| Sciatica
is the term given to pain down the leg, which is caused
by irritation of the main nerve into the leg, the sciatic
nerve. This pain tends to be caused where the nerves pass
through and emerge from the lower bones of the spine (lumbar
vertebrae). Much of the advice regarding this condition
is the same as that for low back pain.
Symptoms:
In
sciatica, there is a pain down into the leg, which travels
below the knee, and may involve the foot. There may be numbness
and there may be weakness of the lower leg muscles. These
symptoms may come by themselves, but are often combined
with low back pain. The order in which the symptoms appear
may vary. Sometimes the back pain comes before the sciatica,
and sometimes will follow.
Dr.
Cady specializes in treating the causes of sciatica. He
uses a combination of gentle joint alignment with physical
therapy modalities, stretches and exercises to speed your
recovery.
Red
Flags:
As
with low back pain, there is a group of features (the Red
Flags) which doctors use to highlight the need to act more
quickly, because they may suggest a problem which is not
as straightforward as simple back pain or sciatica. If you
fit into one of these groups or are concerned, you should
see your doctor soon:
- You
are younger than 20 or older than 55 when you get the
problem for the first time.
- The
pain follows a violent injury, such as a road traffic
accident.
- The
pain is constant and getting worse.
- The
pain is in the back of the chest.
- You
have had cancer in the past or at present.
- You
are on steroids.
- You
are a drug abuser, or have HIV.
- You
are generally unwell.
- You
have lost significant weight recently.
- You
continue to have great difficulty bending forwards.
- You
have developed a number of problems in your nervous system
(e.g. numbness, loss of power, etc).
- You
have developed an obvious structural deformity of your
spine.
It
is wise to see Dr. Cady if you develop sciatica. Certainly
you should consult him if you are not able to adequately
control the pain with home remedies, or if the pain carries
on for more than two weeks.
Causes:
The
most common cause of true sciatica is a herniated or bulging
disc putting pressure on the spinal nerves. The discs (or
inter-vertebral discs) are the cushions which separate the
bones of the spine (vertebrae). Your doctor may refer to
a 'slipped disc' as a prolapsed intervertebral disc (PID)
or a herniated nucleus pulposus.
Intervertebral
discs allow for some flexibility between the bones of the
spine, and also act as shock absorbers. The pressure within
the discs can reach high levels when we bend or twist, even
without carrying a heavy load. If we add to that a heavy
load, especially held out at arms' length, the pressure
rises even higher.
If
part of the fibrous outer ring of the disc is rather weaker
than the rest, the softer center (nucleus pulposus) may
push its way through, bulging outwards. If this bulge presses
against a nerve which is running from the main, central
nervous system to one of the legs, it causes symptoms in
that leg.
Sciatica
occurs when the herniated disc presses against the nerves
which go to make up the sciatic nerve. This is more likely
to cause problems when the nerve is squashed by this, usually
between the disc and an adjacent bone.
Nerves
have many functions, transmitting messages around the body,
rather like a telephone system. They allow us to feel things
that happen to us, such as things we touch or that touch
us, hot and cold, and pain, and they cause our body to do
things, e.g. making your leg muscles contract when you want
to walk. Thus, when a nerve is squashed, it may malfunction,
and we might feel pain, numbness, pins and needles, and
we might find our limbs do not work in the way they should.
Other
things can cause irritation of or pressure on a nerve in
the spine. Sometimes this may be a rough and enlarged part
of one of the vertebrae, brought about by ageing, and sometimes
rarer conditions, infections and tumors are to blame. Most
times the cause is nothing too serious, but one of the reasons
for seeing your doctor if the pain persists, is to make
sure that serious and treatable causes have been ruled out.
Investigation:
If
you still have sciatica after a few weeks, it is likely
that your doctor will arrange for you to have a MRI (Magnetic
Resonance Imaging) scan. This will show the soft structures
in the spine, as well as the bones, and will thus show whether
a nerve is being squeezed by a disc, or whether something
else is causing irritation of the nerve.
Really
the main reason for doing such a scan is to see whether
conservative care such as chiropractic care can fix the
problem or an operation will help the patient.
Treatment:
Conservative
care including chiropractic care and physiotherapy can help
to stabilze sciatica and return you to health in the least
amount of time. Call us at 408-739-2273
to make an appointment today.
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