Back Clinic Treatments. There are various treatments for all types of injuries and conditions here at Injury Medical & Chiropractic Clinic. The main goal is to correct any misalignments in the spine through manual manipulation and placing misaligned vertebrae back in their proper place. Patients will be given a series of treatments, which are based on the diagnosis. This can include spinal manipulation, as well as other supportive treatments. And as chiropractic treatment has developed, so have its methods and techniques.
Why do chiropractors use one method/technique over another?
A common method of spinal adjustment is the toggle drop method. With this method, a chiropractor crosses their hands and pressed down firmly on an area of the spine. They will then adjust the area with a quick and precise thrust. This method has been used for years and is often used to help increase a patient’s mobility.
Another popular method takes place on a special drop table. The table has different sections, which can be moved up or down based on the body’s position. Patients lie face down on their back or side while the chiropractor applies quick thrusts throughout the spinal area as the table section drops. Many prefer this table adjustment, as this method is lighter and does not include twisting motions used in other methods.
Chiropractors also use specialized tools to assist in their adjustments, i.e., the activator. A chiropractor uses this spring-loaded tool to perform the adjustment/s instead of their hands. Many consider the activator method to be the most gentle of all.
Whichever adjustment method a chiropractor uses, they all offer great benefits to the spine and overall health and wellness. If there is a certain method that is preferred, talk to a chiropractor about it. If they do not perform a certain technique, they may recommend a colleague that does.
Automobile accidents and crashes can cause all kinds of damage to the body even when the accident/crash is not severe. Physical symptoms might not present at all for several days, even weeks. This is known as having delayed injury symptoms. These can include:
Swelling.
Stiffness.
Aching.
Pain that radiates all over the body.
Sleep problems.
Headaches.
Brain fog.
Disorientation.
Memory problems.
Chiropractic and physical therapy rehabilitation can restore the body’s alignment, stop inflammation, loosen, stretch and strengthen the musculoskeletal system restoring optimal health.
Adrenaline
When the body is involved in a dangerous physical situation, it protects itself by releasing a surge of adrenaline. This hormone protects the body, causing the fight or flight response when in danger. Adrenaline causes several preservation responses that include:
Intense increase in energy.
Little or no pain.
Enlarged blood vessels and airways increase oxygen flow.
Increased strength from increased blood flow to the muscles.
Changes in vision and hearing that focus on sights and sounds all around.
Endorphins are released that make the body feel calm and in control.
Endorphins affect the way the body responds to pain and stress.
Individuals don’t start feeling aches and pains until the adrenaline and endorphins wear off. However, because everybody is different and the emergency response has turned off, the body still might not feel the injury symptoms. These are delayed injury symptoms.
Rate of Speed
When riding in a vehicle, the body moves at the same speed as the vehicle. During an impact, the vehicle stops, but the body continues moving until it stops, typically with a lot of force from the seatbelt, airbag, or other barriers. The intense momentum change can cause soft tissue damage and ligament or muscle strains from the stretching, pulling, contracting, and tearing. Also, the intervertebral discs can tear, bulge, or herniate over time, creating pressure on nerves and the surrounding tissues.
Delayed Injury Symptoms
Headaches
Headaches that develop days after an accident/crash are common.
They can signal a possible injury to the neck or head, a blood clot on the brain, or a concussion.
Back pain can be caused by injury to the muscles, ligaments, nerves, or damage to the vertebrae.
Low back pain occurs in more than half of rear-impact collisions and almost three-quarters of side-impact crashes.
Chiropractic Rehabilitation
After an accident, soft tissues can sustain minimal damage; however, the minimal damage left untreated can start to worsen and turn into a painful condition. Emergency room visits are to rule out major injuries like brain/nerve injuries, bleeding, punctures, lacerated organs, fractures that require emergency stabilization. Chiropractors look for other symptoms and mechanisms that indicate damage to the body’s soft tissues and nerves to see if they have been stretched or torn and dysfunction in the nervous system.
Body Composition
Calorie Counting
Counting calories can be a stepping stone to change behavior towards food. Tracking what foods are being taken into the body promotes mindfulness of dietary habits. Studies on the subject reveal a significant association between self-monitoring and weight loss. Takeaways include:
Take small steps by saying no to second portions during dinner or take a healthy sweet snack or piece of fruit instead of a pastry, cookie, etc.
Try to start making a habit of eating less processed foods.
Meals high in protein and fiber are generally more filling, making the body feel fuller from fewer calories.
The more attention there is to the food choices, the more likely reexamination occurs.
References
Burke, Lora E et al. “Self-monitoring in weight loss: a systematic review of the literature.” Journal of the American Dietetic Association vol. 111,1 (2011): 92-102. doi:10.1016/j.jada.2010.10.008
D’Elia, Michael A et al. “Motor vehicle collision with seatbelt sign and traumatic abdominal wall hernia should raise suspicion for hollow viscus injury.” Trauma case reports vol. 22 100206. 25 May. 2019, doi:10.1016/j.tcr.2019.100206
Kacprzynski, Gregory, and Joshua Bucher. “Delayed vertebral artery dissection after mild trauma in a motor vehicle collision.” The American Journal of emergency medicine vol. 45 (2021): 678.e1-678.e2. doi:10.1016/j.ajem.2020.11.028
Olinger, Catherine, and Richard Bransford. “Upper Cervical Trauma.” The Orthopedic clinics of North America vol. 52,4 (2021): 451-479. doi:10.1016/j.ocl.2021.05.013
Sterling, Michele. “Whiplash-associated disorder: musculoskeletal pain and related clinical findings.” The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949
Tremors are extremely rare, but they can result from spinal compression and not necessarily a brain condition like Parkinson’s disease. Tremors are abnormal, involuntary body movements with various causes, most of which are connected to the brain and not the spine. A study reports that more than 75% of individuals with Parkinson’s experienced a resting tremor, and about 60% experience tremors while moving. Sometimes the spine is the contributor caused by compression of the spinal cord.
Spinal Compression Study
A 90-year-old man was hospitalized after having tremors, with Parkinson’s being the initial diagnosis. The tremors progressed to the point where the man could not feed himself or walk without support. The case became the focus of a medical report published by physicians in the Department of Orthopaedic Surgery, Division of the Spine, Singapore Tan Tock Seng Hospital. Along with the tremors, symptoms progressed to:
Difficulty with fine motor skills like buttoning a shirt.
However, it was ruled out because the patient was not presenting with other Parkinson’s symptoms.
For individuals with cervical spondylotic myelopathy tremors, surgery can be used to help the condition. However, with cervical myelopathy, there is often some permanent damage. Individuals have shown that post-surgery and decompression, symptoms still present, maybe not as much, but there will be a need for a symptom management plan.
Prevention
The best way to prevent tremors associated with cervical spondylotic myelopathy is to minimize the strain on the spine that can lead to herniated discs and/or other spinal injuries. The discs in the spine degenerate, dry out and start cracking with age, increasing the risk of rupture. If a tremor develops, contact a doctor, spine specialist, or chiropractor to help diagnose the condition. These doctors can perform physical and neurological tests to determine the cause and treatment options.
Body Composition
Aging Health
Steady weight gain throughout life can lead to adult-onset diabetes. This is partly caused by having more body fat and progressive muscle loss. Loss of skeletal muscle mass is linked to insulin resistance that involves:
The less muscle is available, the less insulin sensitive the body becomes.
As insulin sensitivity decreases, the body becomes more resistant, increasing risk factors for type II diabetes.
This can lead to osteoporosis, where the old bone is reabsorbed more and less new bone is created.
Both men and women can experience decreased muscle mass that can lead to:
Thinner bones
Weaker bones
Increased risk of osteoporosis and severe injury from falls.
To help prevent these issues, it is recommended to:
It is recommended to space out protein intake across meals rather than consuming it all at once. This helps to ensure the proper amount is acquired.
Monitoring body composition regularly can help minimize muscle mass loss and fat mass gain as the body ages.
A regular strength training routine will help strengthen bones muscles and maintain optimal circulation.
References
Heusinkveld, Lauren E et al. “Impact of Tremor on Patients With Early Stage Parkinson’s Disease.” Frontiers in neurology vol. 9 628. 3 Aug. 2018, doi:10.3389/fneur.2018.00628
Jancso, Z et al. “Differences in weight gain in hypertensive and diabetic elderly patients primary care study.” The Journal of nutrition, health & aging vol. 16,6 (2012): 592-6. doi:10.1007/s12603-011-0360-6
Srikanthan, Preethi, and Arun S Karlamangla. “Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey.” The Journal of clinical endocrinology and metabolism vol. 96,9 (2011): 2898-903. doi:10.1210/jc.2011-0435
Tapia Perez, Jorge Humberto et al. “Treatment of Spinal Myoclonus Due to Degenerative Compression Myelopathy with Cervical Spinal Cord Stimulation: A Report of 2 Cases.” World neurosurgery vol. 136 (2020): 44-48. doi:10.1016/j.wneu.2019.12.170
Sports chiropractic athletes: A sports chiropractor is a specialist that works with athletes to improve their performance. These doctors specialize in assessing and treating sports injuries. Treatment also prevents future damage/injury by providing a customized rehabilitation, strengthening, flexibility, and mobility program, that includes:
Exercise prescription
Ergonomic recommendations
Health coaching/counseling
Therapeutic sports massage
Sports chiropractic deals with preventing, diagnosing, and treating sports-athletic-based injuries to muscles, tendons, ligaments, and joints. Sports chiropractors have extensive training in evaluating muscular-skeletal problems related to sports participation overuse. Diagnosis is acquired through:
Chiropractors are masters of the human body and trained to use advanced diagnostics tools. A sports chiropractor evaluates individuals from all levels of sports and fitness, including:
Athletes – professional or recreational
Weekend warriors
Military personnel
The objective is to identify musculoskeletal problems related to sporting activity or overuse, alleviate pain, rehabilitate, and strengthen to prevent future injury. They can diagnose and treat sports-related injuries from common overuse injuries like:
Hip pain from frequently running on pavement.
Shoulder pain from damage caused by continued overhead throwing or hitting.
Low back and leg issues from twisting, bending, jumping, and reaching.
Balance
Athletes need a healthy balance of endurance, strength, and structure. Through biomechanics training, sports chiropractic restores the body’s natural balance and proper function. The goal is to get the athlete re-engaged and protected against further injury and play without any problems or limitations. Sports chiropractic athletes can return in a short amount of time from injuries that include:
Torn ACLs
MCL Sprain
Ankle Sprain
Achilles Tendonitis
Rotator cuff tears
Quadriceps Strains
Hamstrings Strains
Shin Splints
Sports Hernia
Neck Pain
Back Pain
Spondylolisthesis
Prevention Regimen
They can recommend prevention programs to prevent potential problems before an athlete gets hurt. A chiropractor will detect developing muscle imbalances before they turn into a chronic condition that can lead to damage to the rest of the body. Additional therapies include:
Massage
Hot/cold treatments
Ultrasound therapy
Low-level laser therapy
Adjustments, stretching, core training, therapeutic sports massage, health coaching, and nutritional counseling will strengthen the body, allowing for performing physical activities and sports at optimum levels.
Body Composition
Sports Performance
Working with sports chiropractic athletes means achieving a balance of lean mass to maintain sports performance and reduce the risk of injury. Athletes, doctors, and trainers monitor gains over time to maximize performance and watch for signs of potential injury. A method of monitoring for potential injury is the ECW/TBW Analysis. When training and engaging in sports, the body is under physical stress. The proper amount of rest and recovery are needed to allow muscles to recover and regrow. Inflammation is reflected in the ECW/TBW by monitoring changes over time. A steady increase can indicate a sign of overtraining or improper recovery. Monitoring this progression can alert doctors and trainers that an athlete needs a less intense workout or longer recovery to reduce the potential for overtraining injury.
References
Corcoran, Kelsey L et al. “Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis.” Pain medicine (Malden, Mass.) vol. 21,2 (2020): e139-e145. doi:10.1093/pm/pnz219
Naqvi U, Sherman Al. Muscle Strength Grading. [Updated 2021 Sep 2]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK436008/
Nelson, Luke et al. “A descriptive study of sports chiropractors with an International Chiropractic Sports Science Practitioner qualification: a cross-sectional survey.” Chiropractic & manual therapies vol. 29,1 51. 13 Dec. 2021, doi:10.1186/s12998-021-00405-1
Williams, Sean et al. “Kinesio taping in treatment and prevention of sports injuries: a meta-analysis of the evidence for its effectiveness.” Sports medicine (Auckland, N.Z.) vol. 42,2 (2012): 153-64. doi:10.2165/11594960-000000000-00000
Sciatica motor vehicle crash. After an automobile crash/accident, symptoms of pain and discomfort can immediately follow the force of impact, indicating an injury. Many injuries and symptoms appear right away, like:
Pain from high-impact trauma and cuts.
Bone fractures.
Dislocations.
Neck whiplash.
Back pain.
The sciatic nerve is the largest in the body, and any damage can cause pain in one or both sides of the body. Pressure and compression on the nerves, ligaments, and muscles accompanied by weakness or numbness in the lower back, legs, or feet could cause delayed sciatica symptoms hours, days, even weeks later. It is critical to meet with a doctor and auto accident chiropractor after any type of accident, large or small, to develop a thorough personalized treatment plan.
Sciatica Motor Vehicle Crash
Sciatica can be brought on by a pinched nerve, which is often the result of the spine shifting out of place, causing herniation and compression on the sciatic nerve. The trauma from a motor vehicle accident can cause the spinal discs to be knocked out of place, rupture, and leak out, irritating the surrounding tissue and nerve endings. Back injuries are among the most common forms of damage/injury resulting from a motor vehicle accident/crash that can lead to sciatica. Broken and/or fractured vertebral, hip, or pelvis bone fragments can compress the sciatic nerve. Even when the initial result of the impact does not result in sciatica, over time, an untreated back injury could lead to sciatica symptoms.
Symptoms
Motor vehicle crashes often activate or aggravate pre-existing conditions like asymptomatic degenerative disc disease, affecting the sciatic nerve causing discomfort and pain. Common symptoms include:
Mild discomfort or achiness.
Tingling sensations from the lower back and down the back of the leg.
Weakness, numbness, or difficulty moving the leg and foot.
Inability to bend the foot upward at the ankle- known as foot drop.
Constant pain in one side of the buttocks or leg.
Sharp pain that makes it difficult to stand up and walk
Difficulty sitting.
Burning or tingling in one leg can worsen when sitting.
Intense pain.
Sharp burning and/or what feels like shooting electricity pain.
Diagnosis
A spine doctor and chiropractor will use diagnostic imaging tools like X-rays, and CT scans to see the scope of the injured area.
An X-ray will show a detailed image of the spine and affected bones in the area.
A CT scan will include a 3D image that shows the surrounding musculature, tissues, and nerves that could be damaged/injured.
Treatment
The doctor and chiropractor will then develop an appropriate and personalized treatment plan that could utilize various methods and techniques.
Chiropractic is commonly the first treatment to realign the spine and relieve pressure on the nerve.
A pain management specialist or physical therapist will be brought in for rehabilitation/recovery as adjustments progress.
Orthopedists and neurologists may be brought in for less conservative treatment in more severe cases, including surgical options.
Other treatments can include steroid injections or anti-inflammatory medicines to relieve nerve pressure.
Body Composition
Injury Rehabilitation Phase
Current in-clinic methods of measuring the composition of an injured body are indirect, while medically advanced techniques limit the frequency of testing. InBody provides cost-effective, comprehensive, and timely measurements that identify areas of weakness from damage, injury, or recent surgery and develop a customized rehabilitation program to improve functional status.
During the rehabilitation phase, increased sedentary behavior and/or immobilization causes muscle loss in the injured or operated region. By independently evaluating lean mass in each segment of the arms, legs, and torso, a chiropractor or physical therapist gathers baseline information on the body segments with restricted mobility.
InBody can help provide further insight into an individual’s body composition to analyze long-term health risks and develop a personalized exercise intervention to improve overall health and reduce health risks. This provides beneficial information for identifying potential imbalances related to muscle loss post-injury/surgery that can be targeted and improved. Identifying these imbalances allows the therapists to increase functional fitness and mobility, helping the individual reduce the risk of re-injury or new injuries.
References
Defouilloux, B et al. “A propos de trois observations chez des polytraumatisées de la route présentag une fracture du bassin associée à des signes neurologiques” [Apropos of 3 cases of multiple traffic injuries presenting pelvic fractures associated with neurologic signs]. Journal de radiologie, d’electrologie, et de medecine nucleaire vol. 48,8 (1967): 505-6.
Noble, J et al. “Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries.” The Journal of trauma vol. 45,1 (1998): 116-22. doi:10.1097/00005373-199807000-00025
Walsh, K et al. “Risk of low back pain in people admitted to hospital for traffic accidents and falls.” Journal of epidemiology and community health vol. 46,3 (1992): 231-3. doi:10.1136/jech.46.3.231
Sleeping with a bulging disc can be challenging for the body to achieve the proper rest. And sleeping in an awkward position can add stress to the spine, making the bulge worse, which can cause tingling, numbness, pain, and digestive problems. This can disrupt the sleep cycle and prevent proper healing of the spinal injury.
Sleeping With a Bulging Disc
When sleeping, most back pain occurs in the lumbar or lower back, in one of two places where the spine meets the pelvis. Around 95% of lower back herniations happen in the L4-L5 spinal segment or the L5-S1 Lumbosacral joint. Any back pain can turn into a vicious cycle of:
Sleeping with a bulging disc requires maintaining the ears, shoulders, and hips aligned to keep the spine aligned.
Sleeping on The Back
Back sleeping done correctly is the best way to sleep for the spine’s health. The important thing is to ensure the entire back is supported when sleeping. If there is a gap or space between the mattress and the back, the weight and gravity force the spine to lower in an unnatural way to fill the space. This can cause back muscle soreness, injury, and sciatica. A thin pillow, blanket, or towel can be used to fill the space, giving the spine the support it needs. Back sleepers can also benefit from a pillow or two under the knees to elevate the legs and help maintain the natural curve of the pine.
Sleeping on The Side
Side sleepers can try pulling the legs up toward the chest, and placing a pillow between the knees can provide relief when sleeping with a bulging disc. Pulling the legs up in the fetal position can relieve pressure on the discs. It is recommended to switch sides to keep the spine balanced. This helps maintain hip alignment, which helps keep the spine in a neutral position.
Sleeping On The Stomach
It is recommended to avoid sleeping on the stomach. This pulls the spine down into an unnatural curve that can cause and exacerbate back pain. For individuals that naturally stomach sleep, it is recommended to place a pillow under the hips and lower abdomen to prevent unnatural spinal positioning.
Chiropractic Relief
Utilizing the right sleeping position can provide pain relief and thorough rest. However, sleeping with a herniated disc is far from what is needed to get back to a normal healthy sleeping pattern. This depends on the location of the bulging disc, severity, and cause. A chiropractor can:
Help the individual develop an optimal sleeping routine and positioning.
Body Composition
Sleep and Growth Hormone In Children
Growth, in all ages, is primarily controlled by growth hormone. The hormone is regulated by the hypothalamus and pituitarygland which plays an important role in sleep. Growth hormone has been found:
It peaks during the beginning of deep sleep.
There are multiple smaller peaks during the other stages of sleep.
Those who have a delay at the beginning of deep sleep have delayed rises in growth hormone levels.
For children to grow they need to have proper levels of growth hormone. This means they need to have the proper amount of sleep for proper body composition. Research has found that increased levels of sleep resulted in less overall fat mass and a reduced percentage of body fat allowing their bodies to grow.
References
Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK560878/
Desouzart, Gustavo et al. ‘Effects of Sleeping Position on Back Pain in Physically Active Seniors: A Controlled Pilot Study. 1 Jan. 2016: 235 – 240.
Kose, Gulsah et al. “The Effect of Low Back Pain on Daily Activities and Sleep Quality in Patients With Lumbar Disc Herniation: A Pilot Study.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 51,4 (2019): 184-189. doi:10.1097/JNN.0000000000000446
Sener, Sevgi, and Ozkan Guler. “Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls.” The International Journal of prosthodontics vol. 25,4 (2012): 348-52.
Back pain and soreness are widespread conditions that affect all genders, races, and lifestyles. The causes for back pain are varied from injury, poor posture, arthritis, age, overuse, etc. If back pain is frequent, perhaps the last assumption is that the pain could be caused by cancer. While it’s far from the most common causes, cancer back pain is possible, which makes consulting a doctor that will figure out the root cause, especially if there are other non-related symptoms, and treat the back pain very important.
Cancer Back Pain
Back pain that could be caused by cancer usually occurs with other symptoms and include:
Back pain that is not related to movement.
Pain does not get worse with activity.
Back pain usually presents at night or early in the morning and fades away or improves as the day progresses.
Back pain persists even after physical therapy or other treatments.
Changes in bowel movements or blood in urine or stool.
Like lung cancers, some breast cancer tumors can press on nerves connected to the spine, causing discomfort and pain.
Gastrointestinal
Cancers of the stomach, colon, and rectum can cause back pain.
The pain radiates from where the cancer is to the back.
Tissue and Blood Cancers
Blood and tissue cancers like:
Multiple myeloma
Lymphoma
Melanoma
Can cause back pain.
Diagnosing Cancer and Back Pain
Medical treatments for back pain-related cancer depend on its type and how advanced it is. A doctor will consider symptoms and medical history when diagnosing possible back pain causes. Because cancer is a rare cause of back pain, a doctor may recommend various treatments before a full cancer work-up. The doctor may order imaging studies and blood testing if the pain persists after chiropractic, physical therapy, or anti-inflammatory medications. These tests will help identify potential cancer markers causing back pain.
Treatments usually include chemotherapy and radiation to shrink a tumor.
A doctor will recommend surgery to remove a tumor.
Chiropractic
Cancer patients have found chiropractic treatment to be effective for:
Pain management.
Flexibility improvement.
Mobility improvement.
Strengthening muscles.
Helping to reduce stress.
Helping the body function more efficiently.
Chiropractic physiotherapy benefits patients undergoing chemotherapy, as it helps the body withstand the debilitating effects of the treatment based on the whole-body approach.
Body Composition
Don’t Hate Dieting
Individuals hate dieting, usually because they go about it the wrong way. Individuals do not need to starve themselves and live at the gym. Reaching quick weight loss goals might sound appealing; however, going through it for an extended time can make individuals feel:
Tired
Depressed
Unmotivated
Individuals can find a nutrition plan/exercise balance that works for them and their lifestyle. For some individuals, dieting alone is effective, but more than likely, they have increased metabolisms. Trying to lose fat by only cutting calories can be difficult for individuals with smaller metabolisms. The goal is to find a balance between diet and exercise. This does not mean having to go on an extreme diet, skip meals, or cut out entire macronutrient groups like fat or carbs, as the body needs both of these nutrients. Finding a sustainable long-term nutrition plan takes planning and support. A dietician, nutritionist, or health coach can offer a variety of nutrition and exercise plans customized to the individual.
References
Downie, Aron et al. “Red flags to screen for malignancy and fracture in patients with low back pain: a systematic review.” BMJ (Clinical research ed.) vol. 347 f7095. 11 Dec. 2013, doi:10.1136/bmj.f7095
Mabry, Lance M et al. “Metastatic cancer mimicking mechanical low back pain: a case report.” The Journal of manual & manipulative therapy vol. 22,3 (2014): 162-9. doi:10.1179/2042618613Y.0000000056
Vasser, Melinda, and Matthew Koroscil. “When Back Pain Turns Deadly: An Unusual Presentation of Lung Cancer.” Respiratory medicine case reports vol. 29 101009. 28 Jan. 2020, doi:10.1016/j.rmcr.2020.101009
Verhagen, Arianne P et al. “Red flags presented in current low back pain guidelines: a review.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,9 (2016): 2788-802. doi:10.1007/s00586-016-4684-0
Sciatic nerve injury happens from trauma to the nerve and can cause numbness, tingling, loss of muscle power, and pain. The traumatic experience can be a muscle spasm that pulls and/or pinches the sciatic nerve, force/pressure impact injury, over-stretching injury, or a laceration/cutting injury. A slipped disk, or herniated disk, is the most common cause of irritation on the sciatic nerve. A slipped disk occurs when one becomes slightly dislodged, pushing out from the spine. This places pressure/compression on the sciatic nerve.
Trauma to the lower back, buttocks, or leg from an automobile accident, sports injury, work injury.
Medical treatment causes:
Direct surgical trauma.
Total hip replacement surgery can cause nerve compression and stretch during the procedure, causing damage to the sciatic nerve resulting in dysfunction.
Injection injuries via intramuscular injection in the gluteal region. This is a situation where there is a loss of movement and or lack of sensation at the affected lower extremity with or without pain.
Injection palsy can begin suddenly or hours following damage to the sciatic nerve.
A misplaced intramuscular injection at the gluteal region is the most common cause of injury. It is attributed to frequent injections or poor techniques resulting from inadequately trained or unqualified staff.
Complaints of radiating pain in the leg, which follows a sensory nerve pattern.
Pain radiates below the knee, into the foot.
Complaints of low back pain, which is often less severe than leg pain.
Report of electrical, burning, numbing sensations.
Diagnosis
A detailed subjective and objective physical examination is necessary to figure out the severity of the sciatic nerve injury. Diagnostic studies include:
Chiropractic and physical therapy exercises and stretches improve nerve regeneration after nerve damage.
Electrical Muscle Stimulation
TENS and Electroacupuncture have been shown to help enhance nerve regrowth.
Bio-laser stimulation can help with nerve nutrition and regeneration.
Joint or Soft Tissue mobilization
Helps to retain muscle, nerve, and soft tissue flexibility and prevent deformity.
Balance Training
Coordination, strength, and flexibility exercises help to restore balance.
Splinting
In the early stages after a sciatic nerve injury, bracing may be needed to prevent deformity and new injury or re-injury risks.
Ankle Foot Orthosis – AFO can help prevent foot drop, muscle damage, and falls risk.
Body Composition
Optimize Diet for Fat Loss
Individuals that want to lose fat need to create a calorie deficit. Individuals need to consistently eat less than they need for Total Daily Energy Expenditure – TDEE. The safest way to handle a caloric reduction is to reduce calorie intake in small doses like 200-300 calories, for example. After a week or two, perform a body composition analysis. If Fat Mass numbers begin to drop or not, adjust calorie needs accordingly. Restricting calories is the most common way, a deficit can also be created by increasing calorie needs through exercise.
References
Kline, D G et al. “Management and results of sciatic nerve injuries: a 24-year experience.” Journal of neurosurgery vol. 89,1 (1998): 13-23. doi:10.3171/jns.1998.89.1.0013
Schmalzried, TP et al. “Update on nerve palsy associated with total hip replacement.” Clinical Orthopedics and related research,344 (1997): 188-206.
Shim, Ho Yong et al. “Sciatic nerve injury caused by a stretching exercise in a trained dancer.” Annals of rehabilitation medicine vol. 37,6 (2013): 886-90. doi:10.5535/arm.2013.37.6.886
Suszyński, Krzysztof et al. “Physiotherapeutic techniques used in the management of patients with peripheral nerve injuries.” Neural regeneration research vol. 10,11 (2015): 1770-2. doi:10.4103/1673-5374.170299
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