In Western society Sciatica is a common ailment, particularly in the 30-50 year age group. It describes a set of symptoms that include hip, buttock and leg pain radiating from the low back along the path of Sciatic Nerve. This nerve is formed from the L4-S3 spinal nerves which join up as they exit the low back. It runs through the buttock, down the back of the thigh and leg, into the foot.
Sciatica may feel like a bad leg cramp that lasts for weeks or months before it goes away. You may have pain especially when you sit, sneeze or cough. Discomfort ranges from mild to incapacitating, and may be accompanied by tingling, numbness or muscle weakness.
Like the term slipped disc, sciatica is a term often misused to describe any pain in the leg that may originate in the lower back. True sciatica only involves pain caused by pressure on the sciatic nerve or its branches. Pain in the front of the thigh or groin, although possibly referred from the low back, is not sciatica.
Sciatica is a set of symptoms not a diagnosis. This point is important, because treatment for sciatica will often vary, depending on what is irritating the nerve, causing the pain.
Some Sources of Sciatica:
Lumbar Disc - this includes disc protrusion that compresses the L4 or L5 nerve root as it exits the spine. The outer fibrous layer of the disc weakens with wear and tear and eventually allows the inner jelly-like nucleus to bulge out and irritate the nerve root. The presence of a disc protrusion can be confirmed by specialised imaging such as CT scan or MRI.
Lumbar Joints - in some cases misalignment of the spine causes inflammation, irritating the nerve roots and producing sciatica. Your chiropractor will perform tests to determine if the sciatica is more disc or joint related.
Muscular - the sciatic nerve passes through, or in front of, the piriformis muscle, deep in the buttock. Spasm of this muscle due to pelvic imbalance can compress the sciatic nerve - a condition known as Piriformis Syndrome.
Only rarely is sciatica caused by serious pathology that requires medical referral. The majority of sciatic cases respond well to chiropractic care and specific exercises.
A Danish study looked at 44 consecutive patients who experienced sudden low back pain after bending forward and turning. Examinations by orthopedic surgeons revealed no pathology and a diagnosis of acute sciatica was given in all cases.
All 44 patients received chiropractic care, either in the orthopedic department of the hospital or in private chiropractic clinics. Chiropractic care reduced average sick leave by two thirds when compared with previous patients who only received conventional medical treatment.
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