It has been compared to the worst possible type of pain anyone can imagine. Other people say it’s even worse than labor because the pain doesn’t seem to have an end to it. These are some of the most common descriptions of sciatica, where a severe case of this excruciating nerve pain can bring anyone to their knees. That’s why lots of patients don’t simply say they have sciatica, they’re victims of its symptoms.
Sciatic nerve pain, or sciatica, is associated with many well-known symptoms, however, is sciatica really that common? What type of treatments are available to help alleviate sciatic nerve pain?And does a person’s everyday activities play a part in whether they will develop sciatica in the first place? Dwight Tyndall, MD, FAAOS answers several of the most commonly asked questions patients need to know regarding their sciatica. Dr. Tyndall is a pioneer in the area of outpatient spine surgery, however, he is also a strong proponent of non-surgical treatment methods, including chiropractic care, to manage back pain and sciatica. Dr. Tyndall shares his perspectives on sciatic nerve pain and discusses what may indicate a need for surgery in severe cases of sciatica.
According to Dr. Tyndall, sciatica is both a spinal disorder and a catch-all term for a group of symptoms. Sciatic nerve pain, best referred to as sciatica, is a spinal condition characterized by nerve pain which radiates down the length of the sciatic nerve. The sciatic nerve is the largest nerve in the entire human body, and it’s made up of spinal nerves from the vertebrae level L4 in the lumbar spine down to the vertebrae level S1 in the sacrum. Anything which impacts those nerves can lead to sciatica. Moreover, sciatica’s symptoms may be grouped under the medical term dysesthesia, meaning any sort of abnormal sensation. Most patients describe sciatica as an odd feeling radiating out of their lower back into their buttocks and down to their thigh and calf, often radiating as far down into the foot.
Dr. Tyndall explains that sciatica’s hallmark symptom include pain in the low back or buttocks which radiates down one or both legs. Signs and symptoms which shouldn’t be ignored include pain which doesn’t respond to non-surgical treatment options and/or pain which greatly restricts an individuals activity level and quality of life. Some red flags which may signal the need for surgical interventions associated with sciatic nerve pain include: reduced motor function in one part of the leg, usually a drop foot at which the patient can’t lift thei foot off the ground, weakness in one or both legs and bladder or bowel changes.
“Most people see sciatica to be more severe than lumbar radiculopathy, but radiculopathy, which comes from the Latin radix significance origin, is a condition that affects the nerve during its origin as it exits the spinal cord. Sciatica and lumbar radiculopathy can be brought on by a pinched nerve from the spinal column due to a disc herniation or stenosis, but kidney problems or a sinus issue, like endometriosis, may also pose sciatica-like symptoms,” states Dr. Dwight Tyndall.
“By my clinical experience, men and women have exactly the same identical risk of developing sciatica. Obesity also doesn’t play a role, either. Concerning age classes, however, sciatica has been estimated to peak during the ages of 30 and 40, and the risk usually declines as people begin reach their 50’s,” added Dr. Tyndall.
As mentioned by Dr. Dwight Tyndall, sciatica and low back pain frequently occur together, but sciatica is much less common. While 80 percent of individuals experience low back pain at any point in their lives, just 2 to 3 percent will actually develop sciatica.
According to Dr. Tyndall, an individual with symptoms of sciatic nerve pain will need to see a healthcare professional if their pain is not reacting to over-the-counter (OTC) medications, or if these create weakness in the leg. Also, a person ought to see a doctor if their pain is so severe that their well-being is affected. Should the sciatica include bladder or bowel changes, the individual must seek immediate medical attention for their health issues. Furthermore, it’s important for a person with sciatica to seek the help of a healthcare professional to rule out any possible underlying causes which may be responsible for their symptoms.
According to Dr. Tyndall, any healthcare professional qualified and experienced in spine health issues, such as a chiropractor, can help diagnose, treat and even prevent sciatica. A doctor of chiropractic, or chiropractor, is a healthcare professional who utilizes spinal adjustments and manual manipulations, among other non-invasive treatment methods, to help correct any spinal misalignments, or subluxations, which may be causing sciatic nerve pain. A chiropractor may also recommend a series of stretches and exercises, as well as lifestyle modifications, to help speed up the patient’s recovery process. Chiropractic care is often the preferred alternative treatment option to help alleviate sciatica without the need for drugs and/or medications or surgery. However, if a patient is experiencing any of the red flag symptoms mentioned above, it may be necessary to visit a spine surgeon in order to discuss the treatment options. Always make sure to consider surgical interventions as a final alternative if your sciatica doesn’t respond to non-surgical treatment methods.
“There are many external factors, but among the greatest is your occupation. Someone who operates in a manual labor industry, like construction, has a higher likelihood of developing sciatica since they put more wear and tear on their back. Tiger Woods is an example of this. He acquired sciatica because his career as a golfer placed significant stress on his spine. There is a genetic element as well, as a few young men and women who do not operate in a strenuous job develop sciatica, however, the genetic tie is not clearly defined. Lastly, pregnancy may also result in sciatica. As the infant develops, it can put pressure on the lumbar spine, pelvis, and sciatic nerve. However, delivering the infant is usually enough to eliminate sciatica caused by pregnancy,” says Dr. Tyndall.
“This question isn’t easy to answer because many factors contribute to whether a person will develop sciatica more than once. Sciatica is likely to re-occur if the spinal disc that led to sciatica the very first time is severely damaged. The more damaged the disk, the more likely it is to re-herniate and lead to sciatica again. Also, if the patient continues to work in a high-physical stress environment, the risk of re-ocurrence increases.
“The physical examination is essential to a sciatica diagnosis. The straight-leg raise test is the traditional diagnostic tool during a physical examination. In this test, a patient be asked to lift up their leg when lying down. If that induces pain down their leg, the patient could have sciatica. Other physical tests healthcare professionals frequently utilize are knee extension tests, where the patient expands their knee to a straight position, like a straight-leg lift. Additionally, healthcare professionals will as patients to walk on their tip toes or on their heel to measure their potency. Other healthcare professionals will also observe how strong they are going down stairs or simply walking. Many doctors can determine a sciatica analysis from a physical examination, but if imaging studies are needed to learn more, the physician may recommend a magnetic resonance imaging (MRI) scan.
As mentioned before by Dr. Dwight Tyndall, there is a variety of treatment options available to help alleviate the symptoms of sciatica. Approximately 80 percent of patients will improve with non-surgical treatment options. Several OTC medications, such as NSAIDs (eg, ibuprofen), are also effective in the management of sciatic nerve pain. If the sciatica does not subside, the doctor may prescribe a low-dose steroid pack (to be obtained over one week). If this doesn’t manage the sciatic nerve pain, then the patient may receive an epidural steroid injection (you will first need an MRI to pin-point the injection region).
Other non-surgical treatment options which are commonly utilized to help alleviate the symptoms of sciatica, include, acupuncture, chiropractic care and physical therapy, and needless to say, time normally works wonders such as pain. Chiropractic care is the most commonly used alternative treatment option for the treatment of sciatica. Chiropractic care focuses on the diagnosis, treatment and prevention of a variety of injuries and/or conditions associated with the musculoskeletal and nervous system. Through spinal adjustments and manual manipulations, a doctor of chiropractic, or chiropractor, can help reduce unnecessary pressure in the structures surrounding the spine, improving strength, mobility and flexibility. Chiropractic care and physical therapy alike, can also help improve a patient’s overall health and wellness, aside from improving their sciatica, through physical activities and nutritional advice.
“It may certainly be so, however, the good thing is that the vast majority of people with sciatica don’t need surgery. And, your doctor may ask you to explore non-surgical treatment options, however, your tolerance for pain is the real predictor as to when you have to consider another option for treatment. Surgery may be necessary if symptoms worsen despite trying non-surgical alternatives, if you have weakness in your leg, or if you experience bladder and/or bowel changes,” explained Dr. Dwight Tyndall.
“The surgical procedure to treat sciatica is also called a lumbar microdiscectomy. It is a normal procedure with very positive individual outcomes when used accordingly. A lumbar microdiscectomy is similar to a traditional lumbar discectomy. Technological advances, like the advent of surgical microscopes, allow surgeons to create smaller incisions that are minimally traumatic to the body and result in a much quicker recovery for the patient”, added Dr. Tyndall.
“Yes, lumbar microdiscectomy can surely be carried out in an outpatient setting. Many patients like the cozy environment and are able to go home the exact same day of operation,” concluded Dwight Tyndall, MD, FAAOS.
As thoroughly explained by Dr. Dwight Tyndall, sciatica can be preventable if the individual doesn’t put significant and repeated stress in their back, which will reduce the chance of damaging or injuring a nerve. Nonetheless, in the present society, through our tasks and daily stresses of modern life, it’s difficult to accomplish that. Fortunately, with the abundance of treatment choices available, people can get relief from sciatic nerve pain with the appropriate healthcare professional’s help.
Dr. Alex Jimenez’s Insight
Many people will experience symptoms of low back pain at least once throughout their lifetime, however, only a few individuals will develop true sciatica symptoms. Sciatica is medically referred to as a collection of symptoms, rather than a single condition, and it’s generally characterized by pain and discomfort, followed by tingling or burning sensations and numbness along the length of the sciatic nerve. The sciatic nerve is the largest nerve in the human body and it travels from the lower back down the buttocks and thighs into the legs and feet. Sciatic nerve pain, or sciatica, has become a common health issue for many people, therefore, its important to be educated regarding this prevalent complaint in order to follow up with the most appropriate treatment.
The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
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