Active Quiroprática, Chiropractic Clinic
serving Lagoa Carvoeiro Portimão Silves Porches, Algarve, Portugal
Dr. Krystov Bock

USA reg. Dr of Chiropractic / Chiropractor

(+351) 282 352 202 / 966 706 606

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Dr. Bock's Blog...

Sciatica..... Not an Italian Island!

(Chiropractic Corner column, The Portugal News)

Sciatica... is most often pain radiating from the lower back, to the buttocks, and/or down the back of the leg. It can be from many different causes, and even health professionals need to do a thorough exam to arrive at an expert diagnosis. 

So, what the heck is Sciatica?
Simply put, Sciatica is irritation of the Sciatic Nerve (largest nerve in the body), which is made up of five lower back spinal nerve roots, which join together (like telephone lines leaving the telephone company) in the lower back/pelvis, then down the back of the leg (telephone lines going down the street). Once past the knee, they branch out to individual muscles (like telephone lines going to individual houses).  If the Sciatic Nerve is irritated, you feel Sciatica down one leg or the other.  In rare cases, it can be felt down both legs.

sciatica herniated disc piriformis active quiropratica dr krystov bock algarve

What does Sciatica feel like?
The pain can be either sharp, stabbing, an ache, electric, burning, or it can be numbness or tingling, along the entire length of the nerve. It can be in a certain area in the buttock, leg or foot. Sometimes you can have weakness of muscles in the leg.

What causes the irritation & pain?  
Usually it is caused by pressure somewhere along the Sciatic Nerve. If our telephone isn't working (leg pain), the problem can be at the telephone company (spine) or the telephone wires running down the street (pressure in the buttock/leg). It takes an expert to find where the problem is. Since there are various places that the pressure can occur, we need a good orthopedic examination to locate the problem, which then guides the correct treatment; in other words, two different people can both have pain at the same spot on the back of the legs, but it can be coming from pressure at a different nerve location and require different treatment. Another cause can be from irritating chemicals leaking from an injured disc, these chemicals can cause pain to the surrounding spinal nerves.

Sciatica is a symptom of one or more of the following conditions, which means... if you are experiencing Sciatica, the cause of yourSciatica... may be very different from your "Uncle Bud's" Sciatica. What worked for "Bud", may not work for you. So, an accurate diagnosis is necessary. Sciatica pain could be from any of the following:

Herniated Lumbar Disc
Degenerative Disc Disease
Lumbar Spinal Canal Stenosis
Piriformis Syndrome
Sacro-iliac Joint Dysfunction

Herniated Lumbar Disc
When a lumbar disc bulges, it can directly push on one of the Sciatic spinal nerves. As the bulge progresses, small tears in the disc occur, releasing chemicals which can irritate the Sciatic spinal nerves.
Degenerative Disc Disease
Degeneration causes a decrease in the height of the disc, narrowing the space for the Sciatic spinal nerve.
Lumbar Spinal Canal Stenosis (narrowing)
When the spinal canal is narrowed (disc herniation, degeneration, bone growth or ligament swelling), one or more of the spinal nerves can be affected. This can be one of the causes of both legs feeling Sciatica symptoms
Piriformis Muscle Syndrome
The Piriformis muscle spans across the lower portion of the pelvis, and the Sciatic Nerve passes either under or through the Piriformis muscle, if the muscle goes into spasm it can create a squeezing pressure on the nerve.
Sacro-iliac Joint Dysfunction
The Sacro-iliac Joints are the major weight-bearing joints in the pelvis, if the ligaments become sprained nearby muscles may go into spasm causing pressure on the Sciatic Nerve.

 

Due to the many different causes of Sciatica, a expert orthopedic exam is needed if your symptoms persist for more than a few days and it is not getting better on its own or with rest.  The results of the exam will guide your specific treatment, since different causes require different treatment. Due to the different causes, recovery time can vary from a couple of days to a month or more.

What can you do at home?
Initially rest (in whatever position you find most comfortable), if you feel best either lying on your side or back try using some pillows under your bent knees for support and to lessen the tension of the Sciatic Nerve.  Absolutely NO LIFTING! Some people respond well to a short course of anti-inflammatory medications to help reduce swelling. An elastic support belt can be very helpful to assist sore muscle working overtime to support and in some cases reduce the pain immediately. If you have tried resting, a low back belt and are still in pain, you should consider a visit to a Chiropractor to determine the exact cause of the Sciatica and begin appropriate treatment.  Once your Sciatica is improving, numerous studies show that it is important to return to a gentle regular exercise and stretching program, prescribed by your Chiropractor, to help maintain and rebuild weakened muscles. Strong back and core muscles help reduce pressure on the spinal nerves, lessening the chance of future Sciatica. Gentle exercise, stretching, yoga, pilates, swimming, and walking may be helpful. 

Types of Chiropractic Treatment to relieve the irritation to the Sciatic Nerve:

1) Spinal Decompression Therapy is best to treat Herniated Discs, Degenerative Disc Disease and Spinal Canal Stenosis. Using a specially designed treatment table, Flexion-Distraction gently "decompresses" the disc, reducing the bulge and flushing irritating chemicals, helping to relieve the pressure on the spinal nerves. It is very gentle and safe, with no quick movements. It is the preferred course of treatment for disc problems, used by more than 40,000 Chiropractors in North America since the 1970's, and it is now becoming more widely used in Europe. If the lumbar disc is only mildly swollen or the degeneration is stable, then very gentle Chiropractic manipulation may help improve spinal motion and reduce pressure of disc and nerves.

2) Chiropractic Manipulation can be very helpful for normalizing motion of the Sacro-iliac Joint and helping relieve Piriformis Syndrome pain. When the pelvic joints function normally, the surrounding muscles lessen their tight hold, reducing irritation and pain in the Sciatic Nerve.

Do Imaging Studies Help?
If there has been some sort of recent trauma, a fall or injury, then X-rays may be needed to ensure that you have not had a fracture of a bone. CT(TAC) and MRI scans can help identify which disc and/or spinal nerve is under stress. However, numerous studies show that early CT/MRI exams do not help you get better faster, and sometimes can be misleading. Just because something is seen on the CT/MRI doesn't necessarily mean it is causing your problem. The best diagnostic tool is simply you and your Chiropractor, combining your own description of your symptoms plus a good orthopedic examination, this is remarkably accurate in determining the cause of your problem.  Gentle Chiropractic treatment can help you recover, without the added cost of a CT/MRI. (Of course, if you are not responding within a month of treatment, then a CT/MRI may be helpful to determine if there is an unusual cause for your problem.) Many neurosurgeons recommend CT/MRI mostly be used immediately before a needed surgery to confirm the location of the disc area that they are going to correct. 

An Important 2013 Study
A government (USA) study published in SPINE magazine, a highly respected medical journal, reviewed lower back conditions and treatment of 1,885 patients. If the person first visited a medical surgeon, 42% would have surgery. If the person first visited a Chiropractor, less than 2% would eventually have surgery. By seeing a Chiropractor first, overall surgery was reduced by 96% !  

First, Chiropractic care to treat the root cause of the Sciatica. Then, if you haven't had any improvement in a month possibly consider CT/MRI studies which could guide future care. If your Chiropractor determines that a disc has degenerated to the point that only surgery can help, a referral to an orthopedist or neurosurgeon may be considered. Many neurosurgeons are now recognizing the benefit of initial Chiropractic care and are referring patients to their local Chiropractor before considering surgery.

Expert qualified Chiropractic treatment and care works, so please give it a try!

Please call today for an appointment!

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Active Quiroprática, Chiropractic Clinic
Dr. Krystov Bock

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Centrally Centro located Chiropractic Physiotherapy Quiropratica Quiropratico in Lagoa, Algarve, Portugal
Formerly associated with Lutz Quiropratica Quiropratico, 2013 and 2014