Sciatica is a frequent problem for many patients over the age of 30.
Pronounced “sigh-at-ih-cuh”, the term sciatica refers to a condition that involves injury, irritation or compression of the sciatic nerve. The symptoms are usually pain, numbness and/or tingling that runs down the leg toward the foot.
Weakness affecting the leg can also be a symptom of sciatica. The symptoms can go down the leg to mid-thigh, to the knee, to mid-calf or sometimes all the way to the toes.
Sciatic begins in the lower back. The sciatic nerve is actually a bundle of spinal nerves that originates from the lower portion of the lumbar spine and the top portion of the sacrum. This nerve courses through the buttock down into the leg to the toes. It is the longest nerve in the body.
Problems with the sciatic nerve often begin gradually or may appear suddenly after an acute injury. The symptoms may be made worse by prolonged sitting or standing or certain positions.
Frequent causes of sciatica include a compressed, bulging or ruptured spinal disc, spinal degeneration or stenosis (narrowing of the canal that nerves pass through).
To resolve sciatica, it is critically important to accurately identify the exact cause of the problem. If the nerve is pinched, it is important to determine exactly what is pinching it.
For example, it could be pinched by a spinal disc that has been compressed or injured and is now protruding to mechanically pinch the nerve. Or it could be the result of gradual degeneration of the joint or bone tissue surrounding the nerve root.
Different causes of sciatica require different types of treatment to be successful.
In some cases, sciatica is caused by temporary swelling in the joint spaces from a recent injury and may respond to medications or treatment such as acupuncture. However, medications or acupuncture will not likely help a case of sciatica that involves physical pinching of the nerve unless the pinching is caused by muscle spasm.
For cases of bulging discs that result in sciatica, certain types of chiropractic care or spinal manipulation have been shown to be very effective. In particular flexion/distraction, a very distinctive treatment that we provide in our office, is typically effective for this type of problem.
Canal stenosis can be a difficult type of case to treat. In some cases of stenosis, spinal manipulation can be helpful. A neurosurgeon once asked me how chiropractic manipulation could be helpful for stenosis. In his view, the canal was physically narrowed and manipulation would not change the actual canal, so surgery was the only viable approach.
I explained that I had frequently seen cases diagnosed as stenosis respond quite favorably to flexion/distraction manipulation. Here’s why: Although actual stenosis may be present, the canal stenosis has been developing slowly over time. Often the symptoms have been present only for a few weeks. Besides the stenosis or narrowing of the bony canal, other factors are responsible for the symptoms. In many cases, the symptoms result from a combination of stenosis along with a recent change in function or position of the disc, joint or nerve.
Using our distinctive flexion/distraction to improve function of the joints often provides enough space to alleviate the nerve root compression that the symptoms are relieved, even in cases where stenosis is present. This allows the patient to avoid the need for surgery. Of course, there are some very severe cases where this approach will not provide enough improvement and surgery may be required.
Non-surgical spinal decompression is a relatively new approach to treatment of sciatica caused by disc problems and spinal degeneration. It involves the use of specialized equipment designed to reverse the effects of spinal degeneration. This new treatment has been shown to be a safe and effective way to reverse the compression of spinal discs and may help patients recover without surgery.
Be aware though, that some providers are erroneously calling old fashioned spinal traction “spinal decompression.” There is a profound difference in the technology of the more advanced devices. For example, our office uses the fourth generation of advanced spinal decompression technology.
In addition, the level of training that the provider has in advanced spinal decompression can make a huge difference in the outcome. In our office the doctor and staff members are nationally certified specifically in Nonsurgical Spinal Disc Decompression.
I have had numerous patients tell me “Oh I tried spinal decompression and it didn’t work for me.” Once I determine where they have been, I often learn that they had spinal traction, not true spinal disc decompression, and that the provider was not nationally certified in spinal disc decompression. True spinal disc decompression provided by a certified provider has a very good success rate.
Dr. Mark Kestner is a licensed chiropractic physician in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.