Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).
Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.
Can individuals with piriformis syndrome incorporate acupuncture with various therapies to reduce sciatic nerve pain and other symptoms?
Introduction
As many individuals move around from one location to another thanks to the lower body extremities, the surrounding muscles, ligaments, nerve roots, and tissues help contribute to the sensory-motor function of the hips, legs, buttocks, and feet. All these muscle groups factor in to ensure they can be mobile without the effects of pain or discomfort. However, many factors and issues can cause the surrounding muscles to develop musculoskeletal problems over time, affecting a person’s mobility. One of the muscles that helps share the responsibility for mobility to hips and buttocks is the piriformis muscle, which is often overlooked when various injuries or repetitive motions start to affect a person’s ability to walk. Today’s article examines how piriformis syndrome affects mobility, how sciatic pain correlates with piriformis syndrome, and how therapies like acupuncture can help reduce piriformis syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to minimize piriformis syndrome affecting a person’s mobility. We also inform and guide patients on how treatments like acupuncture can help reduce sciatic nerve pain associated with piriformis syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from piriformis syndrome that is affecting their ability to walk. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
Piriformis Syndrome Affecting Mobility
Have you been experiencing muscle tightness in your hips or buttock region, affecting your walking ability? Do you feel sensations of numbness, tingling, or burning pain traveling down to your knees and feet? Or, after a long day of work, do you feel pain when you are sitting down? Most of these symptoms are often correlated with piriformis syndrome. The six surrounding muscles surrounding the gluteal region of the thighs and hips all work together to provide lower body movement while stabilizing the hips and rotating the thighs. The piriformis muscle is a small, flat, pear-shaped muscle that runs on top of the sciatic nerve. Piriformis syndrome is a clinical musculoskeletal condition that causes sciatic nerve entrapment that causes many individuals to report shooting and burning pain down to their buttock region. (Hicks et al., 2024) This causes many people to think they are dealing with low back pain associated with sciatica. When a person is dealing with piriformis syndrome, they will experience limited mobility in their hips, which, over time, if not treated, will affect the thighs and legs.
How Does Sciatic Nerve Pain correlate with Piriformis Syndrome?
Additionally, since piriformis syndrome is correlated with sciatic nerve pain, some clinical findings causing overlapping risk profiles include restricted external hip rotation and muscle tightness of the lumbosacral muscles. Other clinical findings range from palpatory pain over the greater sciatic notch to aggravated pain in a seated position. (Sharma et al., 2023) Since sciatic nerve entrapment is correlated with piriformis syndrome, it is still regarded as the non-discogenic cause of sciatica. (Son & Lee, 2022) When that sciatic nerve gets trapped within the piriformis muscle, many people will experience numbness, tingling sensations, and similar pain patterns in the legs, just like sciatica; however, when individuals are looking for treatments to reduce the sciatic nerve pain and improve the piriformis muscle.
Acupuncture Therapy Reduces Piriformis Syndrome
When people are looking for treatments to reduce their sciatic nerve pain correlated with piriformis syndrome, they are seeking treatments that are affordable and can reduce the pain through consecutive sessions. Acupuncture therapy can help reduce the effects of piriformis syndrome. Acupuncture is a complementary and alternative therapy from China that uses solid, thin needles to be placed on the acupoints in the body. Additionally, highly trained professionals can incorporate various acupuncture methods to treat and reduce the effects of piriformis syndrome. (He et al., 2023) At the same time, when a person is being treated for piriformis syndrome, an acupuncturist uses ultrasound-guided techniques to allow accurate needle placement within the deep muscles to provide an effective treatment response. (Fusco et al., 2018) This allows the affected surrounding muscles to relax and reduce sciatic nerve pain.
Acupuncture Reducing Sciatic Nerve Pain
Since sciatic nerve pain and piriformis syndrome have overlapping risk profiles, they can also be associated with other musculoskeletal pain conditions that can affect a person’s mobility. Acupuncture can help mitigate the pain signals causing motor or sensory disturbances within the pelvic and hip regions. (Kvorning et al., 2004) Acupuncture is one of the oldest forms of non-surgical therapy that can be combined with other various therapies to help remobilize the hips and decompress the pain affecting the sciatic nerve while providing relief. (Vij et al., 2021) By incorporating acupuncture as part of a person’s health and wellness treatment plan, they will begin to gradually manage the associated symptoms and reduce the chances of piriformis syndrome from returning to cause sciatic nerve pain in the lower extremities. This allows people to be more mindful and help restore the body’s natural healing process over time.
Reclaim Your Mobility- Video
References
Fusco, P., Di Carlo, S., Scimia, P., Degan, G., Petrucci, E., & Marinangeli, F. (2018). Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. J Chiropr Med, 17(3), 198-200. doi.org/10.1016/j.jcm.2018.04.002
He, Y., Miao, F., Fan, Y., Zhang, F., Yang, P., Zhao, X., Wang, M., He, C., & He, J. (2023). Acupuncture Methods for Piriformis Syndrome: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res, 16, 2357-2364. doi.org/10.2147/JPR.S417211
Kvorning, N., Holmberg, C., Grennert, L., Aberg, A., & Akeson, J. (2004). Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand, 83(3), 246-250. doi.org/10.1111/j.0001-6349.2004.0215.x
Sharma, S., Kaur, H., Verma, N., & Adhya, B. (2023). Looking beyond Piriformis Syndrome: Is It Really the Piriformis? Hip Pelvis, 35(1), 1-5. doi.org/10.5371/hp.2023.35.1.1
Son, B. C., & Lee, C. (2022). Piriformis Syndrome (Sciatic Nerve Entrapment) Associated With Type C Sciatic Nerve Variation: A Report of Two Cases and Literature Review. Korean J Neurotrauma, 18(2), 434-443. doi.org/10.13004/kjnt.2022.18.e29
Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. doi.org/10.5812/aapm.112825
For individuals with arthritis, can incorporating acupuncture with other therapies help manage pain and other symptoms?
Acupuncture For Arthritis
Acupuncture has been around for thousands of years and is a form of traditional Chinese medicine that utilizes needles inserted into various parts of the body to relieve pain and inflammation. The practice is based on the concept of life energy that flows throughout the body along pathways called meridians. When the energy flow becomes disrupted, blocked, or injured, pain or illness can present. (Arthritis Foundation. N.D.) Further research is needed to determine how the acupuncture therapeutic mechanisms work and the overall effectiveness. However, there is emerging evidence suggesting that acupuncture can provide symptom relief for individuals with joint pain, especially those with osteoarthritis and rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)
Benefits
The actual method that reduces the pain and inflammation is still unclear. Theories include that the needles suppress inflammatory responses, improve blood flow, and relax muscles. Although acupuncture cannot cure or reverse arthritis, it may be useful for managing pain and decreasing associated symptoms, especially in combination with other therapies. (Pei-Chi Chou, Heng-Yi Chu. 2018)
Rheumatoid Arthritis
A systematic review of 43 studies, including humans and animals with rheumatoid arthritis, demonstrated varied results. Several studies showed improvement in symptoms and decreased biological markers of rheumatoid arthritis following one to three sessions of acupuncture for four weeks or more. (Sharon L. Kolasinski et al., 2020) Beneficial outcomes following acupuncture treatment for rheumatoid arthritis include:
Reduced pain
Reduced joint stiffness
Improved physical function
The results of the human and animal studies suggested that acupuncture has the potential to down-regulate:
Levels of interleukins
Levels of tumor necrosis factor
Specific cell signaling proteins/cytokines involved in the inflammatory response, which become elevated in autoimmune conditions like rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)
Most of the study subjects were also receiving other forms of treatment, especially medication. Therefore, it is difficult to conclude how beneficial acupuncture is alone or as a supplemental addition to other medical treatments. (Pei-Chi Chou, Heng-Yi Chu. 2018)
Osteoarthritis
Acupuncture for osteoarthritis of the hand, hip, and knee is recommended, according to the American College of Rheumatology and Arthritis Foundation, meaning that it may be worth trying, although more research is needed to confirm its effectiveness. However, since the risk is relatively minor, acupuncture is generally considered a safe alternative treatment option for managing the symptoms. (Sharon L. Kolasinski et al., 2020)
Chronic Pain
As clinical trials suggest that acupuncture may be effective in providing pain relief, it may be a recommended option for individuals suffering from chronic pain. A recent systematic review of 20,827 patients and 39 trials concluded that acupuncture is effective for the treatment of chronic musculoskeletal pain, headache, and osteoarthritis pain. (Andrew J. Vickers et al., 2018)
Triggering the release of endorphins/hormones that help reduce pain.
Safety
Acupuncture is considered a safe procedure by a licensed and certified professional.
To practice acupuncture in the United States, an acupuncturist needs a minimum of a master’s degree from a program accredited by the American Academy of Acupuncture and Oriental Medicine and a license in the state where they received their acupuncture treatment.
Doctors with an MD or DO degree licensed in the United States to practice medicine can also be licensed by the American Academy of Medical Acupuncture after additional training.
Risks
Risks associated with acupuncture are bleeding and bruising, especially for individuals who have a bleeding disorder like hemophilia or take a blood thinning medication. Individuals are recommended to talk to their healthcare provider to determine if acupuncture is a safe option.
Side Effects
Most individuals do not experience any side effects, although possible reactions can include: (Shifen Xu et al., 2013)
Soreness
Bruising
Scarring
Needle shock: a vasovagal response that presents as feeling faint, clammy hands, chills, and slight nausea.
Acupuncture Session
During the initial treatment, individuals will discuss their medical history and what joints and areas of their bodies are presenting with symptoms.
After a physical exam, the individual will lie on a treatment table.
Individuals may be face up or down depending on what areas of the body the acupuncturist needs to access.
It is recommended to wear loose clothing that can be rolled up or moved out of the way to access different areas easily.
Depending on what areas need to be accessed, individuals may be asked to change into a medical gown.
The acupuncturist will use alcohol swabs to disinfect the area before inserting the needles.
The needles are made of stainless steel and are extremely thin.
Individuals may feel a slight pinch in sensitive areas like the hands and feet, but needle insertion should be comfortable and well-tolerated without significant discomfort.
For electroacupuncture, the acupuncturist will pass a mild electric current through the needles, typically 40 to 80 volts.
The needles stay in place for 20 to 30 minutes.
After the treatment is finished, the acupuncturist will remove the needles and dispose of them.
Frequency
The frequency of acupuncture sessions will vary depending on the severity of the symptoms and whether the visits are approved and reimbursed by the health insurance company.
Cost and Insurance
Costs for acupuncture can vary from $75 to $200 per session.
The first session, which involves an initial assessment and evaluation, usually costs more than follow-up visits.
Whether the health insurance will cover some or all of the costs of acupuncture sessions depends on the individual insurance company and the condition being treated.
Medicare currently covers acupuncture services up to 12 visits within a 90-day period for chronic low back pain only.
Medicare will not cover acupuncture for other conditions. (Medicare.gov. N.D.)
Acupuncture is not a cure for arthritis, but it may be a useful tool to help manage pain and other symptoms. Make sure to consult a healthcare provider if acupuncture is safe to try based on medical history.
Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 8596918. doi.org/10.1155/2018/8596918
Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis care & research, 72(2), 149–162. doi.org/10.1002/acr.24131
Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain, 19(5), 455–474. doi.org/10.1016/j.jpain.2017.11.005
Xu, S., Wang, L., Cooper, E., Zhang, M., Manheimer, E., Berman, B., Shen, X., & Lao, L. (2013). Adverse events of acupuncture: a systematic review of case reports. Evidence-based complementary and alternative medicine : eCAM, 2013, 581203. doi.org/10.1155/2013/581203
Can individuals dealing with low back pain find the relief they are looking for by incorporating acupuncture to reduce muscle spasms?
Introduction
Around the world, many individuals, young and old, have dealt with low back pain, which has an impact on their lives and affects their routines. Since low back pain is a multifactorial musculoskeletal issue, it can range from acute to chronic, depending on the severity and environmental factors that are in play. The lower back or the lumbar spinal region has thicker joints and helps stabilize the upper body portion’s weight. However, it is more susceptible to injury, and it causes the surrounding ligaments, soft tissues, and muscles to be overstretched, tight, and weak. When a person is in excruciating pain from the effects of low back pain, it can impact their day and cause them to be miserable. Today’s article focuses on how lower back pain is associated with pain-like symptoms like muscle spasms and how treatments like acupuncture can help reduce muscle spasms associated with lower back pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve low back pain correlated with muscle spasms. We also inform and guide patients on how treatments like acupuncture can help minimize the pain in their lower back. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from low back pain that is affecting their daily routine. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
Low Back Pain Associated With Muscle Spasms
Do you feel radiating or localized pain in your lower back after a long workday? Do you feel stiffness in your lower back region after stretching in the morning? Or have you noticed you are more tense in the different areas of your back and looking for relief? While it is a common problem that many people experience, low back pain can occur to many individuals worldwide and can significantly impact a person. As a major public health concern, low back pain globally transcends through ages, occupations, and socio-economic backgrounds, causing pain-like symptoms to develop over time. (Emorinken et al., 2023) Numerous factors can lead to low back pain and the symptoms that can occur in the lumbar region. Since low back pain can affect many individuals worldwide, this musculoskeletal condition can cause activity limitations in people. It can progressively increase spine degeneration, affecting the joints, bones, and discs. (Hauser et al., 2022) Some of the symptoms that correlate with low back pain include:
Stiffness
Gait instability
Numbing or tingling sensations in the extremities
Myofascial referred pain
Muscle spasms
The painful effects of low back pain can cause muscle spasms in the lumbar region as many people continuously make repetitive motions that cause the surrounding muscles to become overworked and develop trigger points to cause muscle spasms. When a person goes to a doctor to treat their lower back pain, they undergo a physical examination to evaluate their lower extremities’ strength, sensation, and reflexes. These examinations help doctors determine the proper protocol for low back pain through inspection, palpation, and range of motion of the lumbosacral musculature to identify point tenderness, restriction, and muscle spasms. (Will et al., 2018) These identity markers allow doctors to devise a personalized plan to reduce the effects of low back pain and help individuals regain their health.
Exploring Integrative Medicine- Video
Acupuncture Effects On Low Back Pain
When people with back pain are looking for treatment, they are looking for something affordable and can work with their busy schedule. Hence, non-surgical treatments could be the answer to reducing low back pain. Numerous non-surgical treatments can help individuals with specific pain-like symptoms that correlate with various factors. Each treatment, from chiropractic care to traction therapy, is personalized for the individual. Now, one of the oldest forms of non-surgical treatment is acupuncture. Originating from China, acupuncture incorporates solid thin needles at specific body points to balance the energy flow in the body that highly trained professionals perform. The effects of acupuncture can help stimulate the release of adenosine at the sight of needle stimulation while increasing local blood flow to the affected area to promote natural healing. (Mu et al., 2020) So, how does acupuncture help individuals reduce low back pain?
Since low back pain can cause a socio-economic burden many people are affected by, acupuncture can help reduce pain and disability in the affected muscle areas while improving the person’s quality of life. (Baroncini et al., 2022) Acupuncture for low back pain benefits individuals by releasing endorphins and other neurohumoral factors that change brain and spinal cord processing. At the same time, acupuncture can also increase microcirculation and reduce the inflammatory effects of low back pain. (Sudhakaran, 2021) Acupuncture can also be part of a person’s personalized treatment plan, as physical and massage therapy can help strengthen the affected muscles caused by low back pain. When people dealing with low back pain are finally getting the relief they need, they can get their quality of life back through small changes to better themselves. This allows them to be more mindful of the various factors that can cause their bodies pain and prevent them from returning over time.
References
Baroncini, A., Maffulli, N., Eschweiler, J., Molsberger, F., Klimuch, A., & Migliorini, F. (2022). Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis. J Orthop Surg Res, 17(1), 319. doi.org/10.1186/s13018-022-03212-3
Emorinken, A., Erameh, C. O., Akpasubi, B. O., Dic-Ijiewere, M. O., & Ugheoke, A. J. (2023). Epidemiology of low back pain: frequency, risk factors, and patterns in South-South Nigeria. Reumatologia, 61(5), 360-367. doi.org/10.5114/reum/173377
Hauser, R. A., Matias, D., Woznica, D., Rawlings, B., & Woldin, B. A. (2022). Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil, 35(4), 701-712. doi.org/10.3233/BMR-210097
Mu, J., Furlan, A. D., Lam, W. Y., Hsu, M. Y., Ning, Z., & Lao, L. (2020). Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev, 12(12), CD013814. doi.org/10.1002/14651858.CD013814
Will, J. S., Bury, D. C., & Miller, J. A. (2018). Mechanical Low Back Pain. American Family Physician, 98(7), 421-428. www.ncbi.nlm.nih.gov/pubmed/30252425
Can working individuals dealing with degenerative pain syndrome incorporate decompression to provide body relief and mobility?
Introduction
As part of the musculoskeletal system, the spine allows the body to stand vertically and helps protect the spinal cord from injuries. Since the central nervous system provides neuron signals from the brain to the nerve roots, the human body can be mobile without pain or discomfort. This is due to the spinal discs between the facet joints, which can be compressed, absorb the vertical axial pressure, and help distribute the weight to the lower and upper extremity muscles. However, as many people realize, repetitive movements and wear and tear on the spinal structure can lead to overlapping risk profiles that can cause the spinal disc to degenerate and invoke pain in the musculoskeletal system. To that point, it can cause the individual to be in extreme pain and discomfort over time. Today’s article looks at how degenerative pain syndrome affects the spine, the symptoms it’s associated with, and how decompression can reduce degenerative pain syndrome. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve degenerative pain syndrome that is causing mobility issues on the spine. We also inform and guide patients on how decompression can help reduce the pain-like symptoms correlating with degenerative pain syndrome. We encourage our patients to ask their associated medical providers intricated and important questions about the referred pain-like symptoms they are experiencing from degenerative pain that is affecting their quality of life. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
Degenerative Pain Syndrome On The Spine
Do you feel muscle aches or pains in your back after an extended period of lying down, sitting, or standing? Do you feel constant pain after carrying a heavy object from one location to another? Or does twisting or turning your torso provide temporary relief? Many people often don’t realize that many of these pain-like issues are associated with degenerative pain syndrome that affects the spine. Since the body ages naturally, the spine does as well through degeneration. When the spinal discs start to degenerate, it can cause the vertical axial pressure to flatten and squeeze the disc, disrupting its ability to keep hydrated and causing it to protrude out of its original position. At the same time, the height of the spinal disc will gradually fall, and the consequence is a change in dynamics in the affected spine segments. (Kos et al., 2019) Degeneration can cascade down to the surrounding ligaments, muscles, and joints when degeneration starts to affect the spine.
The Symptoms Associated With Degenerative Pain
When the surrounding joints, muscles, and ligaments are affected by degenerative disc pain, it can be due to multiple factors contributing to the pain-like symptoms. Inflammation is one of the symptoms that are associated with degenerative pain syndrome, as disturbances can affect the circadian rhythm and disrupt homeostasis, which then leads to increased stress on the spinal disc, which then contributes to the degenerative process. (Chao-Yang et al., 2021) Inflammation can cause the affected muscles to be inflamed and cause more overlapping risk profiles, as it can affect the upper and lower extremities. Additionally, mechanical loading may affect disc degeneration in various ways at the different vertebral levels. (Salo et al., 2022) This can lead to pain-like symptoms like:
Arm and leg tenderness
Nerve pain
Loss of sensory functions on the upper and lower extremities
Tingling sensations
Muscle pain
However, numerous treatments can help restore spinal mobility and lessen the painful effects of the degenerative pain syndrome of the spine.
The Non-Surgical Approach To Wellness- Video
When it comes to seeking treatment for degenerative pain syndrome, many individuals will do research on which treatment is affordable for their pain, hence why many people opt for non-surgical treatment to alleviate their pain. Non-surgical treatments are customized to the individual’s pain. They can help kickstart the person’s wellness journey, which can include a combination of exercise, manual therapy, and lifestyle modifications. (Brogger et al., 2018) The video above shows how a non-surgical approach can benefit someone with degenerative pain syndrome affecting their spine.
Decompression Reducing Degenerative Pain Syndrome
With many available treatments to reduce pain-like symptoms affecting the spine, non-surgical treatments can be an option. Ranging from chiropractic care to acupuncture, non-surgical treatments can be combined to minimize the pain-like effects. Decompression, as part of the non-surgical treatment options, is an excellent way to reduce the degenerative pain process in the spine. Decompression allows the spinal column to be gently pulled through a traction machine to relieve the spinal disc. When a traction machine decomposes the spine, the pain intensity is significantly reduced in all body parts. (Ljunggren et al., 1984) This is due to negative pressure being reinstated back to the spine to increase disc height and restore the nutrients back to the affected disc and rehydrate them. (Choi et al., 2022) When people start incorporating decompression through consecutive treatment, their pain intensity is reduced, and their spine is mobile again while slowing down the degenerative process on the spine. This allows them to take better care of their bodies by making small changes in their health and wellness.
References
Brogger, H. A., Maribo, T., Christensen, R., & Schiottz-Christensen, B. (2018). Comparative effectiveness and prognostic factors for outcome of surgical and non-surgical management of lumbar spinal stenosis in an elderly population: protocol for an observational study. BMJ Open, 8(12), e024949. doi.org/10.1136/bmjopen-2018-024949
Chao-Yang, G., Peng, C., & Hai-Hong, Z. (2021). Roles of NLRP3 inflammasome in intervertebral disc degeneration. Osteoarthritis Cartilage, 29(6), 793-801. doi.org/10.1016/j.joca.2021.02.204
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P.-B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 1-9. doi.org/10.1155/2022/6343837
Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Med Arch, 73(6), 421-424. doi.org/10.5455/medarh.2019.73.421-424
Ljunggren, A. E., Weber, H., & Larsen, S. (1984). Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. Scand J Rehabil Med, 16(3), 117-124. www.ncbi.nlm.nih.gov/pubmed/6494835
Salo, S., Hurri, H., Rikkonen, T., Sund, R., Kroger, H., & Sirola, J. (2022). Association between severe lumbar disc degeneration and self-reported occupational physical loading. J Occup Health, 64(1), e12316. doi.org/10.1002/1348-9585.12316
Can individuals dealing with sciatica pain find the relief they need from acupuncture to restore low back mobility?
Introduction
The body’s lower extremities provide stability and movement to the individual as they are moving from one location to another without pain or discomfort. The lower extremities consist of the hips, lower back, legs, thighs, pelvis, knees, and feet; each has various muscles, nerve roots, and ligaments with a specific job to each muscle quadrant. The spinal column in the musculoskeletal system helps provide proper posture while protecting the spinal cord from injuries. However, more often than not, the lower extremities can succumb to injuries as many individuals incorporate repetitive motions that can compress the nerve roots that are spread out to the lower extremities, which can invoke pain. The most common pain that seems to affect the lower back and legs is sciatica, and when not treated, it can cause overlapping risk profiles to the lower extremities. Today’s article examines how sciatica is correlated with the lower back and how non-surgical treatments can help reduce the effects of sciatic pain. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve sciatica pain affecting their lower extremities. We also inform and guide patients on how non-surgical treatments can help reduce sciatica pain from the lower musculoskeletal extremities. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from sciatica that are causing them pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
How Does Sciatica Correlate With The Lower Back?
Do you often experience numb or tingling sensations running down your leg that cause your leg or foot to lose sensation briefly? Do you feel shooting pain in your lower back after excessive sitting at your desk? Or do you find that stretching your legs or back temporarily relieves the pain, only for it to come back? Many individual who are experiencing shooting pain running down their legs are dealing with sciatica. When it comes to the lower extremities in the musculoskeletal system, many individuals make repetitive motions on their spine that can cause the spinal discs to become compressed and herniated under pressure. When the spinal disc is herniated in the lumbar spine, that disc will start to press on the surrounding nerve roots, thus sending radiating pain down the legs. Sciatica is defined as when individuals are experiencing pain coming from the lumbosacral nerve root and causing either a burning, heaviness, or tightness sensation. (Aguilar-Shea et al., 2022) Sciatica can range from mild to severe, forcing many individuals to think their foot is asleep. However, the sciatic nerve root is compressed, trapped, stuck, or pinched, which causes muscle spasms within the lower back, buttock, or legs. Hence, many individuals will explain that they are experiencing low back or leg pain when it is sciatica.
Since the sciatic nerve is a long, thick nerve in the human body, it travels from the lumbar region down to the knee and connects to other nerves to reach the foot. Sciatica pain can be two conditions with the same pain-like symptom effects known as true or sciatica-like conditions. True sciatica is where an injury is directly affecting the sciatic nerve. This can relate to a slipped disc caused by environmental factors like lifting a heavy object, aggravating the sciatic nerve root, and causing pain that worsens. (Siddiq et al., 2020) For sciatica-like conditions, this is where other musculoskeletal conditions are causing sciatic pain-like symptoms on the lower extremities. Musculoskeletal conditions like piriformis syndrome can cause sciatica pain-like symptoms where the piriformis muscle is irritated or inflamed, pressing on the sciatic nerve, which causes many people to report pain along the gluteal region that may shoot a burning, aching sensations down the back of the legs. (Hicks et al., 2024) However, there are ways to treat sciatica and reduce the pain-like effects causing mobility issues.
Sciatica, Causes, Symptoms and Tips- Video
Non-surgical Treatments For Sciatica
When it comes to reducing sciatica pain, many individuals will seek out treatment that is cost-effective and customized to the person’s pain. Some treatments, like neural mobilization, can apply mechanical forces to the nerve roots to restore healthy movement to the legs and lower extremities. (Peacock et al., 2023) Other treatments, like spinal decompression, use gentle traction on the spinal disc to lay off the pressure on the sciatic nerve to provide relief. Non-surgical treatments are favorable to many people due to how affordable it is and personalized to the person’s pain as they help reduce pain and disability. (Liu et al., 2023) Luckily, a form of non-surgical treatment can help relieve sciatica and its associated pain-like symptoms.
Acupuncture Relieving Sciatic Pain
Acupuncture is one of the oldest forms of non-surgical treatments in which trained professionals use thin, solid needles to be inserted and placed on the affected area, causing pain. Acupuncture can help reduce the distortion of the affected nerve roots, and local inflammatory cytokines correlated with sciatica. (Yu et al., 2021) What this does is that it normalizes the neuron signals to a default mode from aggravating the surrounding muscle fibers and descending the pain. Additionally, acupuncture can help restore the body’s qi or energy by reducing the pain by placing the needles on the acupoint of the vital organs that share a relationship with the sciatic nerve. (Yu et al., 2022) This is known as somato-visceral, where the vital organs could be the affected area, causing overlapping muscle and nerve risk profiles. Acupuncture is an excellent form of non-surgical treatment that can be combined with other various therapies to help restore the body’s natural healing factor and allow people to be more mindful of how to take care of their bodies easily to prevent sciatica pain-like symptoms from arising.
References
Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-Gonzalez, R., & Paredes, I. (2022). Sciatica. Management for family physicians. J Family Med Prim Care, 11(8), 4174-4179. doi.org/10.4103/jfmpc.jfmpc_1061_21
Liu, C., Ferreira, G. E., Abdel Shaheed, C., Chen, Q., Harris, I. A., Bailey, C. S., Peul, W. C., Koes, B., & Lin, C. C. (2023). Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials. BMJ, 381, e070730. doi.org/10.1136/bmj-2022-070730
Peacock, M., Douglas, S., & Nair, P. (2023). Neural mobilization in low back and radicular pain: a systematic review. J Man Manip Ther, 31(1), 4-12. doi.org/10.1080/10669817.2022.2065599
Siddiq, M. A. B., Clegg, D., Hasan, S. A., & Rasker, J. J. (2020). Extra-spinal sciatica and sciatica mimics: a scoping review. Korean J Pain, 33(4), 305-317. doi.org/10.3344/kjp.2020.33.4.305
Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., . . . Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ Open, 12(5), e054566. doi.org/10.1136/bmjopen-2021-054566
Yu, F. T., Ni, G. X., Cai, G. W., Wan, W. J., Zhou, X. Q., Meng, X. L., Li, J. L., Tu, J. F., Wang, L. Q., Yang, J. W., Fu, H. Y., Zhang, X. C., Li, J., Wang, Y. F., Zhang, B., Zhang, X. H., Zhang, H. L., Shi, G. X., & Liu, C. Z. (2021). Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial. Trials, 22(1), 34. doi.org/10.1186/s13063-020-04961-4
For individuals dealing with chronic pain, can undergoing a nerve block procedure help alleviate and manage symptoms?
Nerve Blocks
A nerve block is a procedure done to interrupt/block pain signals due to nerve dysfunction or injury. They can be used for diagnostic or treatment purposes, and their effects can be short or long-term, depending on the type being used.
A temporary nerve block may involve the application or injection that stops pain signals from transmitting for a short time.
For example, in pregnancy, an epidural injection can be used during labor and delivery.
Permanent nerve blocks involve cutting/severing or removing certain parts of a nerve to stop pain signals.
These are used in cases with severe injuries or other chronic pain conditions that have not improved with other treatment approaches.
Treatment Usage
When healthcare providers diagnose a chronic pain condition caused by nerve injury or dysfunction, they may use a nerve block to locate the area generating pain signals. They may perform electromyography and/or a nerve conduction velocity/NCV test to pinpoint the cause of chronic nerve pain. Nerve blocks can also treat chronic neuropathic pain, such as pain caused by nerve damage or compression. Nerve blocks are regularly used to treat back and neck pain caused by herniated discs or spinal stenosis. (Johns Hopkins Medicine. 2024)
Types
Three types include:
Local
Neurolytic
Surgical
All three can be used for conditions that cause chronic pain. However, neurolytic and surgical blocks are permanent and are only used for severe pain that has worsened with other treatments unable to provide relief.
Temporary Blocks
A local block is done by injecting or applying local anesthetics, like lidocaine, to a certain area.
An epidural is a local nerve block that injects steroids or analgesics into an area around the spinal cord.
These are common during pregnancy, labor, and delivery.
Epidurals can also be used to treat chronic neck or back pain due to a compressed spinal nerve.
Local blocks are usually temporary, but in a treatment plan, they can be repeated over time to manage chronic pain from conditions like arthritis, sciatica, and migraines. (NYU Langone Health. 2023)
Permanent Blocks
A neurolytic block uses alcohol, phenol, or thermal agents to treat chronic nerve pain. (National Institute of Neurological Disorders and Stroke. 2023) These procedures damage certain areas of the nerve pathway on purpose so that pain signals cannot be transmitted. A neurolytic block is mainly used for severe chronic pain cases, like pain from cancer or complex regional pain syndrome/CRPS. They are sometimes used to treat ongoing pain from chronic pancreatitis and pain in the chest wall after surgery. (Johns Hopkins Medicine. 2024) (Alberto M. Cappellari et al., 2018)
The neurosurgeon performs a surgical nerve block that involves surgically removing or damaging specific areas of the nerve. (National Institute of Neurological Disorders and Stroke. 2023) A surgical nerve block is only used for severe pain cases, such as cancer pain or trigeminal neuralgia.
Although neurolytic and surgical nerve blocks are permanent procedures, pain symptoms, and sensations can come back if the nerves are able to regrow and repair themselves. (Eun Ji Choi et al., 2016) However, symptoms and sensations may not return months or years after the procedure.
These procedures can have the potential risk of permanent nerve damage. (Anthem BlueCross. 2023) Nerves are sensitive and regenerate slowly, so a tiny error can cause side effects. (D O’Flaherty et al., 2018) Common side effects include:
Muscle paralysis
Weakness
Frequent numbness
In rare cases, the block could irritate the nerve and cause added pain.
Skilled and licensed health practitioners like surgeons, pain management physicians, anesthesiologists, and dentists are trained to perform these procedures carefully.
There is always a risk of nerve damage or injury, but the majority of nerve blocks safely and successfully decrease and help manage chronic pain. (Anthem BlueCross. 2023)
What to Expect
Individuals may feel numbness or soreness and/or notice redness or irritation near or around the area that is temporary.
There can also be swelling, which compresses the nerve and requires time to improve. (Stanford Medicine. 2024)
Individuals may be asked to rest for a certain amount of time after the procedure.
Depending on the type of procedure, individuals may have to spend a few days in a hospital.
Some pain may still be present, but that does not mean the procedure did not work.
Individuals should consult with a healthcare provider about the risks and benefits to ensure it is the right treatment.
Cappellari, A. M., Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). Intercostal Neurolysis for The Treatment of Postsurgical Thoracic Pain: a Case Series. Muscle & nerve, 58(5), 671–675. doi.org/10.1002/mus.26298
Choi, E. J., Choi, Y. M., Jang, E. J., Kim, J. Y., Kim, T. K., & Kim, K. H. (2016). Neural Ablation and Regeneration in Pain Practice. The Korean journal of pain, 29(1), 3–11. doi.org/10.3344/kjp.2016.29.1.3
O’Flaherty, D., McCartney, C. J. L., & Ng, S. C. (2018). Nerve injury after peripheral nerve blockade-current understanding and guidelines. BJA education, 18(12), 384–390. doi.org/10.1016/j.bjae.2018.09.004
Can individuals dealing with hip pain, find the relief they are looking for from spinal decompression to reduce their sciatica pain?
Introduction
When it comes to individuals doing everyday movements, the body can be in weird positions without pain or discomfort. Hence, people can stand or sit for prolonged periods and feel all right when doing strenuous activities. However, as the body ages, the surrounding muscles and ligaments can become weak and tight, while the spinal joints and discs start to be compressed and wear and tear. This is because many individuals make repetitive motions on their bodies that cause pain-like symptoms in the back, hips, neck, and body extremities, leading to referred pain in different body locations. When individuals are experiencing musculoskeletal pain in their bodies, it can cause overlapping risk profiles that can hinder the individual and cause them to be miserable. Additionally, when people experience musculoskeletal pain in their bodies, many will seek treatment to reduce the referred pain-like symptoms associated with the musculoskeletal pain. Today’s article will examine one type of musculoskeletal pain on the hips, how it can cause sciatica pain-like problems, and how treatments like decompression can reduce the pain-like effects of hip pain correlated with sciatica. We talk with certified medical providers who consolidate our patients’ information to provide numerous treatments to relieve hip pain associated with sciatica. We also inform and guide patients on how decompression can help reduce pain-like symptoms like sciatica and restore hip mobility. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from hip pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.
Hip Pain Associated With Sciatica
Do you often experience stiffness in your lower back and hips after sitting down for an excessive period? How about feeling radiating pain running down from your lower back to your legs? Or do you think your hip and thigh muscles become tight and weak, which is affecting your gait stability? Many individuals experiencing these pain-like issues are experiencing hip pain, and it can be an issue when it is not treated over time. Since hip pain is a common and disabling condition that is challenging to diagnose, many individuals often express localized pain in one of the three anatomic regions: the anterior, posterior, and lateral hip sections. (Wilson & Furukawa, 2014) When individuals are dealing with hip pain, they will also experience referred pain in their lower backs, which causes them to be in distress and miserable. At the same time, simple ordinary movements like sitting or standing can affect the muscles and ligaments surrounding the hips and can be damaging. This can cause hip pain to be referred from the lumbar spine and spine problems, which then cause musculoskeletal issues in the lower extremities. (Lee et al., 2018)
So, how would hip pain be associated with sciatica and causing pain in many lower extremities? The hip areas in the musculoskeletal system have numerous muscles surrounding the pelvic bone area that can become tight and weak, causing referred musculoskeletal pain from intrapelvic and gynecologic issues. (Chamberlain, 2021) This means that musculoskeletal disorders like piriformis syndromes associated with hip pain can lead to sciatica. The sciatic nerve travels down from the lumbar region and the buttocks and behind the leg. When a person is dealing with sciatica and is going to their primary doctor to get treated for the pain, their doctors will do a physical examination to see what factors are causing the pain. Some of the common findings during a physical exam were tenderness and palpation of the greater sciatic notch and the reproduction of pain along the hips. (Son & Lee, 2022) This causes associated symptoms that correlate with sciatica and hip pain, including:
Tingling/numbing sensations
Muscle tenderness
Pain while sitting or standing
Discomfort
Is Motion The Key To Healing- Video
Spinal Decompression Reducing Hip Pain
However, many individuals will find non-surgical treatments to help reduce sciatica associated with hip pain. Non-surgical treatments are customized to a person’s pain and are cost-effective while being gentle on the spine. Spinal decompression can help reduce hip pain associated with sciatica. Decompression on the spine allows gentle traction to stretch out weak muscles along the lower back and hips while the spinal discs are experiencing negative pressure. When a person is dealing with sciatica pain associated with hip pain and trying decompression for the first time, they are provided with the relief they deserve. (Crisp et al., 1955)
Additionally, many individuals who incorporate decompression for their hip pain can begin to feel its effects as it helps improve blood flow circulation back to the hips to start the natural healing process. (Hua et al., 2019) When people begin incorporating decompression for their hip pain, they can relax as they feel all their aches and pain gradually disappear as mobility and rotation are back on the lower extremities.
References
Chamberlain, R. (2021). Hip Pain in Adults: Evaluation and Differential Diagnosis. American Family Physician, 103(2), 81-89. www.ncbi.nlm.nih.gov/pubmed/33448767
Crisp, E. J., Cyriax, J. H., & Christie, B. G. (1955). Discussion on the treatment of backache by traction. Proc R Soc Med, 48(10), 805-814. www.ncbi.nlm.nih.gov/pubmed/13266831
Hua, K. C., Yang, X. G., Feng, J. T., Wang, F., Yang, L., Zhang, H., & Hu, Y. C. (2019). The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis. J Orthop Surg Res, 14(1), 306. doi.org/10.1186/s13018-019-1359-7
Lee, Y. J., Kim, S. H., Chung, S. W., Lee, Y. K., & Koo, K. H. (2018). Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study. J Korean Med Sci, 33(52), e339. doi.org/10.3346/jkms.2018.33.e339
Son, B. C., & Lee, C. (2022). Piriformis Syndrome (Sciatic Nerve Entrapment) Associated With Type C Sciatic Nerve Variation: A Report of Two Cases and Literature Review. Korean J Neurotrauma, 18(2), 434-443. doi.org/10.13004/kjnt.2022.18.e29
Wilson, J. J., & Furukawa, M. (2014). Evaluation of the patient with hip pain. American Family Physician, 89(1), 27-34. www.ncbi.nlm.nih.gov/pubmed/24444505
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
