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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Failed back surgery syndrome is the term used to describe recurring or persistent pain in the back or legs following a lumbar spine surgery.

Often, surgery is used to fix an anatomical problem, such as a herniated disc pushing on a nerve. Unfortunately, even in the hands of the most skilled surgeon, some patients will continue to have pain after the anatomical problem has been repaired. The exact number of patients who continue to suffer pain is not clear, but more surgeries appear to increase the risk of this condition.

There are many reasons why patients may continue to have pain. Low back pain is often from more than one source. For example, there could be pain from a herniated disc, or pain from arthritis in the small joints, known as facet joints. After repair of one problem, pain may persist from the other. There can be a problem related to the surgery itself, such as a complication of hardware that was inserted or an infection. Continued degeneration of the discs and joints of the spine can also cause pain. Scar tissue formation (known as epidural fibrosis) and inflammation around the nerves (known as arachnoiditis) may also cause pain.

The best treatment for FBSS is prevention. Non-operative therapy should be the first step in treating low back pain, unless there is a clear anatomical problem that requires surgical intervention. Patients should be aware that even with a skilled surgeon, there is no guarantee of complete pain resolution from a low back surgery.

If a person develops FBSS, it is important to have a multidisciplinary approach to treatment of this complex problem. If there are no problems requiring surgical intervention, then multidisciplinary care involving physical therapy, medications and spinal injections should be pursued. Physical therapy should include not only treatments for pain, such as deep heat, but also muscular training exercises and instruction on how to do daily activities to prevent increased pain. FBSS therapy may also include spinal injections, such as injections around the nerves, discs or small joints in the back or neck. Epidural steroid injections are the most common, but there are several other injections that may be helpful for treatment or facilitating diagnosis.

There are some patients that do not respond to less invasive techniques, but they may benefit from more intensive treatments, including spinal cord stimulation or pain pump implantation. Spinal cord stimulation is frequently used for the leg pain associated with FBSS. A small lead is placed in the epidural space around the spinal cord and masks pain by producing a tingling or tapping sensation in the place where pain is felt. Before having the device implanted permanently, a screening trial is performed. A temporary lead is placed where the patient feels pain and they are able to test their response to the device. Once the device is permanently implanted, the patient can turn the device on and off, as well as make some adjustments to the stimulation they receive. Another treatment is pain pump implantation, also known as intrathecal drug delivery system implantation. This pump will place medication directly into the fluid around the spinal cord, which requires a much smaller dose of medication than when taken orally. Because the medication does not circulate throughout the body and a much smaller dose is used, the frequency of side effects is less. Though morphine is the most commonly used medication in these pumps, some other opioid and non-opioid medications can be used successfully.

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