Sciatica or sciatic neuralgia is a commoncondition in which one of the spinal nerve roots of the sciatic nerve is compressed resultingin lower back, buttock and leg pain. Sciatic nerve is a large nerve derived from 5 spinalnerve roots: L4, L5, S1, S2 and S3. It runs from the lumbar spine through the buttockdown the leg and the foot on the posterior aspect. There is one sciatic nerve on eachside of the body. Typically, only one side of the body is affected.A typical sciatica pain is described as a sharp shooting pain in the lower back, downthe buttock, thigh and leg on one side of the body. There may also be numbness, burningand tingling sensations. The pain can get
worse with sitting, moving, sneezing, or coughing.The patterns of pain depend on which nerve root is compressed, and follow the dermatomedistribution. The most common cause of sciatica is a herniatedspinal disc. The spinal disc is a soft elastic cushion that sits in between the vertebraeof the spine. With age, the discs become rigid and may crack, the gellike center of thedisc may protrude out and become a herniation outside the normal boundaries of the disc.Disc herniation presses on the nerve root as it exits the spine.In majority of the cases the condition resolves by itself after a few weeks of rest and conservativetreatment. Pain relief, nonsteroidal antiinflammatory
drugs and muscle relaxants may be prescribed.Stretching exercises and physical therapy may be recommended.Surgery may be needed if the pain doesn't go away after 3 months or more of conservativetreatments. The herniated disc may be removed in a procedure called discectomy. Or, in anotherprocedure called laminotomy, part of the bone of the vertebrae may be cut to make room forthe nerve.
Athlete w Bulging Disc Low Back Sciatica Pain Gets Relief Lacey Olympia WA David Warwick
Hi I am David Warwick of Warwick Chiropracticin Lacey Olympia Washington and we have David here. David was doing what a lot of peopledo, including myself. We lift heavy, we hurt ourselves. You did a good job on this onedidn't youé Yes I did. So go heavy or go home is usually the philosophy and when we usethose free style weights there is a good chance we are going to knock our lower back or knocka disc out of position and create some bulging herniation on that. He felt the pop in thelower back and we worked on it now for a few visits, at least 3 maybe even 4 visits. Ihad him seeing a primary doc as well. Are you taking the muscle relaxers now a littlebité Did he prescribe anyé Naproxen and vicoden.
Okay the vicoden is helping you relax a littlebit more. So sometimes we even need a little bit of help depending on how bad you injuredyourself but when you combine multiple modalities it is very effective. So I am going to takeyou through. We have got a good pinching of that nerve coming out of maybe L4 L5 but Iam thinking more L5 going down the back of the leg and to the side and you can feel completenumbness and parethesia on this side. Can you feel when I do this right hereé Did youfeel thaté I did feel that. Okay. Right hereé Did you feel thaté I feel when you start.Then it disappearsé So what happens is that nerve pattern that is going on, that nerveis talking to a certain pattern in the skin
so now we are going to be looking and workingwith those lower back nerves, taking the pressure off of them. I am sure there is more thanone. We have got a really good start, he is moving, he is bending a little bit, gettingmore motion back a little bit so let's start out I want you to start with raising yourright leg, don't bend the knee. Back down, try the other one. Okay, noticeable difference.This is primarily a sacral check. There is a lot of grouping of nerves that come outof there, exactly 10 pair or group of nerves that branch out that can affect down eveninto the lower back and L5 area. You saw the difference in his ability to raise and notraise that leg. Quite significant so I am
going to help bring that sacral bone overa little bit. Try raising that leg, right leg. Significantly better. He was pretty lockedup. No more going heavy or go home for you. I am adjusting the sacral to the side usingthe drop piece here. Can you raise that right leg for me. Significant difference already,so he is definitely responding. I am hoping he doesn't have to go for the MRI but I thinkwe should get it anyway. Do you feel the differenceé Yeah. Can you put your right hand on yourlower backé We are going to test L5. I don't see a big difference or a change right there.I am going to bring it into position 2. Nothing, just a little bit where one leg goes a littlebit further. Hand down. So we are going to
actually adjust this spine right here. Goahead left hand lower back. Right leg goes short, goes longer. Hand down, let's haveyou lay on your left. Top leg right there, let me do the work. I'll go easy with youhere. We are right at L4. Okay let's go the opposite direction. So we can either pushor pull the vertabrae. Not a lot of release in that area, this was the side last timethat helped him. That was it, that was even more movement than last time. Face down. Goahead raise that right leg for me. Big difference. So the communication happens to the leg, happensto the nerves down to the muscles to create that motion or movement. Chiropractors cando it many different ways of assessing it.
You can feel for loss of motion, you can feelfor heat, you can do muscle testing. If we just want to test that space we can test byhaving the patient actually do certain movements. We can push into the area of correction orinto misalignment so I am going to begin with some of the traction with him to open up thatjoint space and help some of that disc get off that nerve. You okay, is that tot muchéNope. So each visit that he was coming in, first couple of visits there was so much swellingand here is what happens when you get injured out there scar tissue starts to lay down inday 3, laying it's foundation, that is what makes it so difficult. Even in 3 weeks periodof time there is a significant amount of change