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Sciatica - What A Pain

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By: Dr. Stephen O’Neil

A common complaint which brings people to my office for treatment is pain in the buttocks and/or down one leg. This pain may be sharp shooting or it may be dull and achy. The pain may be constant or intermittent. The symptoms may also include numbness and tingling in the leg and down into the foot. In severe cases, this pain may even cause the leg to ‘give out' on the patient. Sometimes, this patient may also suffer from cramping in the leg and spasms in the muscles of the leg. This problem is known most commonly as sciatica.

All the symptoms noted above can be caused by a problem with the sciatic nerve. The sciatic nerve is a large bundle of nerves made up of spinal nerve roots from the low back. This bundle of nerves exits the lumbar spine and crosses through the pelvis and through the sciatic notch, below the muscles in the buttocks and down the back of the leg. This nerve then branches out to the different muscles in the leg and controls sensations and muscle function in the legs.

Problems with the sciatic nerve can arise from many places along its path. A specific orthopedic and neurological evaluation is required to correctly locate and diagnose the cause of the problem. The type of pain can be one indication of its origin, sharp or dull, constant or intermittent. The origin of pain and its path can help determine cause. A pain in the buttock that travels no further than the knee is likely to have a different root cause than a pain that travels all the way to the big toe. The mode of onset or history of symptoms can reveal the most probable source.

A proper diagnosis and treatment plan can be put together with a proper history of the ailment and its onset in correlation with information gathered through a comprehensive neurological and orthopedic exam of the area. Treatment can vary depending on the cause of the sciatica. Causes may include muscular cramps resulting in nerve entrapment, disc herniation or disk bulging may also irritate the sciatic nerve. Spinal joint or hip joint dysfunction can promote sciatic symptoms. Acute onset sciatica can be an indication of something more serious, such as a tumor or severe arthritic changes in the spine which may require more aggressive intervention. An x-ray or some more advanced imaging may be required in some cases with complicating factors or those which do not respond to conservative care.

Chiropractors are trained to locate restrictions or misalignments in the spine which can cause nerve interference. Chiropractic adjustments along with some specific stretching exercises will often relieve symptoms and relieve the pressure on the sciatic nerve. Each individual requires a specific diagnosis and treatment plan to correct the specific problem. See your chiropractor for a full spinal evaluation and spinal realignment.