LEG PAIN & SCIATICA


WHAT IS SCIATICA?

Sciatica is a severe pain in the leg caused by compression, irritation, or inflammation of the sciatic nerve. The nerves are the largest nerves nerves in the body. These nerves provide innervation to your thigh, knee, calf, ankle, foot and toes. Each sciatic nerve is composed of five smaller nerves that leave the spinal cord via openings in the lower parts of your spinal column. These nerves join together and travel down the back of each leg to just below the knees where they divide into smaller nerves continuing to your feet and toes. The pain resulting from irritation or compression of these nerves is referred to as sciatica.

WHAT ARE THE SYMPTOMS OF SCIATICA?

Sciatica may cause a wide range of symptoms depending on where the sciatic nerve is affected. The symptoms can vary from severe and debilitating to infrequent and irritating. If left untreated the milder symptoms often get worse.

One or more of the following sensations may occur as a result of sciatic nerve irritation:

- Pain in the bottom and/or leg

- Burning or tingling down the leg

- Weakness, numbness or difficulty moving the leg or foot

- A constant pain on one side of the bottom

- A shooting pain that makes it difficult to do almost anything

There might be a mixture of all of the above symptoms, which change constantly depending on what you are doing. In many cases symptoms are preceded for a few weeks by low back pain. Eventually, the leg pain becomes worst than the back pain.

In general, sciatic pain will be particularly be aggravated by sitting in one position for long periods of time as when driving or working at a computer. Working out or running, or even simple things like walking, bending, turning or standing up may be difficult and painful. Tennis or golf and other twisting activities can cause sciatica pain to flare up. In most severe cases, sciatica can damage reflexes or even cause a wasting of the calf muscles.

CAUSES OF SCIATICA

Because the sciatic nerve is so long, irritation can occur at many points. The first place is the lower back. Commonly, a misalignment of one or more lumbar vertebra, causing pressure on one or more of the nerve roots making up the sciatic nerve, is responsible. This condition is known as a subluxation, one underlying cause of sciatica as well as many other health problems.

Disc Herniation- commonly this is known as a 'slipped disc'. Discs are the cartilage-like cushions occupying the spaces between vertebrae. Healthy discs allow your vertebral column to turn and bend normally and act as shock absorbers to cushion the vertebrae when you move. The most common cause of disc herniation is the result of cumulative damage over a long period of time. Years of bad posture, poor muscle tone, excess weight or countless other causes set the stage. The disc may start to deteriorate, becoming drier, flatter and more brittle. Eventually, the tough outer covering of the disc may develop tears, allowing jelly-like substance in the disc's centre to seep out and herniate. Then, something simple like bending over to tie your shoes can trigger an episode. Disc herniation's can also happen after a traumatic event such as a car accident or a fall. In all instances the pain arises from the bulging disc pressing on a nerve root. This pain is commonly excruciating and may be accompanied with numbness and/or tingling.

Osteoarthritis- spinal decay can be another culprit. Instead of a herniated disc putting pressure on nerve roots, arthritic bone spurs can intrude into the space normally reserved for the nerve. This is also the end result of long standing spinal dysfunction.

Piriformis Syndrome- The piriformis muscle consists of two parts and is located deep in your buttocks. The sciatic nerve runs between the two divisions of the muscle. If the muscle spasms or shortens, which is common when there is any pelvic dysfunction, the nerve may be irritated or compressed causing sciatic symptoms. This is by far the most frequently misdiagnosed cause and one that I see in clinic several times every week. Most commonly this occurs in people that sit a lot (office workers, sales reps spending large amounts of time in the car, etc) and in runners and serious walkers. In addition this might be the result of untreated pelvic misalignments following an accident or a fall.

TREATMENT FOR SCIATICA

Sciatica often worsens with extended bed rest. Pain killers or muscle relaxants relieve the pain somewhat but cannot correct the cause of the nerve compression. Physical therapy merely exercises the already unstable joints. Surgery often involves cutting away disc tissue or removing bone to make room for the nerve.

Sciatica, like other health conditions that can be traced to the spine, often responds dramatically to the restoration of normal spinal function through chiropractic care. Improving joint motion with a series of chiropractic adjustments together with acupuncture to reduce muscle spasm, swelling and inflammation has produced excellent results for many patients.

Most patients are delighted with the results they get. How long it takes naturally varies from patient to patient. Many discover that years of neglect have produced spinal instabilities that never fully heal. These patients elect to continue with periodic chiropractic checkups. It's up to you. There is hope!

DON'T WAIT!

Whatever the cause of sciatica, it is important to seek treatment promptly. Too many people wait, hoping the pain will go away or get better by itself. However, it is usually easier to treat a problem when it is first noticed. Too many people wait until the pain becomes unbearable, suffering needlessly. Long-term nerve damage may result from this delay in seeking treatment.

Karen Williams

B.Sc. M.Chiro

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