Chiropractic Treatment of Sciatica

Chiropractic Treatment of Sciatica

-Susan Spinasanta

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 sma

ll 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.

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.

Smoking and Low Back Pain??

Does Smoking Cause Low Back Pain?
- Donald J. Frisco, MD

A new study strengthens the link between smoking and lower back pain, and also sheds light on the causes of degenerative lumbar spine problems.

The study on smoking and low back pain, which prospectively examined 1,337 physicians who graduated from Johns Hopkins University between 1948 and 1964, followed some participants for more than 50 years. Researchers discovered that smoking history, hypertension and coronary artery disease—all of which are risk factors for atherosclerosis, or occlusion of the arteries—were significantly associated with the development of low back pain.

These same risk factors, along with abnormally high blood cholesterol levels, were also significantly associated with the development of lumbar spondylosis. The findings provide support for the hypothesis that atherosclerosis causes lower back pain and degenerative disorders of the intervertebral discs.

Smoking and Low Back Pain Study Results:
The study results, which were reported at the 2001 annual meeting of the American Association of Orthopaedic Surgeons in San Fransisco, lend support to the theory that the mechanism of injury in low back pain is damage to the vascular structures of the discs and joints.

Numerous researchers have proposed a link between smoking and low back pain, but the exact nature of that link had remained largely untested in terms of long-term prospective studies. "Because we had the subjects' medical records and answers from self-reported questionnaires over such a long period of time, a 53-year period of time for the oldest patients, we were able to determine if the risk factors, such as smoking or high cholesterol, preceded the development of the disease years later," said Nicholas U. Ahn, Chief Resident in the Department of Orthopedic Surgery at the Johns Hopkins Hospital in Baltimore and co-author of the study.

"To prove a causative association from a long-term prospective study is very powerful because one can show that the cause occurred before the effect as opposed to the other way around," Dr. Ahn explained.

Conclusions from Smoking and Low Back Pain Study:
The study concluded that development of lower back pain was significantly associated with smoking history and hypertension, and the development of lumbar spondylosis was significantly associated with smoking history, and hypertension and high cholesterol. No significant association was reported betweekn diabetes and lower back pain or lumbar spondylosis.

At Rosa Chiropractic of Alexandria we use numerous modalities and techniques to help alleviate your back pain!

Ankle and Foot Pain from Summer's Flip Flops

Flip-Flop Flaws
According to a new study, the ubiquitous summer shoe may be bad for your ankles and feet.

Summer is when the rubber hits the road. We're talking about flip-flops, the ubiquitous sandals that consist of little more than a sole held onto the foot by a Y-shaped thong. Flip-flops used to be relegated to the beach or the locker room, but in the last few years they seem to have become the footwear of choice for a whole generation. Back in 2005 some members of the Northwestern University national champion women's lacrosse team drew flack for wearing flip-flops when they met with President Bush at the White House.

Questions of etiquette aside, flip-flops may not be the best choice for health reasons. In a study presented last week at the annual meeting of the American College of Sports Medicine, researchers at Auburn University found that flip-flops actually alter the way wearers walk. That change in gait can cause persistent foot and ankle pain—the kinds of problems usually associated with a fondness for Manolos and Jimmy Choos.

Justin Shroyer, a doctoral student in biomechanics at Auburn, and Dr. Wendi Weimar, the director of Auburn's biomechanics laboratory, were tossing around ideas for a research project when they hit upon a subject that seemed ripe for exploration. "We're biomechanists," explains Shroyer. "We can't go anywhere without analyzing the way someone walks." They noticed that when students came back from summer vacation they often complained of pain in their feet, ankles and lower legs. The same students were also likely to be flip-flop fans (as is Shroyer, as a matter of fact). Could there be a connection?

To find out, Shroyer solicited 39 college-age female and male volunteers. The participants wore thong-style, flat-soled flip-flops and then regular athletic shoes while walking on a platform that measured the force they exerted when their feet struck the ground. Shroyer also filmed them as they walked so he could study differences in the movements of their hips, legs, knees, ankles, feet and toes.

After digitizing all these images and analyzing the data, Shroyer came up with some disturbing conclusions for those of us who treasure the freedom of flip-flops. He found that flip-flop wearers take shorter steps. The result is more stress on the body because you have to move more to go the same distance as people wearing other kinds of shoes. That could mean a higher risk of muscle and joint pain in the legs.

Toes are another problem area. "When you wear flip-flops, you kind of scrunch your toes to keep the flip-flop on your foot," Shroyer says. That constant pressure often adds up to throbbing and tenderness in the toes. "The body is an amazing machine," Shroyer explains. "When you do one thing, other things turn off and on. By engaging the muscles that scrunch your toes, you are turning off the muscles that would bring your toes up." That also means that you can't lift your foot up as much when you walk—hence the characteristic flip-flop shuffle.

Shroyer's analysis of the mechanics of flip-flop wearing isn't the first warning about their dangers. The American College of Foot and Ankle Surgeons has reported an increase in heel pain among flip-flop wearers, especially in the spring, when they make the switch from sturdier winter shoes. The problem is exacerbated when people who are overweight or sedentary wear flip-flops. One of the most common sources of heel pain is plantar fasciitis, an inflammation of the connective tissue that links the toes to the heel bone. Being overweight and wearing ill-fitting shoes make it much more likely that you will suffer from plantar fasciitis. Thin-soled flip-flops without arch support aggravate the effects of any existing sources of strain on the legs and feet (such as too much weight or weak muscle tone).

Does this mean that you should throw out your beloved flip-flops or walk barefoot? Not necessarily. Like all good things, flip-flops are probably fine in moderation. Wear them at the beach or even for short jaunts to the mall. But don't make them your everyday footwear. You can get much the same look from sandals that have a little more arch support or another strap that keeps them on (and gives your scrunched up toes a rest). Shroyer also suggests replacing flip-flops more often. "Usually people break their shoes in so they become more comfortable," he says. With flip-flops, he says, "that is probably the point where you need to get rid of them."

If you're already experiencing pain, kick those flip-flops to the back of your closet and slip on footwear with more support until you feel better. If you have flat fleet, arch supports may help; you can find relatively inexpensive ones at the drugstore. If the pain doesn't go away, see your doctor. In a few cases foot and heel pain could signal more serious medical conditions like arthritis or even a stress fracture.