Treating Sciatica
We regularly treat'sciatica'. Though as a diagnosis it really irritates me, it is nearly as bad a lumbago and as misused as special needs'. Sciatica is not a diagnosis or a disorder; however, it is a symptom of a disorder.
Sciatica is a description of pain that originates in the low back or buttock that travels into one or both legs. It is a radiating or referred pain, so a neuropathy or neuralgia. The pain generating structure itself is the sciatic nerve, hence the name, which is a relatively massive thing, bout the diameter of your thumb, and, as a result, likely to be injured. Sciatic nerve pain varies in intensity and frequency. It is described by our patients as:
Intermittent, frequent or constant
Dull, achy, sharp, toothache-like, pins and needles or similar to electric shocks
Burning, numbness and tingling sensations.
What causes sciatic pain?
Full on, no messing sciatica is generally caused by sciatic nerve compression. This can be caused by:Lumbar spine dysfunction (misaligned vertebra) Lumbar herniated or prolapsed discs (aka "slipped discs" gaaaahhhh, there's another cod-diagnosis for you) Pregnancy and childbirth Tumors Non-spinal disorders such as diabetes, constipation or even sitting on one's back pocket wallet Piriformis Syndrome. This is named after the piriformis muscle. This muscle is in the lower part of the bottom and connects from the pelvis to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle and in a percentage of the population through it. This muscle is susceptible to injury from a slip and fall,hip arthritis or a difference in leg length. Such situations can cause cramping and spasm to develop in the piriformis muscle, thereby, pinching the sciatic nerve and causing inflammation and pain. In extremis the compression of the sciatic nerve may result in the loss of feeling, paralysis of a single limb or group of muscles (monoplegia).How's it treated?Since there are many disorders that cause sciatica, our first step is to determine what of the above is causing your sciatica. Forming a diagnosis is the most important thing we do as, without this, what are we treating. This is why if you hear sciatica given as a diagnosis you should consider your options' and seek a second opinion. The examination involves a thoughtful review your medical history and a physical and neurological examination. Diagnostic testing can be done and includes:X-rays, MRI, CT scan Electrodiagnostic tests (nerve conduction velocity, electromyography). The type of chiropractic manipulation provided depends on the cause of the patient's sciatica A sciatica treatment plan may include several different treatments such as ice/cold therapies, ultrasound, TENS, and spinal adjustments - sometimes called manipulation. 1. Ice/cold therapy reduces inflammation and helps to control sciatic pain 2. Ultrasound is gentle heat created by sound waves that penetrates deep into tissues. Ultrasound increases circulation and helps to reduce muscle spasms, cramping, swelling, stiffness, and pain. We rarely use US as I suspect it is less effective than we'd like to think. 3. TENS (transcutaneous electrical nerve stimulation), which is a small box-like, battery-powered, portable muscle stimulating machine. Variable intensities of electrical current control acute pain and reduce muscle spasms and it is widely used to help during labour. Larger versions of the home-use TENS units are used by chiropractors, physical therapists and other rehab professionals.4. Spinal manipulative therapy to address the underlying causes. Adjustments (Spinal Manipulation) are the core of our chiropractic care. This frees restricted movement of the spine and helps to restore misaligned vertebral bodies to their proper position in your spinal column. Spinal adjustment help to reduce nerve irritability responsible for causing inflammation, muscle spasm, pain and other symptoms related to sciatica. Adjustments should not be painful. Spinal manipulation is proven to be safe and effective.At University and during our training, students of chiropractic learn many different adjustment techniques enabling us to tackle several types of disorders. Techniques vary from a swift high velocity thrust to those that combine minimal force and gentle pressure. Mastery of each technique is an art that requires great skill and precision and spinal manipulation is the treatment that differentiates chiropractic care from other medical disciplines.To prepare a patient for adjustment, we usually get you to sit up or lie down. It is not uncommon that we use totally different adjustment techniques during your subsequent visit. Treatment tables differ too. Some are stationary, flat padded tables and others are elaborate with electrically or manually operated head and foot rests.LimitationsSciatica can be caused by other disorders beyond the scope of chiropractic practice. If we decide that you need treatment by another type of doctor, then you may be referred to another specialty. Treating SciaticaBy: toddlevine
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