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The Sciatic Nerve
The sciatic nerve is the longest and largest in the body. It is made up
of five nerves that leave the spinal cord from the lower spinal column,
join in the pelvic area and then travel down the leg. As this nerve travels
down the thigh into the leg it branches into many smaller nerves to reach
the muscles and joints of the thigh, knees, calf, ankle, foot and toes.
Branches from these same vertebral levels also supply the contents of
the lower abdomen, the bladder and male and female genitalia, and the
skin covering both lower extremities.
What is Sciatica?
Generally, in the initial stage of this condition the first thing to
develop is back pain often related to an injury to the lower back, but
not always. Often, an apparently minor stretch or bend in the wrong direction
will bring on the "attack". Usually, this is a movement that
is just the "straw that breaks the camels back". In other words,
you have a pre- existing problem that is suddenly made serious by this
improper motion. Remember, pain is generally the last thing to show up
and the first thing to leave, and not the best indicator of whether you
are healthy or not. Once the swelling of the sensitive tissues of the
spinal joints sets in, the next stage is swelling of the large sciatic
nerve. When the sciatic nerve is inflamed, the condition is called sciatica
(pronounced SIGH'ADD-IH-'KA). Not all leg pain is sciatica, but most all
sciatica involves leg pain. When is leg pain sciatica? This a gray area.
In our discussion of sciatica, let us keep in mind that leg pain may or
may not be sciatica but no matter what the cause of the leg pain. A Chiropractic
evaluation is very important, to determine if there is a mechanical problem
with your spine or even a "pinched nerve", as noted in the example
above.
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Sciatica sufferers often have severe pain along the sciatic nerve
path, usually in the back of the leg and thigh, sometimes to the
ankle, foot, and toe(s). There may be searing, sharp pain but also
paresthesia--strange nerve feelings such as pins and needles, burning,
tingling, prickling, sensations or tenderness--that may be felt.
Ironically, with all the pain and nerve sensations, the leg might feel
numb! To complicate matters, the location of sciatic pain may vary. It
is usually in the back of the legs or thighs, in some individuals pain
is in the front or side of the legs. Sometimes in the hips. For some
hapless sufferers, the pain is in both legs, bilateral sciatica. This
may mean your lower disc has been seriously damaged. You may still be
able to be helped with chiropractic methods, though your condition
very well may respond more slowly.
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The Pain Varies
The quality of the pain may vary as well. There may be constant pain but
then it may let up for hours or even days. The intensity may vary, it may
ache, or be knife-like. Sometimes postural movements like lying down or
changing positions, affect the pain and sometimes they don't. In this way,
sciatica is like a toothache or earache, always there no matter what you
do. In severe cases, sciatica causes a loss of reflexes or even a
shrinking of the calf and or thigh muscles. To sciatica sufferers, a good
night's sleep may be a thing of the past. Simple things like walking,
bending, turning, sitting, or standing can be difficult or impossible.
Causes of Sciatica
Like most other conditions, sciatica has a wide variety of causes.
Unlike most other conditions, however, this health problem's link to the
spinal column is often very obvious. A misaligned spine, a protruded or
ruptured disc, can irritate the sciatic nerve which may result in
sciatica. Often, spasm of a small muscle in the gluteal area (the
piriformis) due to overstretching or abnormal posture will cause the pain
of sciatica.
This problem has also been related to various non-spinal conditions.
Advanced diabetes can case neuritis or inflammation of the sciatic nerve,
arthritis of the spine can irritate the sciatic nerve, constipation,
tumors and even vitamin deficiencies have been linked to sciatica.
Physical trauma has also been know to cause sciatica. Cases of sciatica
have been reported following automobile accidents, sports injuries and
even childbirth, usually due to spinal or pelvic misalignments or strains.
Backache or hip problems may occur long before the sciatica symptoms
show up, however, that is not always the case. In most instances the lower
back is painful also, and this combined pain is very debilitating.
The Medical Approach
The medical approach to sciatica pain is to treat the symptoms using
painkillers, muscle relaxers and various orthopedic treatments which may
include traction, physical therapy and other therapeutic measures.
Sciatica is particularly frustrating to the medical doctor because in many
cases even strong painkilling drugs bring little or no relief. Temporary
relief may be obtained from injections of painkillers directly into the
nerve roots, however recent studies have conclusively demonstrated that
this practice is generally ineffective, and should be discouraged. Drug
dependency, may develop with some patients.
One should always remember, that even if
medicines reduce or eliminate the pain of sciatica, that does not
represent a cure. When there is a mechanical problem, using a chemical
solution is not logical.
If the pain is not relieved, orthopedic or
neurosurgery may be resorted to as a last resort. Recent studies have
indicated these approaches are far less effective than Chiropractic care.
A study done by the American Public Health Association found that surgery
is effective in only 1 out of 100 cases after 5 years time. Therefore, one
can conclude that surgery should always be your last resort.
The Chiropractic Approach
Chiropractors correct poor spinal alignment using spinal adjustments to
relieve pressure on the spinal nerves, joints, and discs.
Throughout our lives, we have our teeth checked, blood pressure checked
and eyes checked but do we ever have our spines checked? Spinal exams are
important because if the spine becomes misaligned or distorted it could
damage (impinge) the nerves it is designed to protect. The impinged (some
say pinched) nerves can upset the delicate workings of the nervous system,
weaken the body and set the stage for disease, pain and body malfunction.
Just as we get our car's alignment checked and corrected, so we should
get our spine's alignment checked out and corrected if problems are
detected.
Is Chiropractic spinal care a treatment for sciatica?
No, it is a procedure for the analysis and
correction of spinal nerve stress. By eliminating the abnormal stress and
strain upon the spine, and therefore the spinal nerves, the sciatic nerve
can then heal.
And yes. If you do have sciatica, a Chiropractic spinal adjustment is
very badly needed. Every sciatica sufferer needs a healthy spine.
Neurogenic Claudication
Damage to the spinal nerves that go to the legs can cause a condition
known as neurogenic claudication. The sufferer cannot walk for long
periods of time and has to stop walking and rest for awhile. Symptoms may
include pain and paresthesias that commence after walking and disappear
following a rest period. There may be cramping, pain, numbness, aching,
and/or fatigue usually in the calf also in the foot, thigh, hip or
buttocks. Claudication means that it comes back when you walk the same
distance again, There are vascular as well as neurologic causes. Although
one way of dealing with this condition is surgery, spinal care should be
tried first before medical and surgical techniques are resorted to.
Research and Results
Research shows that the relationship between Chiropractic spinal
adjustments and sciatica and leg pain is a close one.
For example, one study of sixty patients showed that spinal care should
be the care of choice for sciatica sufferers.
And still other studies praised Chiropractic spinal adjustments for
sufferers of sciatica and leg pain.
In one controlled study four different approaches (spinal care,
traction, two types of injections) were used to deal with low back pain
and sciatica sufferers. The group that had spinal care experienced the
greatest degree of recovery. Interestingly, a large number in the traction
group eventually required surgery.
Too Many Wait
Chiropractic care appears to have the
most effect on sciatica when used first. Unfortunately, many people first
submit to medical care. Even in those patients who have had medical
intervention, excellent results may be obtained with subsequent
Chiropractic care.
3,136 (three thousand, one hundred and
thirty-six) people with lower back and sciatic pain with disc disease
(protrusion) who had previously had medical treatments such as
physiotherapy and drugs with no positive results were provided
Chiropractic care. A follow-up two years later showed that 50.4 percent
had excellent results with no painful relapses, 34.4 percent had relapses
but then responded favorably after further Chiropractic care, and 15.2
percent showed no significant improvement.
If you even suspect you have the beginnings of sciatica, or you would
like to have your spine evaluated to be sure it is as good as it can be,
do so as soon as possible, your future may depend on it. Recent estimates
are that lower back pain costs $80-100 billion dollars per year in
medical, disability payments and lost productivity. Chiropractic care is
the most cost effective and safest form of treatment for this condition.
Why take a chance on becoming a statistic...
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