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Sciatica & Leg Pain

 

Sciatica is the term given to pain down the leg, which is caused by irritation of the main nerve into the leg, the sciatic nerve. This pain tends to be caused where the nerves pass through and emerge from the lower bones of the spine (lumbar vertebrae). Much of the advice regarding this condition is the same as that for low back pain.

Symptoms:

In sciatica, there is a pain down into the leg, which travels below the knee, and may involve the foot. There may be numbness and there may be weakness of the lower leg muscles. These symptoms may come by themselves, but are often combined with low back pain. The order in which the symptoms appear may vary. Sometimes the back pain comes before the sciatica, and sometimes will follow.

Dr. Cady specializes in treating the causes of sciatica. He uses a combination of gentle joint alignment with physical therapy modalities, stretches and exercises to speed your recovery.

Red Flags:

As with low back pain, there is a group of features (the Red Flags) which doctors use to highlight the need to act more quickly, because they may suggest a problem which is not as straightforward as simple back pain or sciatica. If you fit into one of these groups or are concerned, you should see your doctor soon:

  • You are younger than 20 or older than 55 when you get the problem for the first time.
  • The pain follows a violent injury, such as a road traffic accident.
  • The pain is constant and getting worse.
  • The pain is in the back of the chest.
  • You have had cancer in the past or at present.
  • You are on steroids.
  • You are a drug abuser, or have HIV.
  • You are generally unwell.
  • You have lost significant weight recently.
  • You continue to have great difficulty bending forwards.
  • You have developed a number of problems in your nervous system (e.g. numbness, loss of power, etc).
  • You have developed an obvious structural deformity of your spine.

It is wise to see Dr. Cady if you develop sciatica. Certainly you should consult him if you are not able to adequately control the pain with home remedies, or if the pain carries on for more than two weeks.

Causes:

The most common cause of true sciatica is a herniated or bulging disc putting pressure on the spinal nerves. The discs (or inter-vertebral discs) are the cushions which separate the bones of the spine (vertebrae). Your doctor may refer to a 'slipped disc' as a prolapsed intervertebral disc (PID) or a herniated nucleus pulposus.

Intervertebral discs allow for some flexibility between the bones of the spine, and also act as shock absorbers. The pressure within the discs can reach high levels when we bend or twist, even without carrying a heavy load. If we add to that a heavy load, especially held out at arms' length, the pressure rises even higher.

If part of the fibrous outer ring of the disc is rather weaker than the rest, the softer center (nucleus pulposus) may push its way through, bulging outwards. If this bulge presses against a nerve which is running from the main, central nervous system to one of the legs, it causes symptoms in that leg.

Sciatica occurs when the herniated disc presses against the nerves which go to make up the sciatic nerve. This is more likely to cause problems when the nerve is squashed by this, usually between the disc and an adjacent bone.

Nerves have many functions, transmitting messages around the body, rather like a telephone system. They allow us to feel things that happen to us, such as things we touch or that touch us, hot and cold, and pain, and they cause our body to do things, e.g. making your leg muscles contract when you want to walk. Thus, when a nerve is squashed, it may malfunction, and we might feel pain, numbness, pins and needles, and we might find our limbs do not work in the way they should.

Other things can cause irritation of or pressure on a nerve in the spine. Sometimes this may be a rough and enlarged part of one of the vertebrae, brought about by ageing, and sometimes rarer conditions, infections and tumors are to blame. Most times the cause is nothing too serious, but one of the reasons for seeing your doctor if the pain persists, is to make sure that serious and treatable causes have been ruled out.

Investigation:

If you still have sciatica after a few weeks, it is likely that your doctor will arrange for you to have a MRI (Magnetic Resonance Imaging) scan. This will show the soft structures in the spine, as well as the bones, and will thus show whether a nerve is being squeezed by a disc, or whether something else is causing irritation of the nerve.

Really the main reason for doing such a scan is to see whether conservative care such as chiropractic care can fix the problem or an operation will help the patient.

Treatment:

Conservative care including chiropractic care and physiotherapy can help to stabilze sciatica and return you to health in the least amount of time. Call us at 408-739-2273 to make an appointment today.