation to your spine.
Anulus Fibrosus: The tough outer ring of a vertebral disc; it encases the nucleus pulposus (see description below) within the disc.
Facet Syndrome: An irritation of one or more of the joints on the back of the spinal vertebrae, which comprise the spinal column.
Herniated Disc: Displacement of the center of a vertebral disc through a crack in the outer layer. Disc herniation can put pressure on spinal nerves and cause pain.
Muscle Guarding: Muscle spasming, often in response to a painful stimulus.
Nucleus Pulposus: A gel-like substance within each intervertebral disc, surrounded by the anulus fibrosus.
Sciatica: Pain in the lower back, buttocks, hips, or adjacent anatomical structures, frequently attributable to spinal dysfunction.
Spinal Stenosis: Narrowing of the spine at one or more of three locations: in the center of the spine, where nerves branch from the spine, or in the space between vertebrae. This puts pressure on spinal nerves and can cause pain.
Spondylosis: Otherwise known as spinal arthritis, spondylosis is a degenerative condition in which spinal discs weaken, particularly with age.
James D. Edwards, DC, a graduate of Logan College of Chiropractic in St. Louis, Mo, has been in practice for more than 30 years.