Extremity pain research

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.

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.

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...