Help for Sciatica pain

Keywords; help for sciatica pain, lower back exercises.

For the purist:

  • sciatica (noun)
  • sciatic (adjective)

But internet users like to google "sciatica pain" so sciatica pain it is. The consumer is always right!


What is Sciatica?

Help for sciatica pain is certainly relevant. With about 20% of folk having it at least once in a lifetime, and 5% of people having an attack of sciatica every year, sciatica cures abound. None work all the time.

The origin of the Sciatic nerve

There are two principle causes of sciatica:

  1. Chemical irritation of the sciatic nerve
  2. Pinching of the sciatic nerve

The sciatic nerve is the largest nerve in the body; it's as thick as your finger and runs from the lower back to the foot.

Before thinking about how to cure sciatica you should understand first what it is, otherwise, if you don't do the right exercises, the miserable affliction will start all over again next week.

There are other rare sources such as tumors, but they really are like hen's teeth. If you have loss of bladder control, weight loss, cancer elsewhere, well, yes, the other causes of sciatica leg pain must be considered.



The sciatic nerve is made up primarily of three nerve roots located at the very bottom of the spine: primarily the so called lumbar 4, lumbar 5 and sacral 1 roots. They travel down the spine in what is called the horse's tail and then escape via a foramen.

This foramen, it's full name is an inter vertebral foramen, is a narrow tunnel between the vertebrae which enables the nerve root to escape from the spinal canal on it's way to the leg.

What is a foramen?


On each side of the spine a "intervertebral foramen" or IVF, or just "foramen" is located at each spinal level, strategically and vulnerably placed right between a facet joint and the disc joint. Both can be causes of sciatica by interfering with the nerve roots.


HOW DO THEY INTERFERE WITH THE NERVE ROOTS?

  • Chemical irritation
  • Both the facets and the vertebral end plates are made of hyaline cartilage, one of the tissues in the body that has no blood supply. They are supplied with nutrients and oxygen, and waste products removed, by fluid in and around the joints. HYALINE CARTILAGE ... If either the disc of the facet joints are fixated, the synovial fluids in the joints are not adequately refreshed causing a build up of waste products. This toxic soup of wastes is now known to be one of the causes of sciatica.

  • Pinching by a disc bulge
  • A bulging or slipped disc can physically press on the nerve root causing sciatica symptoms - pain, tingling, numbness and weakness in the leg. Very occasionally it can also cause bladder problems. SLIPPED DISC SYMPTOMS Case File ...

  • Pinching by an arthritic facet
  • A chronically subluxated facet joint is starved of oxygen and nutrients. Experiments on white mice show that degeneration of the hyaline cartilage (scientists call it Immobilisation Arthritis) sets in within 13 hours. Gradually the shape of the facet changes, becoming large and flattened and allowing the vertebra to subluxate forwards (called an "antero-lysthesis") which can pinch the nerve root located just forward of the facet. Soft tissue cysts complicate the issue. Immobilisation Arthritis ...


    Sciatica Back Pain Treatment

    How to cure sciatica

    One's first thought should be of prevention before sciatica cures. From Chiropractic Tips you can get some very basic lumbar exercises. We all sit too much, our core muscles become weak and a few simple exercises done faithfully every day will do wonders for sciatica back pain treatment. Think Immobilisation arthritis prevention and sciatica stretches before sciatica nerve treatment!

    How to cure sciatica? Frankly, a "cure" doesn't exist. Once you've had a bad attack of sciatica, no matter what help for sciatic pain you seek, it will remain a vulnerable part of your body. Exercise, exercise, exercise... is your best bet. And accept that lifting pianos and the like is not for you.



    CHIROPRACTIC EXAMINATION

    Help for Sciatica pain

    Your chiropractor will start with a posture examination. Do you have the sign of Pisa - look like a question mark? Do you have a short leg, what is known in Chiropractic jargon as a Leg Length Inequality? LEG LENGTH INEQUALITY ...


    The sign of Pisa



    Next your chiropractor will test your ranges of motion. Does bending forwards hurt? Most important, does bending increase the pain or cause a tight feeling in the leg? If so, you certainly need help for sciatica pain. If bending backwards, or to the side causes pain to radiate down your leg then you may have a condition called Lumbar stenosis. It too responds well usually to Chiropractic. Here one of our monthly newsletters. Have you signed up yet? CHIROPRACTIC HELP Lumbar Stenosis ...


    NEUROLOGICAL EXAMINATION

    Help for sciatica pain




    Next your Chiropractor will be looking for "hard neurological signs". Can you stand on your heel, raising your big toe, can you go up and down several times on your toes, taking your full weight on one foot? Then the reflexes and tests for numbness or increased sensation in the skin. It's all quite involved and gives precise information as to which nerve root is affected. Sometimes it can be more than one level causing considerable scratching of the head! That's where a MR scan is so useful.



    ORTHOPAEDIC EXAMINATION

    Slump test for sciatica

    Your Chiropractor will do a series of orthopaedic tests to help in making a diagnosis before starting help for sciatic pain. The purpose of these tests is to stress the affected tissue, and they may cause some pain, and occasionally "after pain". The artful examination looks to make a diagnosis without actually aggravating the condition. For example the Slump test places increasing sciatic nerve stretches to determine whether the nerve is just irritated, or actually pinched. SLUMP TEST FOR SCIATICA ...



    MOTION PALPATION

    Help for sciatica pain



    Motion palpation, a technique developed by Belgian chiropractor Henri Gillet, is an important part of the chiropractic examination.

    Your chiropractor will carefully examine your spine and pelvis looking for fixated joints. It's a difficult procedure; more of an art than a science perhaps, and requires a long time to perfect. After nearly thirty five years I'm still learning.

    It's an absolutely vital part of my protocol, because my sciatica back pain treatment is based on these motion palpation findings.



    Why is that, you may well ask? Let's consider the lumbo sacral disc at the base of the spine. Traditionally, it's considered this bottom most joint will pinch the first sacral nerve root. That's because the herniation is usually central.

    However if the disc extrudes laterally into the foramen, then it will pinch the nerve root above, the fifth lumbar, and confuse the examining doctor; the pain will radiate to the big toe area.

    If you can't raise your big toe then he or she is likely to think it's not the bottom most disc, but one higher.

    If he's luckily enough to have a scan then all is revealed. However this is not normally the case; MRIs are very expensive. It's motion palpation that helps your chiropractor decide which level he should be adjusting. Adjust the wrong vertebra and it just won't get better.


    CHIROPRACTIC TREATMENT

    Help for sciatica pain

    Here is where there is considerable variation depending on your condition, and your Chiropractor's preferred treatment protocol. One chiropractor might prefer using a Thompson drop treatment (my first choice), another frank manipulation, an activator, SOT pelvic blocks, McManus traction... all of these have their place, one perhaps more suited to your condition that another.



    REHABILITATION @ Exercises for relieving sciatica

    Lower back exercises ...


    Lower back exercises are vital to properly rehabilitate the injured joint, and strengthen the core muscles; they also help prevent you from joining that group of five percent who will have an episode every year and eventually progress to surgery.



    In all honesty, I cannot guarantee it and, in fact, I think it's unlikely that lower back exercises can fix a sciatica. But they will do wonders to prevent the next bout of pain once your chiropractor has reduced the pressure on the nerve. There's no harm in trying them to see if you can get relief, though; perhaps for a  maximum of a week or two.

    Then, say to yourself, in all honesty, is this improving? If not, well, you know what to do. It's time to get help for sciatica pain.

    Rule of thumb:

    • If you get pain in the leg, or it's very tight in the thigh with forward bending then do the disc exercises on YouTube.
    • If you get pain in the leg whilst bending backwards then do the facet exercises. However, this is not always true; an extruded disc into the foramen will also give pain on extension. Be guided by your doctor who has the responsibility of making the diagnosis.


    Exercises for relieving sciatica

    In short, exercise is more for preventing the next episode than curing you of this one. I am particularly in doubt about the merits of sciatica stretches; if the nerve is tethered and you stretch it, further damage is likely.


    Useful links



    » Help for sciatica pain


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    Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.

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    Permanent sciatic cures don't exist but to help prevent arthritis in the lower back, think:


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    Interesting challenges of the day

    1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

    2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

    3. Mrs T looked like the leaning tower of Pisa; she had a slipped disc at L5 making her lean towards the opposite side. It's called the postero lateral disc hernia; she's much better after two weeks of treatment and will go back to work next week, part time. Lateral discs are more difficult; both take a minimum of six weeks to heal. In my opinion, antalgic patients need what I call exercising bed rest. Sit and it won't get better.

    4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months. He has a pincer deformity in the hip causing the groin pain, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

    5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

    6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your lower back is just as important as the pain.

    7. My own granddaughter, only 7 is hypermobile giving her hip, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Hypermobility is more difficult that too stiff in my opinion. Chiropractic is for kids too.

    8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

    9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

    10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

    11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

    12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

    13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

    And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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