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Sciatic Pain Treatment

Wichita Chiropractor

As a Wichita Chiropractor for more than twenty years, I have treated many people suffering from sciatic pain, therefore, I’m genuinely aware from experience just how incapacitating sciatic pain can be. Those who suffer from sciatica are unfortunately all too familiar with the deep radiating pain that persists during the day and inhibits almost all of their daily activities.

Here’s how you can ascertain if your low back pain is caused by sciatica. You are probably experiencing sciatica if your pain travels from your low back, through your buttock(s), down the large sciatic nerve in the back of one or both legs, and possibly shoots into one or both knees. Moreover, sitting, as well as movement, can be painful. Frequently lying down will lessen, or perhaps even temporarily eliminate the pain. However, it’s important for you to be aware that sciatica cannot be corrected without proper treatment.

Radiculopathy

One of the clinical diagnoses of sciatica is called a “radiculopathy”, a medical term that means simply that a disc has protruded from its natural position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve. This kind of pressure can produce excruciating pain.

Increased pressure on the intervertebral discs, as well as imbalances in the muscles encasing the spine, can take place during and after extended sitting, specifically with bad posture. A particular event or injury isn’t commonly the cause of sciatica, more often sciatica is likely to progress over time as a result of everyday wear and tear on the vertebrae of the lower spine. After a while the lower spine can lose its normal functioning capabilities during common stresses.

If this occurs, the intervertebral disc develops small fissures or cracks, which then allow the soft nucleus to protrude the disc outward. Pain is produced as the disc pushes on sensitive tissues. This occurrence is commonly referred to as a ruptured, or slipped, disc. If the disc presses on the spinal nerve, a person can develop sciatica. The good news is that most disc conditions, including sciatica, can be completely relieved with chiropractic manipulation and therapy that often includes postural exercises.

Periformis Syndrome

Periformis syndrome is another condition that results in sciatic pain. Periformis syndrome occurs when the periformis muscle, which is superficial to the sciatic nerve, goes into spasm and irritates the nerve. Along with chiropractic manipulation, this kind of sciatica can be significantly relieved by sciatica stretches that your chiropractor will advise you on.

If you are experiencing sciatic pain, it is crucial for you to seek chiropractic attention.

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    Back Pain and Spinal Stenosis

    A recent study published by Boston University has found out that lumbar spinal stenosis affects 4.71% of the general population, which seems like a very low number. However, 47.2% of individuals in the 60-69 age group have lumbar spinal stenosis on their MRI scan, which is a significant number. The individuals that actually are diagnosed with severe stenosis will approach 20%. These patients with significant spinal stenosis have a 3 times higher incidence of back pain than the general population. As our population continues to live longer, stenosis of the spine will certainly be a significant health problem.

    Spinal stenosis is the progression of arthritis in the spine occurring in the neck, as well as in the lower back. As we age, the cartilage in the discs of our spine will lose their ability to hold water. The water in the discs is what helps the disc move and remain flexible to bending and compression. As the discs lose their water content, they become more fragile.If the brittle cartilage breaks, the condition is called degenerative disc disease.As discs degenerate, they will begin to expand and put pressure on the spinal canal and nerve roots. This disc bulging will decrease the diameter of the spinal canal,a condition referred to as spinal stenosis. This slows the information that flows between the brain and the extremities. The arms will be affected by spinal stenosis in the neck and the legs will be affected by lower back (lumbar) spinal stenosis.

    Patients with lumbar spinal stenosis will feel back pain, as well as leg pain or fatigue. Because of the fatigue in the legs, patients will have to sit frequently during walks.Lumbar spinal stenosis will also cause patients to find benches in the mall and grab the cart at the grocery store, in order to make it through their errands due to the fatigue. Some patients may attribute their fatigue to age and as they continue to remain active later in life, this may severely limit their ability to join in their families activities.The leg fatigue can cause significant pain and cramping during activity, but is lessened when the patient sits down. The act of sitting opens the spinal canal by decreasing the curve in the lower back,which also occurs while the patient is leaning on the grocery cart.

    Spinal stenosis in the neck may cause more severe symptoms. The cervical spine protects the spinal cord as it descends from the base of the brain.Because spinal stenosis in the neck puts pressure on the spinal cord, the disc pressure will cause symptoms related to the area. These include a decrease in the ability to walk as well as problems with the hands.Patients may find they tend to stumble, as it becomes harder to control the feet and legs as the disease progresses. They may also find their handwriting getting severely worse and that they have difficulty differentiating the size and feel of coins or shirt buttons.

    Spinal stenosis is usually treated with physical therapy and anti-inflammatory medications. Physical therapy is intended to help position the spine and open the spinal canal. With better posture and stronger core muscles, patients may find their leg symptoms and fatigue improve. They may find they are able to walk farther or faster. Oral anti-inflammatory medications are a first-line option for improving the inflammation related to the degenerating discs. When physical therapy and oral medications no longer provide relief, injections of steroid around the discs and nerves may decrease the pain and symptoms related to the nerve pressure. Some patients are able to tolerate their symptoms with a few injections per year.

    When all of these efforts fail, surgery becomes an option for improving the patient s pain.Surgery is aimed toward relieving the pressure from the arthritis on the spinal canal and nerves.The mechanical pressure can only be alleviated by physically removing the bone spurs or disc protrusions. The surgical procedures involve removal of bone and disc, as well as protecting the nerve roots. Fellowship-trained orthopedic spine specialists have undergone the most intense training available in the treatment of the spine and are uniquely qualified to treat patients with spinal stenosis.

    Dr. Jeffrey R. Carlson is a doctor at the Orthopedic and Spine Center, a leading provider of Hampton Roads orthopedics services such as Hampton Roads spine surgery, Hampton Roads custom fit knee replacement, and many other services. The Orthopedic and Spine Center can be found online at: OSC-Ortho.com

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    Spondylolisthesis Treatment

    In adolescents back pain may begin as the bones shift and become irritated because of their abnormal connection in the spine. Children who are active in sports and athletic activities will experience instability related to a lack of connection in the back bones that will start to be painful.

    X-rays, taken at this time, may show a break in the bones; however, there are a significant number of these kids with back pain who will have normal looking x-rays. These children may need to have a further evaluation with a CT scan to help visualize the bones of the spine more specifically. Many individuals live their whole lives with a break in their vertebrae and are pain-free until their discs start to degenerate.

    The largest group of patients with spondylolisthesis have degeneration in the discs that leads to back pain and doctor visits is the middle age population. As the discs degenerate, they are not able to support the weight of the spine, which allows the bones to shift. Due to the change in the position of the bones, the discs will have to bear the brunt of the patient’s body weight and movement, which in turn, applies more stress to the discs and forces them to degenerate faster.

    sciatica

    The back or leg pain associated with a mild slippage of the bones will not be any more severe than the normal pain associated with age. There are no particular restrictions in activities that need to be considered in mild spondylolisthesis. As patients age the discs that are between the slipped bones will continue to degenerate. Disc cartilage degeneration can be painful and can lead to an increase in the slippage of the bones. As the spine continues to degenerate and slip, the nerves that are protected by the bones will begin to receive pressure from the discs and bones. Pinching the nerves in the back will cause pain in the distribution of the nerve roots. This pain is felt in the back of the legs and down to the foot, called sciatica. The nerve pain is usually the most painful and many patients will wonder why the doctor is checking their back when it is the leg that is hurting.

    The initial treatment for the pain associated with spondylolisthesis is physical therapy combined with anti-inflammatory medications. Exercise, stretching, traction, as well as manual therapies, can be very helpful in relieving the pain. The goal is to try to relieve the pressure on the nerve and mobilize the bones and discs to allow for a more fluid motion of the back without irritating the muscle, tendon or nerves. Most patients respond favorably to this treatment and can maintain their spines with exercise at home. If this treatment is not successful, injections of steroids around the nerves and joints may be helpful in relieving some of the acute pains. After pain reduction, the exercise program may be more effective. If all of these treatments don t work, surgery should be considered to relieve the back and leg pain. Although, most patients are reluctant to have back surgery, with the improved techniques used by the fellowship-trained orthopedic spine surgeon, spondylolisthesis is one of the conditions of the spine that responds very successfully to surgery.

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