Sciatica "The Scourge & The Treatments"

Cause Of Sciatica: Several lumbar spine (lower back) disorders can cause sciatica. Sciatica is often described as mild to intense pain in the left or right leg. Sciatica is caused by compression of one or more of the 5 sets of nerve roots in the lower back. Sometimes doctors call sciatica a radiculopathy. Radiculopathy is a medical term used to describe pain, numbness, tingling, and weakness in the arms or legs caused by a nerve root problem. If the nerve problem is in the neck, it is called a cervical radiculopathy. However, since sciatica affects the low back, it is called a lumbar radiculopathy.

Pathways To Sciatic Nerve Pain

Five sets of paired nerve roots in the lumbar spine combine to create the sciatic nerve. Starting at the back of the pelvis (sacrum), the sciatic nerve runs from the back, under the buttock, and downward through the hip area into each leg. Nerve roots are not "solitary" structures but are part of the body's entire nervous system capable of transmitting pain and sensation to other parts of the body. Radiculopathy occurs when compression of a nerve root from a disc rupture (herniated disc) or bone spur (osteophyte) occurs in the lumbar spine prior to it joining the sciatic nerve.

What Causes Sciatic Nerve Compression?

Several spinal disorders can cause spinal nerve compression and sciatica or lumbar radiculopathy. The 6 most common are:

• a bulging or herniated disc
• lumbar spinal stenosis
• spondylolisthesis
• trauma
• piriformis syndrome
• spinal tumors

Sciatica Cause: 6 Leading Sources

Several lumbar spine (lower back) disorders can cause sciatica. Sciatica is often described as mild to intense pain in the left or right leg. Sciatica is caused by compression of one or more of the 5 sets of nerve roots in the lower back. Sometimes doctors call sciatica a radiculopathy. Radiculopathy is a medical term used to describe pain, numbness, tingling, and weakness in the arms or legs caused by a nerve root problem. If the nerve problem is in the neck, it is called a cervical radiculopathy. However, since sciatica affects the low back, it is called a lumbar radiculopathy.

Sciatica Cause #1: Lumbar Bulging Disc Or Herniated Disc

A bulging disc is also known as a contained disc disorder. This means the gel-like center (nucleus pulposus) remains "contained" within the tire-like outer wall (annulus fibrosus) of the disc.

A herniated disc occurs when the nucleus breaks through the annulus fibrosus. It is called a "non-contained" disc disorder. Whether a disc bulges or herniates, disc material can press against an adjacent nerve root and compress delicate nerve tissue and cause sciatica.

The consequences of a herniated disc are worse. Not only does the herniated disc cause direct compression of the nerve root against the interior of the bony spinal canal, but the disc material itself also contains an acidic, chemical irritant (hyaluronic acid) that causes nerve inflammation. In both cases, nerve compression and irritation cause inflammation and pain, often leading to extremity numbness, tingling, and muscle weakness.

Herniated disc is a relatively common condition that can occur anywhere along the spine, but most often affects the lower back or neck region. Also known as a slipped disc or ruptured disc, a herniated disc develops when one of the cushion-like pads between the vertebrae moves out of position and presses on adjacent nerves.

Herniated discs are typically caused by overuse injuries or trauma to the spine; however, disc conditions can also develop as a result of the normal aging process. It is also known that there is a genetic factor that contributes to the development of disc degeneration and herniated disc. In most cases, a herniated disc in the lower back will heal within six months, as the size of herniation shrinks with time via resorption. Surgery may be needed if medication, physical therapy and other treatments fail.

What Is A Disc?

Spinal discs are cushion-like pads located between the vertebrae. Without these “shock absorbers,” the bones in the spine would grind against one another. In addition to giving the spine flexibility and making movements such as twisting and bending possible, discs protect the spine by absorbing the impact of trauma and body weight. Each disc has a strong outer layer called annulus fibrosus and a soft, gel-like center, called nucleus pulposus. There are fibers on the outside of each disc that attach to adjacent vertebrae and hold the disc in place. A herniated disc occurs when the outer layer tears or ruptures and the gel-like center leaks into the spinal canal.

The spinal canal has just enough space to house the spinal cord and spinal fluid. When a disc herniates and spills into the spinal canal, it can cause compression of the nerves or spinal cord. Intense, debilitating pain and alterations in sensation often occur. In addition, the gel-like substance inside the disc releases chemical irritants that contribute to nerve inflammation and pain.

What Causes A Herniated Disc?

As we age, the spinal discs gradually lose fluid volume. This process starts at about age 30 and progresses slowly, over time. As the discs dry out, microscopic cracks or tears can form on the outer surface, causing it to become brittle, weak and more susceptible to injury. The most common causes of herniated disc are:

• Wear and tear: Discs dry out and aren’t as flexible as they once were.
• Repetitive movements: Work, lifestyle, and certain sports activities that put stress on the spine, especially the lower back, further weaken an already vulnerable area.
• Lifting the wrong way: Never lift while bent at the waist. Proper lifting entails lifting with your legs and a straight back.
• Injury: High-impact trauma can cause the disc to bulge, tear or rupture.
• Obesity: Carrying excess weight puts an undue amount of strain on the spine.
• Genetics: There are some genes that are more commonly present in individuals with disc degeneration. More research is needed to investigate the role of these genes—they could be targets of biological treatment in the future.

What Are The Symptoms Of A Herniated Disc?

Pain from a herniated disc can vary, depending on the location and severity of the injury. It is typically felt on one side of the body.

If the injury is minimal, little or no pain may be felt. If the disc ruptures, pain can be severe and unrelenting. Pain may radiate to an extremity in a specific nerve root distribution if significant nerve impingement has occurred. For example, sciatica is frequently caused by a herniated disc in the lower back. Herniated disc can manifest itself with a range of symptoms, including:

• Dull ache to severe pain
• Numbness, tingling, burning
• Muscle weakness; spasm; altered reflexes
• Loss of bowel or bladder control (Note: These symptoms constitute a medical emergency. If they occur, seek medical attention immediately).

How Is A Herniated Disc Diagnosed?

History and physical examination point to a diagnosis of herniated disc. A herniated disc is likely if low back pain is accompanied by radiating leg pain in a nerve root distribution with positive straight leg raising test (ie, elevating the leg while lying down causes radiating pain down the leg), and other neurologic deficits such as numbness, weakness, and altered reflexes.

Imaging studies are usually ordered to confirm a diagnosis of herniated disc. X-rays are not the imaging medium of choice because soft tissues (eg, discs, nerves) are hard to capture with this technology. However, they may be used as an initial tool to rule out other disorders such as a growth or fracture. Confirmation of the suspicion of herniated disc is generally accomplished with:

• Magnetic Resonance Imaging (MRI): This technology reveals the spinal cord, surrounding soft tissue and nerves. It is the best imaging study to support the diagnosis of a herniated disc.
• Nerve Conduction Studies (NCS) and Electromyogram (EMG): These studies use electrical impulses to measure the degree of damage to the nerve/s caused by compression from a herniated disc and other conditions that cause nerve impingement can be ruled out. NCS and EMG are not routine tests to diagnose herniated disc.

Herniated discs sometimes heal on their own through a process called resorption. This means that the disc fragments are absorbed by the body. Most people suffering from herniated disc respond well to conservative treatment and do not require surgery.

Sciatica Cause #2: Lumbar Spinal Stenosis

Spinal stenosis is a nerve compression disorder most often affecting older adults. Leg pain similar to sciatica may occur as a result of lumbar spinal stenosis. The pain is usually positional, often brought on by activities such as standing or walking and relieved by sitting down.

Spinal nerve roots branch outward from the spinal cord through passageways called neural foramina comprised of bone and ligaments. Between each set of vertebral bodies, located on the left and right sides, is a foramen. Nerve roots pass through these openings and extend outward beyond the spinal column to innervate other parts of the body. When these passageways become narrow or clogged causing nerve compression, the term foraminal stenosis is used.

What Is Spinal Stenosis?

A clue to answering this question is found in the meaning of each word. Spinal refers to the spine. Stenosis is a medical term used to describe a condition where a normal-size opening has become narrow. Spinal stenosis may affect the cervical (neck), thoracic (chest), or lumbar (lower back) spines.

The most commonly area affected is the lumbar spine followed by the cervical spine.

Visualize Spinal Stenosis?

Consider a water pipe. Over time, rust and debris builds up on the walls of the pipe, thereby narrowing the passageway that normally allows water to freely flow. In the spine, the passageways are the spinal canal and the neuroforamen. The spinal canal is a hollow vertical hole that contains the spinal cord. The neuroforamen are the passageways that are naturally created between the vertebrae through which spinal nerve roots exit the spinal canal.

The neuroforamen are the passageways that are naturally created between the vertebrae through which spinal nerve roots exit the spinal canal.

Illustration above: The spine's bony structures encase and protect the spinal cord. Small nerve roots shoot off from the spinal cord and exit the spinal canal through passageways called neuroforamen.

Lumbar (low back) spinal stenosis is illustrated below. Notice the narrowed areas in the spinal canal (reddish-colored areas). As the canal space narrows, the spinal cord and nearby nerve roots are squeezed causing different types of symptoms. The medical term is nerve compression.

Anatomy Overview Can Help You Understand Spinal Stenosis

The spine is a column of connected bones called vertebrae. There are 24 vertebrae in the spine, plus the sacrum and tailbone (coccyx). Most adults have 7 vertebrae in the neck (the cervical vertebrae), 12 from the shoulders to the waist (the thoracic vertebrae), and 5 in the lower back (the lumbar vertebrae). The sacrum is made up of 5 vertebrae between the hipbones that are fused into one bone. The coccyx is made up of small fused bones at the tail end of the spine.

Lamina and Spinous Processes: At the back (posterior) of each vertebra, you have the lamina, a bony plate that protects your spinal canal and spinal cord. Your vertebrae also have several bony tabs that are called spinous processes; those processes are attachment points for muscles and ligaments.

Ligaments, Especially the Ligamentum Flavum: Vertebrae are connected by ligaments, which keep the vertebrae in their proper place. The ligamentum flavum is a particularly important ligament. Not only does it help stabilize your spine, it also protects your spinal cord and nerve roots. Plus, the ligamentum flavum is the strongest ligament in your spine.

The ligamentum flavum is a dynamic structure, which means that it adapts its shape as you move your body. When you're sitting down and leaning forward, the ligamentum flavum is stretched out; that gives your spinal canal more room for the spinal nerves. When you stand up and lean back, though, the ligamentum flavum becomes shorter and thicker; that means there's less room for the spinal nerves. (This dynamic capability helps explain why people with spinal stenosis find that sitting down feels better than standing or walking.)

Discs: In between each vertebra are tough fibrous shock-absorbing pads called the intervertebral discs. Each disc is made up of a tire-like outer band (annulus fibrosus) and a gel-like inner substance (nucleus pulposus).

Spinal Nerves and the Spinal Cord: Nerves are also an important part of your spinal anatomy—after all, they're what sends messages from your brain to the rest of your body. The spinal cord, the thick bundle of nerves that extends downward from the brain, passes through a ring in each vertebra. Those rings line up into a channel called the spinal canal.

Between each vertebra, two nerves branch out of the spinal cord (one to the right and one to the left). Those nerves exit the spine through openings called the foramen and travel to all parts of your body.

Normally, the spinal channel is wide enough for the spinal cord, and the foramen are wide enough for the nerve roots. But either or both can become narrowed, and cause spinal stenosis.

Sciatica Cause #3: Spondylolisthesis

Spondylolisthesis is a disorder that most often affects the lumbar spine. It is characterized by one vertebra slipping forward over an adjacent vertebra. When a vertebra slips and is displaced, spinal nerve root compression occurs and often causes sciatic leg pain. Spondylolisthesis is categorized as developmental (found at birth, develops during childhood) or acquired from spinal degeneration, trauma or physical stress (eg, lifting weights).

Spondylolisthesis occurs when one vertebra slips forward over the vertebra below it. The term is pronounced spondy-low-lis-thesis and is derived from the Greek language: spondylo means vertebra and listhesis means to slip. There are several types or causes of spondylolisthesis; a few are listed below.

• Congenital spondylolisthesis means the disorder is present at birth.
• Isthmic spondylolisthesis occurs when a defect, such as a fracture occurs in a bony supporting vertebral structure at the back of the spine.
• Degenerative spondylolisthesis is more common and is often associated with degenerative disc disease, wherein the discs (eg, due to the effects of growing older) lose hydration and resilency.

How Spondylolisthesis May Develop

The lumbar spine is exposed to directional pressures while it carries, absorbs, and distributes most of your body's weight at rest and during activity. In other words, while your lumbar spine is carrying and absorbing body weight, it also moves in different directions (eg, rotate, bend forward). Sometimes, this combination causes excessive stress to the vertebra and/or its supporting structures, and may lead to a vertebral body slipping forward over the vertebrae beneath.

Who May Be At Risk

If a family member (eg, mother, father) has spondylolisthesis, your risk for developing the disorder may be greater. Some activities make you more susceptible to spondylolisthesis. Gymnasts, linemen in football, and weight lifters all put significant pressure and weight on their low backs. Think about gymnasts and the positions they put their body in: They practically bend in half backwards—that's an extreme arched back. They also twist through the air quickly when doing flips and then land, absorbing the impact through their legs and low back. Those movements put substantial stress on the spine, and spondylolisthesis can develop as a result of repeated excessive strains and stress.

X-Ray View Of Spondylolisthesis

The x-ray below shows you a good example of a lumbar spondylolisthesis. Look at the area the arrow is pointing to: You can see that the vertebra above the arrow isn't in line with the vertebra below it. It's slipped forward; it's spondylolisthesis.

Arrow Points To A Lumbar Spondylolisthesis

Grading Spondylolisthesis

Doctors "grade" the severity of a spondylolisthesis using five descriptive categories. Although there are several factors your doctor considers when evaluating your spondylolisthesis, the grading scale (below) is based on the far forward a vertebral body has slid forward over the vertera beneath. Often, the doctor uses a lateral (side view) x-ray to examine and grade a spondyloisthesis. Grade I is a smaller slip than Grade IV or V.

• Grade I: Less than 25% slip
• Grade II: 25% to 49% slip.
• Grade III: 50% to 74% slip.
• Grade IV: 75% to 99% slip.
• Grade V: The vertebra that has fallen forward off the vertebra below it. This is the most severe type of spondylolisthesis and is termed spondyloptosis.

Sciatica Cause #4: Trauma

Sciatica can result from direct nerve compression caused by external forces to the lumbar or sacral spinal nerve roots. Examples include motor vehicle accidents, falling down, football and other sports. The impact may injure the nerves or, occasionally, fragments of broken bone may compress the nerves.

Sciatica Cause #5: Piriformis Syndrome

Piriformis syndrome is named for the piriformis muscle and the pain caused when the muscle irritates the sciatic nerve. The piriformis muscle is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome develops when muscle spasms develop in the piriformis muscle thereby compressing the sciatic nerve. It may be difficult to diagnose and treat due to the lack of x-ray or magnetic resonance imaging (MRI) findings.

If you’ve ever felt pain in the hip, pain in the center of the butt, or pain down the back of the leg, you are likely suffering, at least partially, with piriformis syndrome. The piriformis is a muscle which runs from your sacrum (mid-line base of spine) to the outer hip bone (trochanter). This muscle truly works overtime on anyone who runs at all.

The muscles in and around the gluteal region help with three areas

• rotation of the hip and leg;
• balance while one foot is off the ground; and
• stability for the pelvic region.

Needless to say, all of these characteristics are highly needed by runners (and everyone else, when you come to think of it).

Injuries To The Piriformis

This muscle is a prime candidate for repetitive motion injury (RMI). RMI occurs when a muscle is asked to perform beyond it’s level of capability, not given enough time to recover, and asked to perform again. The typical response from a muscle in this situation is to tighten, which is a defensive response of the muscle. This tightness, however, manifests itself in several ways to a runner.

The first symptom suggesting piriformis syndrome would be pain in and around the outer hip bone. The tightness of the muscle produces increased tension between the tendon and the bone which produces either direct discomfort and pain or an increased tension in the joint producing a bursitis. Again, a bursitis is an inflammation of the fluid filled sac in a joint caused by an elevation of stress and tension within that joint.

The second symptom suggesting piriformis syndrome would be pain directly in the center of the buttocks. Although this is not as common as the other two symtpoms, this pain can be elicited with direct compression over the belly of the buttocks area. A tight muscle is a sore muscle upon compression due to a reduced blood flow to that muscle.

The third symptom suggesting piriformis syndrome would be a sciatic neuralgia, or pain from the buttocks down the back of the leg and sometimes into different portions of the lower leg. We have an article that can teach you more about how piriformis syndrome and sciatica are related.

The sciatic nerve runs right through the belly of the piriformis muscle and if the piriformis muscle contracts from being overused, the sciatic nerve now becomes strangled, producing pain, tingling and numbness.

Simple Physiology

Any muscle repetitively used needs to have an opportunity to recover. This recovery can either be on Nature’s clock, or can be facilitated and sped up with proper knowledge and treatment. Since the muscle is tightening due to overuse, continued use will only make it worse. This injured muscle needs to relax and have increased blood flow encouraged to it for more rapid healing. This tightness that exists also reduces the normal blood flow going to the muscle reducing the speed with which the muscle can recover. To encourage fresh, oxygen-rich blood to the muscle is the most powerful means of getting the muscle to begin to relax and function normally. Multiple massages per day to this area is greatly encouraged.

The next step in this "recovery" process is to use a tennis ball under the butt and hip area. While sitting down on the floor, roll away from the side of involvement and place a tennis ball just inside the outer hip bone under the butt area. As you begin to allow your weight onto the tennis ball, note areas of increased pain and soreness. Trigger points will tend to accumulate in a repetitively used muscle, and until these toxins are manually broken up and eliminated, the muscle will have an artificial ceiling with regard to flexibility potential and recovery potential. So, if it’s sore and hurts while your sitting on it, you’re doing a good job. Let the ball work under each spot for 15-20 seconds before moving it to another area. Once you’ve been on the ball for 4-5 minutes, now put the ankle of the involved leg over the knee of the non-involved leg (crossing your legs). Now place the tennis ball just inside the outer hip bone again and work the tendon of the piriformis muscle. While this pain is typically excruciating and takes some time to effectively reduce, the benefits here are huge. Be patient, be consistent and good things will happen.

Additional Treatments

Due to the fact that the sciatic neuralgia and the hip bursitis or tendonitis are both inflammatory in nature, ice, or cryotherapy, over the involved area 15-20 minutes at a time will be beneficial. This should be done multiple times per day.

Stretching of the hip muscles should not be done until the acute pain is gone. At that point in time, begin with gentle stretching, such as the cross-legged stretch while pulling up on the knee. The muscle should have increased flexibility before an active return to running.

Finally, I’m always discouraging the use of pharmaceutical anti-inflammatories. Not only do they greatly aggravate the intestines, but they also suggest an artificial wellness that can lead to bigger problems. Proteolytic enzymes, such as bromelain, are both natural and extremely beneficial with no side effects.

Conclusion: The piriformis muscle is pretty important for all of us.

Sciatica Cause #6: Spinal Tumors

Spinal tumors are abnormal growths that are either benign or cancerous (malignant). Fortunately, spinal tumors are rare. However, when a spinal tumor develops in the lumbar region, there is a risk for sciatica to develop as a result of nerve compression.

If you think you have sciatica, call your doctor or chiropractor. The first step toward relieving pain is a proper diagnosis.

Written by Jean-Jacques Abitbol, MD; Reviewed by Brian R. Subach, MD

Howard S. An, MD, Stewart G. Eidelson, MD; Reviewed by Howard S. An, MD, Jason M. Highsmith, MD, Timothy J. Maggs, D.C.; Reviewed by Edward C. Benzel, MD

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Chiropractic, Massages & Spinal Injections Are Your Papal Prescription For Low Back & Leg Pain.

Should you suffer from the low back and leg symptoms of sciatica, the pope feels your pain. Reports reveal that Pope Francis has spent part of his 2017 summer undergoing spinal shots and massage therapy to help manage his sciatica.

Sciatica is intense low back and leg pain which runs along the course of the sciatic nerve, that is the longest and largest nerve in the human system. The sciatic nerve extends from your low back all the way down to a foot. Several spinal ailments can irritate the sciatic nerve and cause sciatica, including a herniated disc, lumbar spinal stenosis, spondylolisthesis, and trauma (you can read more in common sciatica causes). The root reason for Pope Francis' sciatica is unclear.

The 80-year-old pope has suffered from sciatica for many years, having first remarked on his struggle with it in a 2013 through a media conference when he said, "Sciatica is very painful, very painful! I don't wish it on anyone!"

More recently, the pope has received epidural steroid shots and massages twice a week to handle his back pain pain, according to the Italian news magazine Famiglia Cristiana.

Sciatica PSA

How Spinal Injections & Massage Can Help Relieve Sciatica

Pope Francis' routine of epidural steroid injections and massages underscores the fact that while the pain of sciatica can be extreme--almost indescribable--spine operation isn't always the answer. The pope's non-surgical approach to sciatica pain management is one that many individuals suffering from the illness adopt.

With epidural steroid shots, strong anti-inflammatory drugs known as corticosteroids are injected near the spinal nerve roots. The therapy works with varying success, but some people experience decreased pain for months following an injection.

With massage, a therapist can target the muscle tension that may be compressing the sciatic nerve or associated nerve roots. Deep tissue massage treatment may be type of massage used, since it utilizes direct pressure and friction to release the pressure in the soft tissues (ligaments, tendons, muscles) surrounding the sciatic nerve.

The importance of Magnetic Resonance Imaging to evaluate the integrity of the lumbar posterior ligament complex post trauma.

Abstract: Posterior ligamentous complex(PLC), consisting of the supraspinous ligament, interspinous ligament, ligamentum flavum, and the facet joint capsules is thought to contribute significantly to the stability of the lumbar spine. There has been much debate on whether Magnetic Resonance Imaging(MRI) is specific and sensitive in diagnosing pathology to the PLC. The objective is to determine the necessity of MRI imaging for evaluating the integrity of the lumbar posterior ligament complex post trauma.

Key Words: Magnetic Resonance Imaging(MRI), interspinous ligament, posterior ligament complex, low back pain, ligament laxity, electromyography, impairment rating

A 41-year-old male, presented to my office for an examination with complaints of low back pain with numbness, tingling and weakness into the left lower extremity after he was the restraint driver in a motor vehicle collision approximately three and a half months’ post trauma. He rated the pain as a 3/10 on a visual analog scale with 10/10 being the worst and the pain and noted the pain as being present most of the time.  He stated that he was on pain killers daily and this helped manage his daily activities. Without pain killers his pain levels are rated 8/10 being present most of the time. The pain killers stated by the patient are Oxycodone and Naproxen.

He reported that the pain would be aggravated by activities which required excessive standing, repetitive bending, and lifting. He further noted that in the morning the pain was increased and his left leg would be numb and weak for about the first hour.

The patient stated that his care to date had been managed by a pain management clinic and that he had minimal improvement with treatment which has included physical therapy and massage therapy. He reported the pain clinic next recommended steroid injections which he refused. He states there has been was no imaging ordered and that an Electromyography(EMG) had been performed. He was told the test was negative for pathology.

Prior History: No significant medical history was reported.
Clinical Findings: The patient is 6’0” and weighs 210 lbs.

Physical Exam Findings:

Cervical Spine:
Cervical spine range of motion is full and unrestricted. Maximum cervical compression is negative. Motor and other regional sensory exam are unremarkable at this time.

Thoracic Spine:
Palpation of the thoracic spine region reveals taught and tender fibers in the area of the bilateral upper and mid thoracic musculature. Thoracic spine range of motion is restricted in flexion, extension, bilateral lateral flexion, and bilateral rotation. Regional motor and sensory exam are unremarkable at this time.

Lumbar Spine:
Palpation of the lumbosacral spine region reveals taught and tender fibers in the area of the lumbar paraspinal musculature. Lumbar spine range of motion is limited in flexion, extension, bilateral lateral flexion and bilateral rotation. Extension restriction is due to pain and spasm. Straight leg raise causes pain at approximately 50 degrees when testing either side in the left low back. There is no radicular symptomatology down the leg. Kemp’s maneuver recreates pain in the L4 region on the left. No radicular symptoms are noted. The patient is able to heel and toe walk. Regional motor and sensory exam is unremarkable at this time other than L4, L5 and S1 dermatomes having decreased sensation with light touch.

Muscle testing of the upper and lower extremities was tested at a 5/5 with the exception of the left quadricep tested at a 4/5.  The patient’s deep tendon reflexes of the upper and lower extremities were tested including triceps, biceps, brachioradialis, patella, and Achilles and all were tested at 2+ bilaterally except the left patellar reflex was 1+.

RANGES OF MOTION EVALUATION

All range of motions are based on the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 5th Edition1 and performed by a dual inclinometer for the lumbar spine.

   Range of Motion      Normal         Examination         % Deficit

A lumbar MRI reveals;

1)    Mild disc bulges at T11-T12, T12-L1, L1-L2 and L5-S1
2)    Low disc signals indicative of disc desiccation at T11-T12, T12-L1, L1-L2, L2-L3, L3-L4 and L4-L5
3)    Retrolisthesis of 2mm at L3-L4
4)    Mild ligamentous hypertrophy at L1-L2, L2-L3, L3-L4, L4-L5 and L5-S1
5)    L4-L5 has a Grade 1-2 tear of the interspinous ligament with mild inflammation
6)    L5-S1 has a Grade 1 interspinous ligament tear with mild inflammation

After reviewing the MRI I ordered lumbar x-rays to rule out ligament laxity.

X-RAY STUDIES

El Paso, TX. Chiropractor Dr. Alex Jimenez examines if sciatica can radiate to the arms.

Muscular pain that comes on suddenly in your lower back is indicative of a muscle spasm. Your muscles will feel as though they have locked up, and the pain can be unbearable.

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Several lumbar spine (lower back) disorders may cause sciatica. Sciatica is usually referred to as light to severe pain in the left or right leg. Occasionally doctors call a radiculopathy that is sciatica. Radiculopathy is a medical term used to spell out pain, numbness, tingling, and weakness in legs or the arms caused by a nerve root issue. It’s known as a cervical radiculopathy, in the event the nerve difficulty is in the neck. But since sciatica influences the low back, it is called a lumbar.

PATHWAYS TO SCIATIC NERVE PAIN

Five sets of matched nerve roots in the lumbar spine combine to generate the sciatic nerve. Beginning at the rear of the pelvis (sacrum), the sciatic nerve runs in the trunk, under the buttock, and down through the hip region into each leg. Nerve roots aren’t “solitary” structures but are part of the entire body’s entire nervous system capable of transmitting pain and sensation to different parts of the body. Radiculopathy happens when compression of a nerve root from a disc rupture (herniated disc) or bone spur (osteophyte) happens in the lumbar spine prior to it joining the sciatic nerve.

WHAT CAUSES SCIATIC NERVE COMPRESSION?

Several spinal ailments can cause spinal nerve compression and sciatica or lumbar radiculopathy.

• spondylolisthesis
• Injury
• piriformis syndrome
• spinal tumors

COMMON SCIATICA CAUSE #1: LUMBAR BULGING DISC OR HERNIATED DISC

A bulging disk is also called a contained disc illness. What this means is the gel-like center (nucleus pulposus) remains “included” within the tire-like outer wall (annulus fibrosus) of the disk.

A herniated disc happens when the nucleus breaks through the annulus fibrosus. It is called a “non-controlled” disk disorder. Whether a disc bulges or herniates, disk stuff compress delicate nerve tissue and cause sciatica and can press against an adjacent nerve root.

The effects of a herniated disc are worse. In both instances, nerve compression and irritation cause inflammation and pain, muscle weakness, tingling, and often ultimately causing extremity numbness.

COMMON SCIATICA CAUSE #2: LUMBAR SPINAL STENOSIS

Spinal stenosis is a nerve compression illness most frequently affecting older adults. Leg pain similar to sciatica may happen as an effect of lumbar spinal stenosis. The pain is generally positional, frequently brought on by actions like standing or walking and relieved by sitting down.

Spinal nerve roots branch outward through passageways in the spinal cord called neural foramina comprised of bone and ligaments. Between each group of vertebral bodies, located on the left and right sides, is a foramen. Nerve roots pass through these openings and extend outward to innervate other portions of the body. The term foraminal stenosis can be used when these passageways become clogged causing nerve compression or narrow.

COMMON SCIATICA CAUSE #3: SPONDYLOLISTHESIS

Spondylolisthesis is a disorder that almost all commonly influences the lumbar spine. It’s distinguished by one vertebra slipping forwards over an adjacent vertebra. When a vertebra slips and is displaced, spinal nerve root compression happens and frequently causes sciatic leg pain. Spondylolisthesis is categorized as developmental (located at birth, grows during childhood) or got from spinal degeneration, trauma or physical stress (eg, lifting weights).

COMMON SCIATICA CAUSE #4: TRAUMA

Examples include motor vehicle accidents, falling down, football and other sports. The impact may injure the nerves or, sometimes, the nerves may compress.

Piriformis syndrome is named after the piriformis muscle and the pain caused when the sciatic nerve is irritated by the muscle. The piriformis muscle and the thighbone is found in the lower part of the spine, connect, and aids in hip rotation. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome grows when muscle spasms develop in the piriformis muscle thereby compressing the sciatic nerve. It may be challenging to diagnose and treat because of the shortage of x ray or magnetic resonance imaging (MRI) findings.

COMMON SCIATICA CAUSE #5: PIRIFORMIS SYNDROME

Piriformis syndrome is named after the piriformis muscle when the muscle irritates the sciatic nerve and the pain caused. The piriformis muscle and the thighbone is located in the low part of the backbone, connect, and aids in hip rotation. When muscle spasms develop in the piriformis muscle thus compressing the sciatic nerve, piriformis syndrome develops. It can be hard to diagnose and treat due to the lack of x-ray or magnetic resonance imaging (MRI) findings.

COMMON SCIATICA CAUSE #6: SPINAL TUMOURS

Spinal tumors are abnormal growths which are either benign or cancerous (malignant). Fortunately, spinal tumors are uncommon. But when a spinal tumor develops in the lumbar region, there’s a risk for sciatica to grow as a result of nerve compression.

Call your doctor should you imagine you have sciatica. The very first step toward relieving pain is a proper diagnosis.

Sciatica is a disabling condition characterised by pain in the leg along the distribution of the sciatic nerve. It can be accompanied by back pain, tingling, numbness, reduced strength and reflex changes in the leg.

Sciatica is most commonly caused by irritation of the nerve roots emerging from the lower spine. For this reason it is often considered a type of nerve pain.

It is estimated that around 5 to 10% of people with low back pain have sciatica, equating to around 200,000 to 400,000 Australians. It is notoriously difficult to treat sciatica with over-the-counter medications and complementary therapies.

Our study released today examines the commonly prescribed nerve pain treatment pregabalin for acute and chronic sciatica. The results show that pregabalin does not improve pain symptoms or function, but is associated with unwanted side effects such as dizziness when compared to a placebo.

HUGE UPTAKE OF NEW DRUG

Medicines that have shown to be effective for treating nerve pain were considered to be an exciting new treatment option for sciatica.

These include drugs used to treat epilepsy, such as gabapentin and pregabalin. These medicines, sometimes called gabapentinoids, seem to work by preventing normal conduction of pain signals along a nerve.

Pregabalin became subsidised by the Australian government for nerve pain in 2013 and quickly became widely prescribed for conditions such as sciatica. In its first year of listing, nearly 1.4 million prescriptions were written and in its second year, this figure increased to 2.4 million. This was 32% more than the government predicted.

Since its first approval in 2004 pregabalin has become the most widely prescribed medicine for nerve pain globally, with worldwide sales of between US$3-5 billion annually. The astonishing growth is likely to be a consequence of many factors but may partly be a reflection of the lack of effective treatments for sciatica.

But while pregabalin has been shown to be effective for other types of nerve pain, there was little evidence it helped patients with sciatica. There were also emerging concerns of increased harmful effects, including risk of suicidality and misuse.

We designed our study to examine whether pregabalin is effective and has tolerable side effects in patients with sciatica.

PREGABALIN DOES NOT WORK FOR SCIATICA

The research compared the effects of pregabalin against placebo (identical inactive capsules) in 207 patients with sciatica.

Patients were randomly assigned to take up to eight weeks of pregabalin or placebo, prescribed and monitored by a general practitioner or a medical specialist. To keep the results as unbiased as possible, patients, doctors and study staff were kept blinded to who was treated with pregabalin and who received placebo capsules.

This study found after eight weeks there was no difference in the severity of leg pain between those who took pregabalin and those who took placebo capsules. The same result was seen at one year. There were also no differences in other relevant outcomes, such as back pain severity and function, at either eight weeks or one year.

However, people who took pregabalin reported more adverse effects. The most common adverse effect reported in the trial was dizziness.

The study shows that taking pregabalin does not improve your sciatic symptoms when compared with placebo, but you are more likely to have adverse effects when taking pregabalin.

TREATMENT OPTIONS FOR SCIATICA

Few alternative treatment options exist for people suffering from sciatica.

There is limited data describing the effects of nonsurgical treatments such as exercise, spinal manipulation or acupuncture on sciatica.

There is also no convincing evidence to show medicines such as anti-inflammatory drugs, oral corticosteroids or opioid analgesic medicines are effective. Epidural corticosteroid injections have been shown to have a small benefit in the short-term only.

Surgery confers a short-term effect in selected patients with sciatica, but after a year people with sciatica who have not had surgery do just as well as people who’ve had the procedure.

The good news is that sciatica does get better with time. It’s important to stay as active as possible and to avoid prolonged bed rest (as this can delay recovery).

If you’re currently taking pregabalin, speak to a doctor about your condition, and mention any improvement or adverse effects you’ve experienced since starting pregabalin. It’s important not to stop pregabalin abruptly – usually doses should be reduced slowly over a few weeks. Abruptly stopping pregabalin can have some ill effects and should be done with care, close monitoring and advice from a doctor.

It’s unfortunate, but we do not currently have a lot of effective treatment options for people with sciatica. Speak to your doctor or treating clinician (such as a physiotherapist) about what may be appropriate for you, including specific advice on how you can stay as active as possible.

A small muscle located deep in the buttocks, the piriformis muscle performs the essential function of rotating the leg outwards. Piriformis Syndrome is a painful condition that occurs when the piriformis muscle is tight and intrudes upon the sciatic nerve in the buttocks. Causing pain and tenderness and sometimes numbness in the buttocks, piriformis syndrome pain may also radiate down the sufferer's leg, and in some cases, even into the calf.

There are two commonly identifiable potential causes for piriformis syndrome. One is sitting for prolonged periods of time, which can cause tightening of the muscle. The second cause is an injury to the buttocks, either by a fall, an accident, or a sports injury. Trauma causes the piriformis muscle to swell and irritate the sciatic nerve.

Spasms can also cause piriformis syndrome, however, the underlying cause of the spasms frequently remains unknown.

Unfortunately, once an individual has suffered from piriformis syndrome, the condition can recur periodically, usually brought on by too much exercise or sitting for a long time without stretching.

Whatever the initial cause, piriformis syndrome treatment options are vital in relieving the painful symptoms and healing the condition.

These Four Treatment Options Are Frequently Used To Treat Piriformis Syndrome.

Medication. Over-the-counter or prescribed pain medicines, anti-inflammatory drugs, or muscle relaxers frequently serve to reduce the pain from piriformis syndrome. A doctor may also inject medicine directly into the piriformis muscle to improve the condition.

Heat. A common way to relax tight muscles is to apply heat. Piriformis syndrome sufferers may find relief from painful symptoms by periodically applying heat directly to the tender area.

Heat therapy may relieve the tightness of the muscle and promote healing of the entire area. However, it's important to avoid treating the muscle with heat if there is a chance the muscle may be torn.

Exercise. The overall cause of the condition is a tight piriformis muscle, so it stands to reason a proper exercise regimen will loosen the muscle and alleviate the symptoms associated with piriformis syndrome. A doctor can prescribe the correct exercises to stretch and subsequently strengthen the muscles and the body's other muscles. A strong body will reduce the chances of the issue recurring down the road.

Hands on therapy. Used with other types of treatment or on their own, these types of therapies are popular because of their effectiveness, as well as the fact they are drug-free ways to gain relief from the pain. Massage is a commonly used therapy for piriformis syndrome, as it helps increase blood flow to the area. The massage therapist can manipulate the area to relieve the tightness of the muscle.

Another hands on therapy that produces positive results is chiropractic care.

Chiropractors view the body in its entirety, and will often treat other parts of the body, such as a foot or leg, in order to improve the condition of the piriformis muscle. They may also utilize a regimen of pelvic and spinal adjustments along with joint manipulation and stretching to loosen up the muscle and help heal the afflicted area.

As stated earlier, once the condition has been controlled and the area has healed, it's vital to take precautions to avoid re-aggravating the area. Proper stretching before exercise, periodic breaks when sitting, and maintaining spinal and pelvic alignment will increase an individual's chances of living free of the pain of piriformis syndrome in the future.

Treating Sciatica

If you have a question about how chiropractic care can help with the symptoms of piriformis syndrome, or other health conditions, contact us today.

When the piriformis becomes tight or inflamed, it can put pressure on the sciatic nerve and you can get the sensations going down the leg.  Symptoms such as numbness, tingling, and sharp shooting pain.

A common mistake I’ve seen on YouTube videos and at different gyms and clinics, is people using a tennis ball, lacrosse ball, or foam rollers to apply pressure to the piriformis muscle in order to relax it.

How Not To Fix Sciatica

If your sciatica is caused by piriformis syndrome, applying pressure to an area that’s already compressed will only add more pressure to the sciatic nerve and cause more pain.

What you should do instead, is stretch the muscle causing the problem so that it relaxes and takes pressure off the sciatic nerve. In this video you’ll learn an easy stretch you can do on the floor.

You simply lay on your back with both legs bent. Then cross the painful leg over the good one. And pull the affected leg towards the opposite shoulder and hold that stretch for 30 seconds.

Repeat the stretch as needed.

This will help to relieve the sciatic pain associated with piriformis syndrome.

As with any conditions, there is no quick fix. You have to consistently perform sciatica stretches and exercises to achieve the best results.

Source:

Doctor of Chiropractic, Dr. Alexander Jimenez examines why sciatica can be so painful.

Sciatica may be perceived as the worst form of nerve malady, but that’s more reputation than reality.

Nerve pain is one of the most extreme forms of pain. It elicits imagery of searing heat, electric shock, and lightning bolt -like shooting sensations. And, the most dreaded kind of spinal nerve damage is arguably the tell tale low back and leg pain of sciatica.

A question patients frequently ask is, “ Why is sciatica so distressing?” That’s not the case, although they often consider there’s something exceptional about sciatica versus other kinds of spinal nerve malady.
  
Myth-busting Sciatica Pain

Many assume sciatic nerve compression delivers more pain than other pinched nerves through the body because sciatica requires the sciatic nerve, which can be the longest and largest nerve within the body. But in 99 percent of sciatica cases, it’s not the sciatic nerve that’s compressed—it’s the nerve roots in the lumbar spine (low back) that join as they leave the spinal column and form the sciatic nerve.

When most folks refer to sciatica, they describe pain that shoots down the leg after the path of the sciatic nerve, but it’s actually one or two nerve roots compromised (commonly, the L4 or L5 nerve root). Doctors ascertain the exact nerve roots which are compressed by the positioning of the pain, like if the pain goes down to the side of the foot or the big toe.

Other Sources Of The Sciatica Stigma

It Affects Your Legs

One of the reasons sciatica gets so much attention is since the sciatic nerve’s roots feed to the legs, and we use our legs a lot. Sciatica may be perceived by patients as being more painful when compared to a compressed root in a less active portion of the human body, for example in the torso. In case you compressed or irritated another nerve of prominence or identical use to your own leg, it will be equally as distressing as sciatic pain.

Muscle Spasms Are The Actual Culprit

Another rationale sciatica is associated with intense pain isn’t related to nerve compression muscle spasms. A patient with sciatic symptoms is hunched over and can’t stand up straight when, that’s a signal the patient has had a back spasm due to the nerve irritation. As sciatica changes your lumbar spine, the muscles that could spasm following nerve damage will be the large, postural back muscles. You’ll feel them when they spasm, because these muscles are so large. On the other hand, if a neck nerve root is compressed by you, you won’t find a muscle spasm that is potential quite as much because the muscles near the cervical spinal column are much smaller. (But spasms of neck muscles can nevertheless be really painful!)

Sciatica Is A Standard Enemy

The lumbar spine is prone to wear and tear on the intervertebral discs. When this happens, materials that irritate the encompassing nerves are leaked by the discs. Discs can also herniate, and that may irritate the nerve. Sometimes, the commonality of sciatica helps it be a catch all diagnosis when a patient doesn’t even have nerve root problem. For example, tweaking your back from lifting is generally a muscular problem, not a nerve issue.

Nerve Pain Is Created Equal

There are various causes of back malady, and sciatica is merely one. As they are all equally hazardous, sciatica isn’t especially unique when you compare it to other types of nerve malady. It can be really intense and debilitating, when nerve pain happens everywhere in the body. Lives are turned upside down from nerve pain, so don’t hesitate to see a spine specialist to simply help alleviate nerve pain in your neck or back.

El Paso, TX. Chiropractor Dr. Alex Jimenez listens in on how chiropractors can help with sciatica.

Dr. Joseph Licitra DC, a chiropractor that serves Clifton, NJ as well as Montclair, Bloomfield, and Passaic, recently discussed sciatica on a local cable show. Dr. Licitra says that chiropractors can help treat sciatic nerve pain.

Clifton, United States
 
Dr. Joseph Licitra DC, the owner of a chiropractic practice that serves Clifton, New Jersey and surrounding areas such as Montclair, Bloomfield, and Passaic, recently discussed sciatica on a local cable show called “Meet Clifton.” Those interested in learning more about the challenges of sciatica and how it can be treated can view an exclusive video clip for free on Dr. Licitra’s website: http://www.josephlicitra.com/sciatica

In addition to speaking about the prevalence of sciatica in America, Dr. Licitra also touched upon the economic consequences of the debilitating condition. An interesting fact explored during his presentation brought to light the extent of which sciatica negatively affects employee attendance in the workplace. Dr. Licitra said: “People with sciatica have difficulty sitting and bending and therefore they can’t go to work. There is tremendous economic strain on the cities, on the companies, and on the families.”

The Causes Of Sciatica

Sciatic nerve pain can stem from many different things such as repetitive bending, direct trauma to the spine, as well as a sedentary lifestyle.

How chiropractors can help – There is hope for people who suffer from sciatica. Chiropractors can determine the origin of the sciatic condition and then focus on balancing out the spine to get the bones in correct alignment. Chiropractors like Dr. Licitra who specialize in kinesiology will also focus on the musculature to pinpoint the cause(s) of sciatic pain.
Dr. Licitra has been in practice for over 30 years and has worked on many professional athletes such as the New York Giants and the National Hockey League. His practice is now offering free consultations to new patients interested in receiving treatment for sciatica, as well as to patients suffering from other health conditions like neck or back pain, shoulder pain, and even migraines.

Struggling With Sciatica?

If you are experiencing pain that radiates from the back or buttocks all the way down the legs, you may have a common condition called sciatica. Many people in Clinton suffer with the pain of sciatica and may never achieve a long-term solution. An untreated sciatic condition can continue to worsen and make the daily tasks of living go from difficult to nearly impossible. Fortunately, chiropractic treatment can help you overcome this debilitating condition.

Sciatica In Clifton

Sciatica, also known as sciatic neuralgia, is a condition that causes pain in the lower back, down the back of the leg, and into the foot. It can make sitting and standing for long periods of time difficult and can lead to weakness, tingling, and numbness in the leg and foot. It will often come and go throughout a person’s lifetime, causing periods of varying degrees of pain and discomfort. If left untreated, sciatic pain will generally grow worse and the nerve can become permanently damaged.
 
Video: Your Complete Guide To Sciatic Pain

The reason why the pain travels so far, radiating up and down the legs and back, is due to the compression of the sciatic nerve which is the longest nerve in the body. This nerve originates in the lumbar spine and extends into the buttocks before traveling down the leg to the ankle and foot. When the vertebrae in the lower back are compressed, the roots of the sciatic nerve can become pinched and irritated which is what causes the pain.

How Do You Develop Sciatica?

There are a number of factors that can lead to sciatica. It is most commonly caused by disc injuries and bulges. In this occurrence, the disc presses against the nerve root causing sciatic pain. Disc Injuries can occur because of poor posture, repetitive use injuries, and accidents. Sciatica is also common when there are subluxations (misalignments) in the spine due to postural issues, pregnancy, or trauma. Some patients report simply bending over to pick up a piece of paper and then being suddenly hit with extreme pain. The reality, however, is that the spinal condition was probably already developing for quite some time before the triggering incident occurred.

Chiropractic Treatment For Sciatica

Chiropractors in Clifton are highly trained to zero in on the source of the sciatica and to work with the patient in determining the most suitable approach to treatment. After a thorough assessment of the individual’s unique issue, gentle adjustments are made that will allow the body to recover its natural alignment.

Some people respond very quickly while others take more time to recover. It really depends on the condition of the disc or the joints that the chiropractor has to correct. In most cases, the longer the issue persists, the longer it will take to achieve correction. The great news is that it typically takes less time to fix an issue like this than it took to create it in the first place. Once the position of the spine and discs are corrected, patients often report improvements in their overall health. If you are experiencing symptoms of sciatica, please call our team at Joseph Licitra, DC today.

 
For more information and access to the video, visit Dr. Licitra’s website at http://www.josephlicitra.com/sciatica
For more information, please visit http://josephlicitra.com
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Sciatica is a pain that radiates down the back, though the buttocks, and into the leg. The most common question people ask is: how long is this going to last? We want to know how long each attack will last and how long between flare-ups, but the answer may be more complicated than just simply giving a definite length of time. There are unfortunate individuals who have pain that doesn’t go away, often leaving them with suffering from chronic and persistent pain.

What most doctors and medical professionals can agree on is that there is no universally applicable answer to this question. This article will address questions such as, does sciatica go away on its own? What does sciatica feel like? And can sciatica go away? We will also discuss the causes of sciatica pain, severe complications of sciatica, and sciatica relief.

WHAT DOES SCIATICA FEEL LIKE?

Sciatica is a pain in the lower back or hip that radiates down into the buttocks and into the back of the leg along the sciatic nerve, with the pain often terminating in the foot. It is often the result of a pinched or inflamed sciatic nerve, which can occur after an injury, muscular strain, or herniated vertebral disc. Sciatic pain typically goes away on its own within a few weeks.

This type of pain can be difficult to describe, as it can take a number of different forms. It may feel like more of a cramping or numbing pain sensation that worsens when you sit, sneeze, or cough. It may be described as numbness combined with an electrical or burning sensation running down the leg, or even just as “pins and needles” along the leg. Pain associated with sciatica can be accompanied with muscle weakness, and it sometimes results in loss of bowel and bladder control, which would require emergency care treatment.

Current statistics show that 80 to 90 percent of all patients recover within six weeks without surgery.


ACUTE SCIATICA ATTACKS

Acute attacks are by far the most common complaint in those with sciatic pain, with symptoms coming and going. The frequency of flare-ups can vary from patient to patient, with some having more episodes and others only having them on occasion. The following are some of the facts associated with acute episodes of sciatica:

Attack episodes do not typically last long in patients with a limited history of attacks—less than five years. These patients have occasional bouts of sciatic pain they might endure for about a week or two that gets better on its own. However, some may find these flare-up periods severely debilitating, as they are not accustomed to the pain, frequently leading to feelings of anxiousness and stress.
There is no clear evidence of any triggers that lead to flare-ups of sciatica pain, but certain physical and emotional instigators may be potential causes.
Statistically, acute pattern flare-ups may occur between two to six times a year, but there are patients who experience more or even less.

CHRONIC SCIATICA ATTACKS

As the name suggests, chronic symptoms exist over longer periods of time or virtually all the time. This category of sciatic pain is often described as a pain that never really goes away. The severity of the symptoms, however, is often not as intense as it was when they first developed sciatica. Over time, their tolerance for pain has increased, allowing them to endure it for lengthy periods of time. The following are some facts associated with chronic episodes of sciatica:

Chronic pain sufferers often report their symptoms to be less severe over time, along with decreased levels of anxiety and fear that once was associated with the condition
It is rare for a person to just suddenly develop chronic sciatica from nowhere and have the pain remain for an extended period of time
Chronic sciatic is, unfortunately, a lifelong condition, as it is one of the most difficult pain disorders to resolve
While there are cases of individuals who make full recovery from sciatic pain, the harsh truth of the matter is that the majority of patients will have some degree of pain for the rest of their lives. Sciatica does not respond well to most forms of treatment, with no accurate explanation for its cause.

COMPLICATIONS OF SCIATICA

While most people fully recover from sciatic pain, it can still potentially cause some serious complications, such as:

WHEN TO SEE A DOCTOR?

Experiencing sciatic type symptoms should prompt you to go see your doctor right away, as it can drastically reduce the length of time you suffer from the condition. Your doctor may also help you determine if you are at risk for any further complication and provide treatment that is best for you. While mild sciatic pain can go away in time, it’s a good rule of thumb to call your doctor if you are finding your pain to be particularly unbearable.

Back pain is the second most regular side effect related explanation behind exercise based recuperation in the United States. Up to 84% of grown-ups have low back pain eventually in their lives, with sciatica influencing up to 40% of those with low back pain. The long haul result of low back pain is for the most part good, yet relentless indications influence a great many people. Sciatica represents around 5% of individuals with back pain who go on handicap, and for up to 75% of the expenses related with low back and hip pain products Noninvasive mediation, for example, non-intrusive treatment is an essential apparatus that can assume a huge part in decreasing human services costs.

What is Sciatica?

The term sciatica portrays the indications of leg pain-and potentially shivering, deadness or shortcoming that begin in the lower back and go through the butt cheek and down the expansive sciatic nerve in the back of the leg.

Sciatica is not a therapeutic finding it is an indication of a basic restorative condition, for example, a lumbar herniated circle, degenerative plate ailment, or spinal stenosis. Sciatica is frequently described by one or a mix of the following side effects:

Steady pain in just a single side of the butt cheek or leg (once in a while can happen in both legs)

Pain that is more terrible when sitting

Leg pain that is regularly portrayed as copying, shivering or singing (versus a dull hurt)

Shortcoming, deadness or trouble moving the leg or foot

A sharp pain that may make it hard to stand up or to walk

Step by Step Instructions: Treat Sciatica Symptoms Brought On By Low Back Pain

Ultrasound: Ultrasound is regularly suggested before extending of the piriformis muscle. Ultrasound is a type of profound warming in which sound waves are connected to the skin and infiltrate into the delicate tissues. Ultrasound is particularly helpful in alleviating intense scenes of pain and may upgrade tissue recuperating.

TENS: Transcutaneous Electrical Nerve Incitement

Is a back treatment methodology that utilizations low voltage electric current to ease pain. TENS is viable for treatment since it causes the neighborhood arrival of neurotransmitters, for example, serotonin to obstruct the pain motions in the cerebrum.

Iontophoresis: Iontophoresis gives a methods for controlling pharmaceutical transdermally utilizing a low, guide electrical current to drive it to the included tissues of the low back. Every now and again, it is utilized to oversee mitigating drugs to nearby tissues. An auxiliary advantage for iontophoresis is the electrical current itself that can instantly decrease side effects by blocking pain receptors.

Footing table: Lumbar footing utilizing a footing table works under the hypothesis that division of the lumbar vertebrae will diminish impingement of the spinal nerves and in addition diminish weight between the circles.

Sciatic Nerve Pain: Prevention, Stretches & Exercises For Pain Relief

Sciatica occurs when a person experiences feelings of numbness or tingling, which begins in the lower back region, through the buttocks, and runs down the leg—the sciatic nerve.

Nerve pain resulting from sciatica is a symptom related to an underlying condition that affects the sciatic nerve. Conditions that can lead to sciatica are a lumbar herniated disc, degenerative disc disease, and spinal stenosis.

Fortunately, physical therapy and exercises can help relieve sciatic nerve pain and improve the condition by increasing strength through stretching and aerobic techniques.

Sciatic Stretches

Sciatic nerve pain stretches aim to target the muscles that lead to pain. These muscles are often tight and inflexible, so stretching can loosen the tightness and minimize pain.

Stretching the hamstring is best for dealing with sciatic nerve pain, as the sciatic nerve runs through the hamstring—this is the area behind the quadriceps, underneath your buttocks.

Here are some examples of sciatic nerve pain stretches:

Towel hamstring stretch: Lay on your back with a towel wrapped around your thigh. With your leg up in the air and your hands grasping the towel, begin to straighten the knee until a stretch is felt at the back of the thigh. Hold the position for 10 seconds and gradually begin to increase the duration of the hold.


Wall hamstring stretch: Once again, lay on the floor with your buttocks up against a wall. With one leg stretched out in front and the other up against the wall, push the knee straight until a stretch is felt.

 
Hamstring stretch while sitting: Sit at the edge of a chair and have one leg straight out in front of you with your heel on the floor, toes pointing upward. Sit up straight while pushing your navel towards your thigh without actually leaning over. Hold the stretch for 30 seconds and repeat three times for each leg.


Pigeon pose: Lay with your back flat on the floor, then raise your right leg up to a right angle and interlock your fingers behind the thigh. Raise you left leg, resting your right ankle on its knee, and press that knee towards your head to stretch the tiny piriformis muscle. Lower both legs then repeat on the opposite side.


Knee to opposite shoulder: Begin by lying flat on your back with your feet flexed upwards. Lift your right leg, then link your fingers around your knee and pull it gently across your body towards the opposite shoulder. Hold the position for 30 seconds before returning to the starting position and repeat the movement with your left leg.


Sitting spinal stretch: Start by sitting on the ground with your legs extended in front of you and your feet flexed upwards. Bend your right knee and cross your leg over the left, planting your right foot flat on the outside of your left knee. Turn your upper body and place your left elbow to the outside of your right knee, helping to keep your body turned towards the right. Hold this pose for 30 seconds, then return to the starting position and repeat on the left side.


Standing hamstring stretch: Place your right foot on an elevated surface either at or below hip level and flex your foot so that your toes and leg are straight. Bend forward towards your foot and reach for your toes – the further you bend the deeper the stretch. Hold this position for 30 seconds, then switch legs.


Reclining Cow’s Face Pose: Lay face-up on your back and cross your left leg over your right. Raise both legs off the floor, flexing both feet, and reach for your outer ankles to hug your legs towards your stomach. Hold for 30 seconds, then switch sides and repeat.


Low Lunge: Begin in a regular lunge position with your right leg forward and your left knee on the ground. The top of your left foot should be flat on the ground. Lift your torso slowly and rest your hands on your right thigh, then lean your hips forward to stretch the left hip flexor. Hold this pose for 30 seconds, then repeat on the other side.

Sciatica Exercises

Exercising for sciatica nerve pain has been found to be more effective than simply staying in bed. Strengthening and low aerobic exercises should be your go-to, as they offer the most relief from sciatica nerve pain.

Strengthening exercises should work to strengthen the spinal column and the supporting muscles, tendons, and ligaments. This includes targeting the lower back, abdomen, glutes, and hip muscles.

Low aerobic exercises consist of walking, swimming, and pool therapies. They aim to increase fluid and nutrient exchange in order to promote a healthy environment for healing. Furthermore, low aerobic exercises work as a natural painkiller, as exercise has been shown to help alleviate pain by increasing endorphins in the body.

Speak to your physical therapist or trainer with regards to appropriate exercises to help strengthen your muscles in order to reduce sciatica nerve pain.

Other Tips To Relieve Sciatica Nerve Pain

Along with stretches and exercises, there are other home remedies you can utilize in order to alleviate sciatica nerve pain.

Tips to improve sciatica nerve pain include:

• Take over-the-counter anti-inflammatory medications
• Apply hot and cold packs
• Wear a supporting lower back brace
• Get proper sleep
• Try yoga
• Quit smoking – smokers have higher incidences of back pain
• Maintain a healthy weight
• Practice maintaining proper posture
• Ensure you lift and carry objects properly

If you are on a long driving trip or flight, ensure you take plenty of moments to move around as much as possible, i.e., make stops, get up from your seat

By practicing these tips as well, you can help improve sciatica nerve pain and prevent future injury.

Related: How to get rid of sciatica pain

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Related Reading:

Spinal stenosis causes, symptoms, natural treatment, and exercises

Exercises and tips to improve posture and alleviate back pain

Sources:

http://www.prevention.com/fitness/yoga/stretches-sciatic-nerve-pain
http://www.healthline.com/desktop-article/back-pain/sciatic-stretches
http://www.nytimes.com/health/guides/disease/sciatica/prevention-and-self-care.html
http://www.spine-health.com/wellness/exercise/sciatica-exercises-sciatica-pain-relief