Back Clinic Sciatica Chiropractic Team. Dr. Alex Jimenez organized a variety of article archives associated with sciatica, a common and frequently reported series of symptoms affecting a majority of the population. Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move. The pain most often occurs on one side.
Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower back and runs down the back of each leg as it controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot. Dr. Jimenez explains how sciatica and its symptoms can be relieved through the use of chiropractic treatment. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
For individuals considering acupuncture for sciatica relief and management, can knowing how it works and what to expect during a session help in making the decision?
Acupuncture Sciatica Treatment Session
Acupuncture for sciatica is a safe and effective medical treatment to relieve and manage pain symptoms. Studies suggest it is as effective as other treatment strategies and causes fewer side effects. (Zhihui Zhang et al., 2023) The frequency of acupuncture to relieve sciatica pain depends on the severity of the condition and injury, but many report improvement within two to three weeks. (Fang-Ting Yu et al., 2022)
Needle Placement
Circulation problems can cause the body’s energy to stagnate in one or more meridians/channels, leading to pain in and around the surrounding area. (Wei-Bo Zhang et al., 2018)
The objective of acupuncture is to restore optimal circulation by stimulating specific points in the body called acupoints.
Thin, sterile needles stimulate the acupoints to activate the body’s natural healing abilities and relieve pain. (Heming Zhu 2014)
Some practitioners use electroacupuncture – a gentle, mild electrical current is applied to the needles and passes through the tissues to activate the nervous system. (Ruixin Zhang et al., 2014)
Acupoints
Acupuncture sciatica treatment involves specific acupoints along the bladder and gallbladder meridians.
Bladder Meridian – BL
The bladder meridian/BL runs down the back along the spine, hips, and legs. The acupoints within the meridian for sciatica include: (Fang-Ting Yu et al., 2022)
BL 23 -Shenshu – Location on the lower back, near the kidney.
BL 25 – Dachangshu – Location on the lower back.
BL 36 – Chengfu – Location on the back of the thigh, just below the buttocks.
GB 30 – Huantiao – Location on the back, where the buttocks meet the hips.
GB 34 – Yanglingquan – Location on the outside of the leg, below the knee.
GB 33 – Xiyangguan – Location lateral to the knee, on the side.
Stimulating acupoints in these meridians increases blood flow to the area, reduces inflammation, and releases endorphins and other pain-relieving neurochemicals to relieve symptoms. (Ningcen Li et al., 2021) The specific acupoints vary depending on symptoms and the root cause. (Tiaw-Kee Lim et al., 2018)
Example Patient
An example of acupuncture sciatica treatment session: A patient with persistent shooting pain extending down the back and side of the leg. A standard treatment consists of the following:
The acupuncturist thoroughly goes over the patient’s medical history and symptoms and has the patient point to where the pain is located.
Then, they palpate on and around the area to find where the pain worsens and lessens, communicating with the patient as they go along.
Depending on the site and severity, they may start placing needles at the lower back, focusing on the site of the injury.
Sometimes, the sacrum is involved, so the acupuncturist will place needles on those acupoints.
They then move to the back of the leg and insert needles.
The needles are retained for 20-30 minutes.
The acupuncturist leaves the room or treatment area but regularly checks in.
The patient may feel a warmth, tingling, or mild heaviness, which is a normal response. This is where patients report a calming effect. (Shilpadevi Patil et al., 2016)
The needles are carefully removed.
The patient may feel deeply relaxed and will be advised to get up slowly to avoid dizziness.
There may be soreness, redness, or bruising at the needle insertion site, which is normal and should resolve quickly.
The patient will be given recommendations as to avoiding strenuous activity, properly hydrating, and performing gentle stretches.
Acupuncture Benefits
Acupuncture has been shown to be a complementary therapy for pain relief and management. The benefits of acupuncture:
Improves Circulation
Acupuncture stimulates blood circulation, which nourishes damaged or irritated nerves and promotes healing.
This helps relieve sciatica symptoms, like numbness, tingling, and pain. (Song-Yi Kim et al., 2016)
Releases Endorphins
Acupuncture triggers the release of endorphins and other natural pain-relieving chemicals, which help relieve pain. (Shilpadevi Patil et al., 2016)
Regulates the Nervous System
Acupuncture rebalances the sympathetic and parasympathetic responses, which reduces stress, tension, and pain. (Xin Ma et al., 2022)
Relaxes the Muscles
Nerve pain often accompanies muscle tension and spasms.
Acupuncture relaxes tight muscles, reducing pressure and providing relief. (Zhihui Zhang et al., 2023)
From Symptoms to Solutions
References
Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Frontiers in neuroscience, 17, 1097830. doi.org/10.3389/fnins.2023.1097830
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., Wan, W. J., … 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
Zhang, W. B., Jia, D. X., Li, H. Y., Wei, Y. L., Yan, H., Zhao, P. N., Gu, F. F., Wang, G. J., & Wang, Y. P. (2018). Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance. Chinese journal of integrative medicine, 24(4), 304–307. doi.org/10.1007/s11655-017-2791-3
Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. doi.org/10.1089/acu.2014.1057
Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology, 120(2), 482–503. doi.org/10.1097/ALN.0000000000000101
Perreault, T., Fernández-de-Las-Peñas, C., Cummings, M., & Gendron, B. C. (2021). Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms-A Scoping Review. Journal of clinical medicine, 10(10), 2189. doi.org/10.3390/jcm10102189
Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., Chen, Z., Dou, B., Lin, X., Chen, B., Chen, Z., Xu, Z., & Lyu, Z. (2021). The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of inflammation research, 14, 7191–7224. doi.org/10.2147/JIR.S341581
Lim, T. K., Ma, Y., Berger, F., & Litscher, G. (2018). Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines (Basel, Switzerland), 5(3), 63. doi.org/10.3390/medicines5030063
Kim, S. Y., Min, S., Lee, H., Cheon, S., Zhang, X., Park, J. Y., Song, T. J., & Park, H. J. (2016). Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2016, 9874207. doi.org/10.1155/2016/9874207
Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. doi.org/10.1007/s11916-016-0552-1
Ma, X., Chen, W., Yang, N. N., Wang, L., Hao, X. W., Tan, C. X., Li, H. P., & Liu, C. Z. (2022). Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Frontiers in neuroscience, 16, 940343. doi.org/10.3389/fnins.2022.940343
Can the effects of electroacupuncture reduce sciatica in individuals dealing with low back pain to restore their mobility?
Introduction
When many people start to overuse their muscles in the lower quadrants, it can lead to numerous issues that cause pain and discomfort. One of the most common pain issues in the lower quadrants of the musculoskeletal system is sciatica, which is associated with low back pain. This pain duo can affect a person’s daily routine and lead them to pain and discomfort. This musculoskeletal condition is common, and when it affects one of the legs and lower back, many people state that it’s a radiating shooting pain that doesn’t go away for a while. Luckily, there are treatments like electroacupuncture to reduce sciatica associated with low back pain. Today’s article looks at the sciatica-low-back connection, how electroacupuncture reduces this pain connection, and how electroacupuncture can restore mobility to the individual. We talk with certified medical providers who consolidate our patients’ information to assess how to reduce the sciatica-low-back connection with electroacupuncture. We also inform and guide patients on how electroacupuncture therapy can be combined with other therapies to restore mobility to the body. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating electroacupuncture therapy as part of their routine to reduce sciatica associated with low back pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Sciatica & Low Back Connection
Do you feel muscle aches or pain in your lower back or your legs? Do you experience radiating, throbbing pain in your legs that affects your walking ability? Or have you noticed that your legs and lower back ache more when carrying a heavy object? Many of these scenarios are associated with sciatica, which correlates with lower back pain. Now, sciatica is often characterized by aggravating pain traveling along the sciatic nerve from the lower back region, impairing a person’s quality of life. In the musculoskeletal system, the sciatic nerve plays an important role by providing motor function to the legs. (Davis et al., 2024) Now, when the sciatic nerve, the lumbar region also has a pivotal role. The lumbar region in the musculoskeletal region also has a crucial role in providing support, strength, and flexibility to the body. However, both the sciatic nerve and lumbar spinal region are more prone to stress and injuries from traumatic injuries and environmental factors that can impact the lumbar spinal discs and the sciatic nerve.
Repetitive motions, obesity, improper lifting, degenerative spinal issues, and musculoskeletal conditions are a few causes and risk factors contributing to the development of sciatica associated with the lower back. What eventually happens is that the water content and the progressive loss of the proteoglycans of the spinal discs break down between the vertebrae and protrude out to press on the sciatic nerve, which then can become irritated and cause referred radiating pain in the legs and lower back. (Zhou et al., 2021) The combination of sciatica and lower back pain can become a socio-economic issue depending on the severity of the pain that the sciatic nerve is causing and can make individuals miss out on any activities they are participating in. (Siddiq et al., 2020) While sciatica pain-like symptoms often correlate with the lumbar region, many individuals can find the relief they are looking for through various treatments.
Sciatica Causes- Video
Electroacupuncture Reducing The Sciatica-Low Back Connection
When it comes to reducing the sciatic-low-back connection, many individuals seek out treatment that is affordable and effective in decreasing pain-like issues. Non-surgical treatments like electroacupuncture can be beneficial to many individuals who are experiencing sciatica pain correlated with the lower back. Electroacupuncture is another form of traditional acupuncture therapy that originates in China. Highly trained acupuncturists follow the same acupuncture principles by placing solid thin needles at different acupoints in the body to restore qui or chi (energy flow). Electroacupuncture combines needles and electrostimulation to reduce the central pain-regulatory mechanisms causing low back pain and sciatica by blocking the pain signals and providing pain relief. (Kong, 2020) At the same time, electroacupuncture offers analgesic properties to stimulate endorphins and reduce pain medication for low back pain safely. (Sung et al., 2021)
Electroacupuncture Restoring Mobility
When the lower extremities are experiencing limited mobility due to sciatica associated with low back pain, electroacupuncture can help relax the muscles that are aggravating the sciatic nerve and even help improve blood flow to the lumbar muscles. That is because electroacupuncture can stimulate specific body regions to reduce the somato-vagal-adrenal reflexes to relieve and restore mobility to the lower extremities. (Liu et al., 2021) Additionally, electroacupuncture can be combined with other non-surgical therapies to help strengthen the core and lower back muscles, allowing people to be more mindful of what factors are causing sciatica and lower back pain. By doing this, many people struggling with sciatica associated with low back pain can incorporate electroacupuncture as part of their treatment program combined with holistic approaches to improving their quality of life and providing a pathway to improving their mobility.
Kong, J. T. (2020). Electroacupuncture for Treating Chronic Low-Back Pain: Preliminary Research Results. Med Acupunct, 32(6), 396-397. doi.org/10.1089/acu.2020.1495
Liu, S., Wang, Z., Su, Y., Qi, L., Yang, W., Fu, M., Jing, X., Wang, Y., & Ma, Q. (2021). A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis. Nature, 598(7882), 641-645. doi.org/10.1038/s41586-021-04001-4
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
Sung, W. S., Park, J. R., Park, K., Youn, I., Yeum, H. W., Kim, S., Choi, J., Cho, Y., Hong, Y., Park, Y., Kim, E. J., & Nam, D. (2021). The effectiveness and safety of electroacupuncture for nonspecific chronic low back pain: A protocol for systematic review and/or meta-analysis. Medicine (Baltimore), 100(4), e24281. doi.org/10.1097/MD.0000000000024281
Zhou, J., Mi, J., Peng, Y., Han, H., & Liu, Z. (2021). Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne), 12, 740200. doi.org/10.3389/fendo.2021.740200
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
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
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
The discs between the spine’s vertebrae provide cushioning and shock absorption in the spine and the rest of the body. Degenerative changes to the discs are believed to be the start of spinal stenosis. When the discs lack sufficient hydration/water and disc height decreases over time, the cushioning and shock absorption becomes less and less effective. The vertebrae can then become compressed, causing friction. Degenerative spinal stenosis can also develop from excess scar tissue and bone spurs (growth that develops on the edge of a bone) that can form after injury or spinal surgery.
Assessment
A physician will make a diagnosis of spinal stenosis. The doctor will take an imaging scan of the spine to determine the exact location of the degeneration and to measure how narrow the openings have become. Pain, stiffness, limited mobility, and loss of range of motion are often present. If spinal stenosis has caused nerve compression, there may also be pain, numbness, tingling, or weakness in the buttocks (sciatica), thighs, and lower legs. A physical therapist will determine the degree by assessing the following:
Vertebrae mobility – how the spine bends and twists in different directions.
Ability to change positions.
The strength of the core, back, and hip muscles.
Balance
Posture
Gait pattern
Nerve compression to determine if there are any symptoms in the legs.
Milder cases usually do not involve nerve compression, as back stiffness is more common.
In more severe cases, there may be significant pain, limited mobility, and nerve compression, causing leg weakness.
The most common symptom of spinal stenosis is increased pain with backward bending or extension of the lumbar spine. This includes positions that extend the spine, such as standing, walking, and lying on the stomach. Symptoms usually improve when bending forward and when the spine is positioned more into a flexed or bent position, like when sitting and reclining. These body positions open up the spaces in the central spinal canal.
Surgery
Spinal stenosis is the most common reason for undergoing surgery in adults 65 and older. However, surgery is almost always performed as a last resort if pain, symptoms, and disability persist after trying conservative therapies, including chiropractic, non-surgical decompression, and physical therapy, for months or years. The severity of symptoms and current state of health will determine whether a doctor will recommend surgery. (Zhuomao Mo, et al., 2018). Conservative measures can be safer and just as effective. A systematic review or study based on all available primary research found that physical therapy and exercise resulted in similar outcomes to surgery for improving pain and disability. (Zhuomao Mo, et al., 2018). Except for severe cases, surgery is often not necessary.
Physical Therapy for Spinal Stenosis
The objective of physical therapy includes:
Decreasing pain and joint stiffness.
Relieving nerve compression.
Reducing tightness in the surrounding muscles.
Improving the range of motion.
Improving postural alignment.
Strengthening the core muscles.
Improving leg strength to help with balance and overall function.
Stretching of the back muscles, including those running vertically along the spine and those running diagonally from the pelvis to the lumbar spine, helps relieve muscle tightness and pain and can improve overall mobility and range of motion of the lumbar spine.
Stretching the hip muscles, including the hip flexors in the front, the piriformis in the back, and the hamstrings that run from the back of the hip down the leg to the knee, is also important as these muscles are attached to the pelvis, which directly connects to the spine.
Exercises for strengthening the abdominal core muscles, including the muscles in the trunk, pelvis, lower back, hips, and abdomen, help stabilize the spine and protect it from excessive movement and compressive forces.
With spinal stenosis, the core muscles often become weak and inactive and unable to do their job to support the spine. Core exercises often begin by activating the deep abdominal muscles while lying flat on the back with the knees bent.
Exercises will progress as the individual gains more strength and control as the spine stabilizes.
Spinal stenosis physical therapy will also involve balance training and glute exercises for strengthening the leg muscles.
Prevention
Working with a physical therapist can help prevent future problems by maintaining spinal mobility, keeping the individual active, and exercising to maintain strength and stability to provide a solid foundation to support the lower back and prevent symptoms from worsening.
Severe Spinal Stenosis Physical Therapy
Physical therapy usually involves performing stretches for the lower back, hips, and legs, mobility exercises, and core strengthening exercises to improve spinal support and decrease pain. Treatments like heat or electrical stimulation may also be used on a case-by-case basis if there is significant pain or tightness in the back muscles. However, there is not enough clinical evidence to support that there are additional benefits. (Luciana Gazzi Macedo, et al., 2013) The effectiveness of physical therapy is high because surgery alone cannot strengthen the muscles that stabilize the spine, increase the mobility or flexibility of the surrounding muscles, and improve postural alignment.
The Root Causes of Spinal Stenosis
References
Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. doi.org/10.1136/bmj.h6234
Mo, Z., Zhang, R., Chang, M., & Tang, S. (2018). Exercise therapy versus surgery for lumbar spinal stenosis: A systematic review and meta-analysis. Pakistan journal of medical sciences, 34(4), 879–885. doi.org/10.12669/pjms.344.14349
Macedo, L. G., Hum, A., Kuleba, L., Mo, J., Truong, L., Yeung, M., & Battié, M. C. (2013). Physical therapy interventions for degenerative lumbar spinal stenosis: a systematic review. Physical therapy, 93(12), 1646–1660. doi.org/10.2522/ptj.20120379
Individuals that have gone through a back injury may develop a synovial spinal cyst as a way to protect the spine that could cause pain symptoms and sensations. Can knowing the signs help healthcare providers develop a thorough treatment plan to relieve pain, prevent worsening of the condition and other spinal conditions?
Spinal Synovial Cysts
Spinal synovial cysts are benign fluid-filled sacs that develop in the spine’s joints. They form because of spinal degeneration or injury. The cysts can form anywhere in the spine, but most occur in the lumbar region/lower back. They typically develop in the facet joints or junctions that keep the vertebrae/spinal bones interlocked.
Symptoms
In most cases, synovial cysts don’t cause symptoms. However, the doctor or specialist will want to monitor for signs of degenerative disc disease, spinal stenosis, or cauda equina syndrome. When symptoms do present, they typically cause radiculopathy or nerve compression, which can cause back pain, weakness, numbness, and radiating pain caused by the irritation. The severity of symptoms depends on the size and location of the cyst. Synovial cysts can affect one side of the spine or both and can form at one spinal segment or at multiple levels.
Effects Can Include
Radiculopathy symptoms can develop if the cyst or inflammation caused by the cyst comes into contact with a spinal nerve root. This can cause sciatica, weakness, numbness, or difficulty controlling certain muscles.
Neurogenic claudication/impingement and inflammation of spinal nerves can cause cramping, pain, and/or tingling in the lower back, legs, hips, and buttocks. (Martin J. Wilby et al., 2009)
If the spinal cord is involved, it may cause myelopathy/severe spinal cord compression that can cause numbness, weakness, and balance problems. (Dong Shin Kim et al., 2014)
Symptoms related to cauda equina, including bowel and/or bladder problems, leg weakness, and saddle anesthesia/loss of sensation in the thighs, buttocks, and perineum, can present but are rare, as are synovial cysts in the middle back and neck. If thoracic and cervical synovial cysts develop, they can cause symptoms like numbness, tingling, pain, or weakness in the affected area.
Causes
Spinal synovial cysts are generally caused by degenerative changes like osteoarthritis that develop in a joint over time. With regular wear and tear, facet joint cartilage/the material in a joint that provides protection, a smooth surface, friction reduction, and shock absorption begins to waste away. As the process continues, the synovium can form a cyst.
Traumas, large and small, have inflammatory and degenerative effects on joints that can result in the formation of a cyst.
Around a third of individuals who have a spinal synovial cyst also have spondylolisthesis.
This condition is when a vertebrae slips out of place or out of alignment onto the vertebra underneath.
It is a sign of spinal instability.
Instability can occur in any spine area, but L4-5 are the most common levels.
This segment of the spine takes most of the upper body weight.
Epidural corticosteroid injections can reduce inflammation and could be an option to relieve pain.
Patients are recommended to receive no more than three injections per year.
Surgical Options
For severe or persistent cases, a doctor may recommend decompression surgery to remove the cyst and surrounding bone to relieve pressure on the nerve root. Surgical options range from minimally invasive endoscopic procedures to larger, open surgeries. The best surgical option varies based on the severity of the situation and whether associated disorders are present. Surgical options include:
Laminectomy – Removal of the bony structure that protects and covers the spinal canal/lamina.
Hemilaminectomy – A modified laminectomy where a smaller portion of the lamina is removed.
Facetectomy – The removal of part of the affected facet joint where the synovial cyst is located, usually following a laminectomy or hemilaminectomy.
Fusionof the facet joints and vertebra – Decreases vertebral mobility in the injured area.
Most individuals experience immediate pain relief following a laminectomy or hemilaminectomy.
Fusion can take six to nine months to heal completely.
If surgery is performed without fusion where the cyst originated, the pain could return, and another cyst could form within two years.
Surgery Complications include infection, bleeding, and injury to the spinal cord or nerve root.
How I Gained My Mobility Back With Chiropractic
References
Wilby, M. J., Fraser, R. D., Vernon-Roberts, B., & Moore, R. J. (2009). The prevalence and pathogenesis of synovial cysts within the ligamentum flavum in patients with lumbar spinal stenosis and radiculopathy. Spine, 34(23), 2518–2524. doi.org/10.1097/BRS.0b013e3181b22bd0
Kim, D. S., Yang, J. S., Cho, Y. J., & Kang, S. H. (2014). Acute myelopathy caused by a cervical synovial cyst. Journal of Korean Neurosurgical Society, 56(1), 55–57. doi.org/10.3340/jkns.2014.56.1.55
Epstein, N. E., & Baisden, J. (2012). The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration. Surgical neurology international, 3(Suppl 3), S157–S166. doi.org/10.4103/2152-7806.98576
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