The term Sciatica refers to pain, numbness and occasionally muscle weakness in the area supplied by the sciatic nerve, i.e. hip, buttock, posterior thigh, calf and foot. The patient may experience a crawling sensation over the affected area and an inability to walk on his toes or heels due to muscle weakness. There are many possible causes for sciatica, but the most frequent cause has been found to be faulty alignment and mechanics of the lower spine and pelvis. Such faulty alignment serves to compress or irritate the sciatic nerve with a resulting painful inflammation of the nerve. Faulty spinal-pelvic alignment may result from a single fall, accident or unusual exercise or such structural deficits may develop gradually as part of an overall posture distortion pattern.
The top four ways the sciatic nerve is injured:
1. The nerve openings between adjacent vertebrae in the lower back may be partially occluded by a misaligned or subluxated vertebra. Nerves which make up the sciatic nerve are compressed and irritated as they pass through the partially occluded openings.
2. A sacro-iliac subluxation or distortion may exert a direct pressure on the sciatic nerve.
3. The deep muscles of the buttock may be placed under unusual stress by a faulty pelvic alignment. The stretched or even collapsed muscles may squeeze and irritate the sciatic nerve as it passes between them.
4. Disc Bulges/Herniation (see below).
Treatment for Sciatica:
Chiropractic treatment typically consists of physical therapy to help reduce the muscle spasm and tightness, and the chiropractic adjustment which helps restore normal spine and nerve function to the affected areas. Also, ice therapy (cryotherapy) is used to help reduce swelling. It is important in most cases to avoid the use of heat therapy such as a heating pad on the lower back as this causes increased swelling and eventually more pain.
Disc Bulge/Herniation
The 24 vertebrae of your spine are separated from one another by pads of cartilage called discs. These discs have a fairly tough outer layer with a soft interior to cushion against the shocks and strains experienced as you move and put various stresses on your spine. The discs are subject to injury, disease, and degeneration with use over time. Certain activities and types of work increase the risk of discs being damaged or deteriorating. When the soft interior material of a disc pushes out through a tear or weakening in the outer covering, the disc is said to be herniated. Herniated discs are also called protruding, bulging, ruptured, prolapsed, slipped, or degenerated discs. There are fine distinctions between these terms, but all really refer to a disc that is no longer in its normal condition and/or position. Herniated discs cause pain by impinging on (intruding upon, irritating, and pinching) and even injuring nerves in the spinal column.
What are some of the typical symptoms of bulged/herniated discs?
Most disc herniation takes place in the lower back (lumbar spine). The second most common site of herniation is the neck (cervical spine). A herniated lumbar disc may send pain shooting down through your buttock and thigh into the back of your leg (sciatica). Cervical disc herniation may cause pain in the shoulder, arm, and hand. Herniated discs can cause muscle weakness, make it hard to get up when you've been sitting or lying down, cause pain when you strain to do something, even when you cough or sneeze. They sometimes produce pain in the lower right side of the abdomen. Herniated discs may also affect nerves to the bladder and bowel, causing incontinence. This symptom signals the need for immediate, emergency attention.
What can chiropractic do?
There is broad acceptance among health care professionals and the public of the recommendation that the pain from herniated discs be initially treated conservatively. That is, as long as there are no signs (such as severe pain, numbness, or functional impairment from nerve involvement) of the need for more invasive treatment, two or three months of chiropractic care may be the best choice before considering spinal surgery or shots of analgesics (painkillers) in your back. Only a minority of disc herniations turn out to require treatment as traumatic and costly as hospitalization and surgery or with as many side effects (especially for older people) as opioid analgesics and muscle relaxants. Always consult with your Chiropractor before opting for surgery for disc bulge/herniation.