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Doctors of Chiropractic medicine regularly treat sciatica. Sciatica is characterized
by pain that originates in the low back or buttock that travels into one or
both legs. Sciatic nerve pain varies in intensity and frequency; minimal, moderate,
severe and occasional, intermittent, frequent or constant.
Pain is described as dull, achy, sharp, toothache-like, pins and needles or
similar to electric shocks. Other symptoms associated with sciatica include
burning, numbness and tingling sensations. Sciatica is also called radiating
or referred pain, neuropathy, or neuralgia. A misconception is that sciatica
is a disorder - however, sciatica is really a symptom of a disorder.
Caused by Nerve Compression
Sciatica is generally caused by sciatic nerve compression. Disorders known to
cause sciatic nerve pain include lumbar spine subluxations (misaligned vertebral
body/ies), herniated or bulging discs (slipped discs), pregnancy and childbirth,
tumors, and non-spinal disorders such as diabetes, constipation, or sitting
on one's back pocket wallet.
One common cause of sciatica is Piriformis syndrome. Piriformis syndrome is
named after the piriformis muscle. The piriformis muscle is located in the lower
part of the spine, connects to the thighbone, and assists in hip rotation. The
sciatic nerve runs beneath the piriformis muscle. This muscle is susceptible
to injury from a slip and fall, hip arthritis, or a difference in leg length.
Such situations can cause cramping and spasm to develop in the piriformis muscle,
thereby pinching the sciatic nerve and causing inflammation and pain.
Sciatic nerve compression may result in the loss of feeling (sensory loss),
paralysis of a single limb or group of muscles (monoplegia), and insomnia.
Proper Diagnosis
Since there are many disorders that cause sciatica, the chiropractor's first
step is to determine what is causing the patient's sciatica. Forming a diagnosis
involves a thoughtful review the patient's medical history, and a physical and
neurological examination. Diagnostic testing includes an x-ray, MRI, CT scan
and/or electrodiagnostic tests (nerve conduction velocity, electromyography).
These examinations and tests help to detect possible contraindications to spinal
adjustments and other chiropractic therapies.
Treatment Approach
The purpose of chiropractic treatment is to help the body's potential to heal
itself. It is based on the scientific principle that restricted spinal movement
leads to pain and reduced function and performance. Chiropractic care is non-invasive
(non-surgical) and drug-free. The type of chiropractic
therapy provided depends on the cause of the patient's sciatica. A sciatica
treatment plan may include several different treatments such as ice/cold therapies,
ultrasound, TENS, and spinal adjustments - sometimes called manipulation.
1. Ice/Cold therapy reduces inflammation and helps to control sciatic
pain.
2. Ultrasound is gentle heat created by sound waves that penetrates
deep into tissues. Ultrasound increases circulation and helps to reduce muscle
spasms, cramping, swelling, stiffness, and pain.
3. TENS unit (transcutaneous electrical nerve stimulation) is a small
box-like, battery-powered, portable muscle stimulating machine. Variable intensities
of electrical current control acute pain and reduce muscle spasms. Larger versions
of the home-use TENS units are used by chiropractors, physical therapists and
other rehab professionals.
4. Adjustments (Spinal Manipulation) At the core of chiropractic care
are spinal adjustments. Manipulation frees restricted movement of the spine
and helps to restore misaligned vertebral bodies to their proper position in
the spinal column. Spinal adjustment helps to reduce nerve irritability responsible
for causing inflammation, muscle spasm, pain, and other symptoms related to
sciatica. Adjustments should not be painful. Spinal manipulation is proven to
be safe and effective.
In college and during their training, students of chiropractic learn many different
adjustment techniques enabling them to treat several types of subluxations and
disorders. Techniques vary from a swift high velocity thrust to those that combine
minimal force and gentle pressure. Mastery of each technique is an art that
requires great skill and precision. Spinal manipulation is the treatment that
differentiates chiropractic care from other medical disciplines.
To prepare a patient for adjustment, the chiropractor may instruct the patient
to sit up or lie down. It is not uncommon for the chiropractor to use a totally
different adjustment technique during the patient's subsequent visit. Treatment
tables differ too. Some are stationary, flat padded tables and others are elaborate
with electrically or manually operated head and foot rests.
Chiropractic's Limitations
Sciatica can be caused by other disorders beyond the scope of chiropractic practice.
If the Doctor of Chiropractic determines the patient's disorder requires treatment
by another type of doctor, then the patient is referred to another specialty.
In some cases, the referring chiropractor may continue to treat the patient
and co-manage the patient's care with the specialist.
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