It is estimated that up to 80% of individuals will suffer from lower back pain at least once in their lives. With symptoms ranging from transient and mild to chronic and debilitating, it is important to appreciate some of the causes of this condition and the treatment options available which can help to alleviate severe levels of discomfort. Let’s look at the relationship between sciatica and lower lumbar pain before moving on to some of the most common ways in which these conditions can be treated by a professional.
Lower Back Pain Types and Duration
There are several different types of lower back pain. Health practitioners will generally separate these into three categories. Acute pain will not last longer than one month. Sub-acute situations can last up to 12 weeks. Pain is chronic if it lasts for 12 weeks or longer. The good news is that many forms of lower back pain (such as those caused by a muscular strain or injury) tend to subside on their own and with little medical intervention. Unfortunately, this is not always the case. Some individuals have no option but to endure chronic discomfort. One common scenario involves a condition known as sciatica. What is sciatica, what are some of its primary symptoms and what types of treatment options exist?
Sciatica occurs when the sciatic nerve (a major nerve in the lower back which travels to the hips and buttocks) becomes impinged or otherwise irritated. There can be several causes of this situation such as:
- A narrowing of the spine (spinal stenosis).
- A herniated disc
- A bone spur
Many patients who suffer from sciatica will experience a pain that radiates down from the lower back to one or both legs and occasionally as far down as the ankle. This pain may also be accompanied by sensations of numbness and tingling. Depending upon the severity of the impingement, muscular weakness may also accompany the symptoms mentioned above.
The main takeaway point here is that many treatments focus upon the “trigger points” which cause sciatica symptoms. The theory is that addressing these discrete locations by targeted therapeutic treatments will help to alleviate the pain and discomfort that a patient is experiencing.
Low Back Pain Treatment: Discovering the Source of the Pain
It is a difficult task is to accurately determine the origin of the low back pain itself. Correct diagnosis of sciatica or low back pain is more challenging than it may appear, as many factors can come into play. For example, cramped muscles not associated with the sciatic nerve will sometimes cause similar sensations (commonly referred to as “muscle knots”). Several other conditions mimic the discomfort attributed to sciatica. These include:
- Piriformis syndrome
- An anatomical abnormality in the sciatic nerve
- Pain from the hamstring which radiates up to nearby nerves
- Cluneal nerve entrapment (nerves within the lower back and sacrum which become tangled in nearby ligaments and connective tissues)
A final problem is that the pain described by those affected by low back pain or sciatica is often very different and varies with everyone. For example, one individual may speak of “pain below the knee” while another will complain of “a tingling down the side of the leg”. While both scenarios could very well indicate the presence of sciatica, they are by no means comprehensive enough to make an accurate diagnosis.
How is Sciatica Diagnosed?
As we can see from the previous section, effectively diagnosing sciatica can be somewhat tricky. Therefore relying upon patient testimony and symptoms alone may not be sufficient. A more discrete appreciation of the situation is required. This is normally achieved through various imaging techniques which can highlight the source of the problem. Examples here include MRIs, CT scans and common x-rays. Professionals will also seek to develop a working knowledge of the medical history of the patient in order to determine any additional causal factors. These actions are generally used in conjunction with thorough physical examinations. Such exams are meant to test flexibility, muscular strength and reflexes.
Chiropractic Treatment Options for Sciatica
The main intention of chiropractic care is to allow the body to heal itself. Based upon the principle of restoring spinal movement, the ultimate goal is to increase mobility and mitigate pain. Non-invasive techniques will be used and the exact treatment will depend upon the type of sciatica as well as the severity of the associated symptoms.
Trigenics is an increase in neurological summation that, simply put, is the process of using repeated stimuli to produce the correct response in a nerve, muscle or tendon that a single stimulus would not be able to produce. This neurological treatment system resets the way the brain communicates with the body to relieve some of the pain instantly and increase strength and flexibility.
Most often sciatica patients have underlying neuromuscular issues ( poor muscle recruitment ) beforehand in the form of significant malfunction and weakness and subsequent lesions within the spine , whether it be disc, facet joint, tendon, muscle or ligament.
Targeted Ultrasound Treatments
This technique involves the use of sound waves that penetrate the skin and underlying musculature. The waves will mildly heat the immediate area. In turn, this heat helps to relieve swelling and to increase local circulation. Muscle cramps and generalised stiffness can often be addressed with ultrasound therapy.
TENS is an acronym for trans-cutaneous electrical nerve stimulation. This is another way of referring to a small machine which electrically stimulates nearby muscles. Once again, these units are intended to provide pain relief and to reduce instances of muscle spasms.
This is arguably the most common (and one of the most effective) chiropractic treatment options available. Sometimes simply referred to as an “adjustment”, the primary intentions are to increase the movement of the spinal column and to realign any vertebrae (a process known as subluxation) that may have shifted out of place. This technique can also decrease the irritability of nearby nerves. So, patients will often notice fewer muscle spasms and lower levels of pain. Spinal adjustments are not painful and that they are generally quite effective.
This is arguably the oldest method and it often proves to be quite effective if carried out on a regular basis. Individuals will be provided with hot and cold packs. These are applied to a specific area in order to reduce inflammation and lessen the symptoms of sciatica. However, such a method will often be used in synergy with other treatments.
Providing Additional Advice
The role of a chiropractor will often extend beyond a physical office. They are likely to recommend other lifestyle changes in order to further alleviate the symptoms of sciatica and to prevent them from recurring in the future. Some common suggestions can include:
- Targeted stretching and flexibility routines.
- Adopting a regular exercise programme such as swimming, pilates, yoga.
- Methods intended to strengthen the muscles that support the lower back and lumbar region.
- Using a foam roller to provide at-home pain relief.
- Avoiding sitting or standing in one position for extended periods of time.
Of course, these and other suggestions will also be based upon other factors such as the age of the patient as well as their current physical condition. Consulting a chiropractor such as Dr Rocchi in order to obtain a one-on-one evaluation is very useful.
Can Sciatica be Cured?
This is a tricky question and the answer will depend upon the severity of the condition as well as its root causes. Most acute scenarios can be effectively treated within short periods of time. However, those who experience chronic bouts will often require more extensive treatments. This is even more relevant in situations when sciatica is coupled with other injuries such as a herniated disc. The good news is that modern chiropractic methods will nonetheless provide a substantial amount of relief that would not otherwise be possible.
It is finally important to mention that the best way to accurately diagnose what might be causing any type of lower back pain is to seek the advice of a trained professional. If you suspect that you are suffering from sciatica, please do not hesitate to contact the team at Spine Scan Chiropractic. We will be happy to schedule a consultation in order to provide you with much-needed answers.