Sciatica
Sciatica is a symptom of lower limb (leg) pain due to slipped discs or pinched nerves in the spine. However, according to studies from Wisconsin in the Unites States, 95% of all leg pains aren’t due to true pinched nerves. Many leg pains are either due to muscles or joints referring pain into the lower limb(s).
Many people develop leg pain – affecting either one or both lower limbs. It is not dependent on age or gender. Nor is it necessary to have sustained an injury to the leg or back. One doesn’t need to have back pain associated with the leg pain either.
The extent of leg pain will vary. Some patients’ leg symptoms will commence in the low back, travel into the buttock, down the thigh, calf, and into the foot. Others’ symptoms will only travel into the upper thigh. Generally, those that do not travel past the knee are not true pinched nerves. Conversely, those that do radiate into the foot aren’t necessarily true pinched nerves either.
So faced with these apparent contradictions, it is important to have the correct health care professional diagnose the problem before attempting any treatment. This will help the patient understand where the pain is coming from – true pinched nerve in spine vs muscle / joint? The Chiropractor is well trained to establish this. After a thorough history, this spinal specialist will perform some tests like a straight leg raiser, well leg raiser, and femoral nerve stretch, amongst other tests. They will probably discuss the diagnosis with you thereafter.
Depending on the origin of the pain, your Chiropractor will either treat the low back, buttock, leg, or other structures. (S)he may use dry needling, manipulation, stretches, and ergonomic advice (amongst other things) to treat this problem. Depending on the severity of symptoms, medication, (brief) bed rest, and being booked off work may also be considered by your doctor. These latter approaches are of some benefit to assist in managing the symptoms.
These problems generally respond well to treatment, usually requiring three to four treatments if the symptoms emanate from the muscles or joints. Some patients may need more treatments if they have true pinched nerves. If your leg pain is not resolving timeously, your Chiropractor may consider further investigations like x-rays, ultrasound, and in extreme cases MRI scans. The latter will generally be performed in conjunction with the Neurosurgeon, who may choose to admit you into hospital.
Previous treatments included using corsets or traction. Most of these modalities have gone out of favour, as the research doesn’t support their use. The medical aids have also stopped paying for these interventions based on their lack of efficacy in the literature.
Other patients have also been told that their backs need to be operated on in order to remove the offending disc; or to have a minor surgical procedure. Although these may be necessary in a small percentage of patients, its important to have tried all reliable conservative care before attempting this approach.
So should you be experiencing any leg or buttock pain, or know of someone that is, be sure to give your Chiropractor a call to schedule an appointment.