Sciatica Pain

Acute, Chronic, Alternating, and Bilateral Sciatica Clinic

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Sciatica is common and affects up to 40% of the general population. Different types include acute, chronic, alternating, and bilateral sciatica. The sciatic nerve comprises three specific nerve roots in the lower back. The three nerves originate in the L4 and L5 vertebrae and the sacrum, just below the vertebrae. The nerve then branches off and runs through the back of each thigh. Injury, compression, or irritation of these nerves can cause various symptoms, including numbness, tingling, electrical shooting pain, and muscle spasms in the low back, the leg, and the foot. Chiropractic care can realign the spine, relax the muscles, release compression and relieve sciatica.

Acute, Chronic, Alternating, and Bilateral Sciatica

Acute

  • Acute pain can be brought on by sudden irritation to the nerves that have become pinched, compressed, or a combination.
  • Causes a constant burning or shooting sensation through the low back, buttocks, down the leg, and possible hip discomfort.
  • It becomes worse when sitting.
  • It can cause immediate and short-term pain lasting for 1-2 weeks.

Chronic

  • Chronic sciatica can last for months or years on and off or continuously.
  • It can be caused or worsened by inflammatory conditions like rheumatoid arthritis, injuries, infections, and spinal misalignment issues.
  • It can resolve but will come back without treatment or lifestyle and activity adjustments.

Bilateral

  • Sciatica typically takes place in one leg; it has been known to be bilateral and experienced in both legs.
  • This type of sciatica is rare but can occur from degenerative changes in the vertebrae and/or the discs at several spinal levels.
  • If there is pain in both legs, it is likely not a herniation but degenerative changes like spinal stenosis.
  • The symptoms can range from infrequent to irritating to severe and debilitating.
  • It could be a red flag symptom of cauda equina syndrome.
  • Weakness may be felt in the leg and foot, or a feeling of heaviness, making it difficult to lift the foot off the floor.

Alternating

  • Alternating sciatica affects both legs alternately. It is usually connected to bilateral sciatica that switches sides.
  • This type is rare and can result from degenerative problems in the sacroiliac joint, the joint connecting the spine to the hips, or sacroiliac arthritis.

Spinal Sources

Sciatica occurs when L4, L5, and/or S1 nerve roots are affected.

L4 Nerve Root

  • Pain in the hip, thigh, inner medial areas or the knee, and the calf.
  • Weakness in the thigh and hip muscles.
  • Reduced knee-jerk reflex.
  • Loss of sensation around the calf.

L5 Nerve Root

  • Pain in the buttock and the outer area of the thigh.
  • Weakness in the buttock and leg muscles.
  • Difficulty moving the ankle and lifting the big toe upward.
  • Loss of sensation between the big toe and the second toe.

S1 Nerve Root

  • Known as classic sciatica.
  • Pain in the buttock, back of the calf, and side of the foot.
  • Fatigue in the buttock and foot muscles.
  • Difficulty and discomfort raising the heel off the ground or walking on tiptoes.
  • Loss of sensation in the foot’s outer side, including the third, fourth, and fifth toes.
  • Reduced ankle-jerk reflex.

Chiropractic Care

Chiropractic care can directly address the root cause of the problem, treat the cause, and alleviate the symptoms. Chiropractic manipulation is recommended by the American College of Physicians as a first line of treatment for back pain before medication, muscle relaxants, injections, and surgery. Treatments to address sciatic nerve impingement:

Ice/Cold Therapy

  • Reduces inflammation and swelling.
  • Prepares the patient for massage and adjustments.

Therapeutic Tissue Massage

  • This therapy promotes muscle relaxation and lessens the muscle spasm/recoil response.

Ultrasound

  • Soothing heat created by sound waves penetrates the muscles, increases circulation, and relaxes the muscles to alleviate spasms, stiffness, and pain.

Transcutaneous Electrical Nerve Stimulation/Tens Unit

  • A muscle stimulation machine applies electrical impulses to relax the muscles and untangle muscle knots.

Spinal Manipulation

  • This process realigns the spine to move properly and restores vertebral health.

Stretches and Exercises

  • This ensures treatment will last once treatment has or is coming to an end.

Spinal Decompression

  • Pulls and stretches the body to release any compression on the nerve roots and infuse circulation back into the discs.

The pressure is taken off the sciatic nerve, and routine adjustments will retrain the muscles to maintain their re-alignment. The duration of treatment will vary based on the root cause of sciatica. Each treatment plan is tailored to the individual patient’s situation.


Severe and Complex Sciatica Syndromes


References

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/

Hernández C.P., Sanchez N., Navarro-Siguero A., Saldaña M.T. (2013) What is Sciatica and Radicular Pain?. In: Laroche F., Perrot S. (eds) Managing Sciatica and Radicular Pain in Primary Care Practice. Springer Healthcare, Tarporley. doi.org/10.1007/978-1-907673-56-6_1

Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Ngnitewe Massa R, Mesfin FB. Herniation, Disc. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441822/

Ombregt L. The dural concept. In: A System of Orthopaedic Medicine. Elsevier; 2013:447-472.e4. doi:10.1016/b978-0-7020-3145-8.00033-8

Witenko, Corey, et al. “Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low-back pain.” P & T : a peer-reviewed journal for formulary management vol. 39,6 (2014): 427-35.

Wright R, Inbody SB. Radiculopathy and Degenerative Spine Disease. In: Neurology Secrets. Elsevier; 2010:121-130. doi:10.1016/b978-0-323-05712-7.00007-6

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Specialties: Stopping the PAIN! We Specialize in Treating Severe Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sports Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal Mobility, Posture Control, Deep Health Instruction, Integrative & Functional Medicine, Functional Fitness, Chronic Degenerative Disorder Treatment Protocols, and Structural Conditioning. We also integrate Wellness Nutrition, Wellness Detoxification Protocols and Functional Medicine for chronic musculoskeletal disorders. We use effective "Patient Focused Diet Plans", Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols, and the Premier "PUSH Functional Fitness System" to treat patients suffering from various injuries and health problems. Ultimately, I am here to serve my patients and community as a Chiropractor passionately restoring functional life and facilitating living through increased mobility. Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training, functional medicine, and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional & Integrative Nutrition, Agility & Mobility Fitness Training and Cross-Fit Rehabilitation Systems for all ages. As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises and advanced agility treatment options. We have teamed up with the cities' premier doctors, therapist and trainers in order to provide high-level competitive athletes the options to push themselves to their highest abilities within our facilities. We've been blessed to use our methods with thousands of El Pasoans over the last 3 decades allowing us to restore our patients' health and fitness while implementing researched non-surgical methods and functional wellness programs. Our programs are natural and use the body's ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living. With a bit of work, we can achieve optimal health together, no matter the age, ability or disability.

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