Back Clinic Sciatica Nerve Pain Chiropractic, Physical Therapy Treatment Team. The common cause is a bulging or ruptured disc (herniated disc) in the spine pressing against the nerve roots that lead to the sciatic nerve. Sciatica nerve pain can also be a symptom of other conditions affecting the spine, such as narrowing of the spinal canal (spinal stenosis), bone spurs (small, bony growths that form along joints) caused by arthritis, or nerve root compression (pinched nerve) caused by injury. In rare cases, sciatica can also be caused by conditions that do not involve the spine, i.e. tumors or pregnancy.
What are the symptoms?
Pain that begins in your back or buttock and moves down your leg and may move into the foot. Weakness, tingling, or numbness in the leg may also occur.
Sitting, standing for a long time, and movements that cause the spine to flex (such as knee-to-chest exercises) may make symptoms worse.
Walking, lying down, and movements that extend the spine (such as press-ups) may relieve symptoms.For answers to any questions you may have please call Dr. Jimenez at 915-850-0900
Determining if sciatica pain and symptoms are showing improvement can be as simple as the pain significantly reducing or it could be a bit more complex, depending on the severity of the condition. Chiropractic treatment keeps track of the location and movement of the pain as a reliable indicator that complete relief is getting closer. When the pain retreats up the leg, it is a sign of improvement even with back and buttock aches/pain that feel like it’s worsening.
Various Symptoms
The most common symptoms include:
Tingling
Numbness
Sharp pain
Dull pain
Radiating/spreading pain
A feeling like insects crawling or water trickling down the leg
Changing sensations in the buttock, back, leg, or foot
Does It Get Worse Before Getting Better?
Sciatica can get worse before it gets better. This is known as centralization where the pain moves or retreats back towards the midline of the spine after repeated movements or guided/chiropractic positioning and adjusting. It can be misleading, making the individual think the sciatica is worsening, or that something has caused a sciatica flare-up. However, healing is taking place.The furthest location away from the low back is the area to pay attention to. It’s different for individuals. It could be the:
Foot
Calf
Back of the thigh
No matter where the pain is pay attention to that particular area. If it feels like the sciatica is getting worse, take a moment to determine where the pain is presenting. If the pain has retreated and there is no pain in the foot, calf, or leg, the sciatica is getting better. What happens is the retreating pain going up the spine increases the pain in the back and buttocks. This means there is an improvement.
Sciatica Getting Worse
How to tell if it’s getting worse? An increase in pain could indicate that it is getting worse. But, the key is to pay attention to the location and movement of the pain. When it gets worse the pain is advancing, for example, if there was pain only in the back and buttock yesterday, and today the pain is radiating down the back of the leg into the calf, then the sciatica is getting worse.
Length of Time Sciatic Nerve Pain Lasts
For most individuals, sciatic nerve pain lasts from two to six weeks.
The acute pain lasts around 1 to 2 weeks, with lingering discomfort as the condition heals
There are factors that can cause sciatica to remain longer, or increase the chances of returning This includes:
Tight hamstrings
Weight gain
Pregnancy
Poor posture
Improper lifting
Sciatica that lasts more than six weeks is considered chronic. Medical intervention should be sought out if it lasts this long. Non-invasive treatment like chiropractic or physical therapy is recommended to help speed the healing process and reduce pain.
Permanent Cure
Most sciatica cases are caused by a spinal disc disorder in the lower back. Around 85% of sciatica cases are disc-related. There is a chance that sciatica can return. For most individuals, it only takes a small amount of work to keep sciatica at bay. Staying healthy and flexible are two ways to prevent sciatica from returning. This can be done through:
Healthy diet
Maintain a healthy weight
Staying active with 2 ½ hours of physical activity/exercise a week
Maintain proper posture
Regular stretching
Quitting smoking
If overweight it is highly recommended to lose weight. One study showed that obesity increased the risk of hospitalization by 36%. Other factors that increase the potential for sciatica are frequent intense physical activity levels in sports, exercise, DIY projects, etc.
Chiropractic Improvement
Whether dealing with sciatica during pregnancy, from tight hamstrings, or piriformis syndrome, chiropractic can help. A chiropractor can bring relief through:
Surgery is rarely needed and only as a last resort. Chiropractic care will generate improvement and will educate the individual on what to do to prevent sciatica from flaring up.
Body Composition Improvement
Essential Fat vs Storage Fat
There is essential fat in the body. It has a significant role in overall health and is essential for survival. Essential fat is present in the:
Organs
Bone marrow
Nerve cells
Brain
Essential fat helps with:
Maintaining sufficient energy reserves that function as a metabolic fuel
Conserves body heat and functions as an insulator
Protects the internal organs and joints acting as a soft cushion
Non-essential/storage fat is adipose tissue that accumulates as an energy reserve. Storage fat affects body shape and appearance.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
Traditional medical treatment for sciatica can sometimes be not as effective or ineffective for individuals, but nerve flossing is an option that could help. Flossing is not something individuals expect to hear from a medical professional treating their sciatica. However, when sciatica does not respond to common treatment methods like light physical activity or medications, a physician, chiropractor, or physical therapist might suggest combining traditional treatment with nerve flossing to alleviate sciatic nerve pain.
Nerve Flossing
The nerves can get jammed/stuck between the tissues and are not able to move, flex as they should. Nerve flossing involves performing gentle exercises to mobilize and stretch the nerves that help reduce irritation, inflammation, and improve mobility, especially in the hips. Nerve flossing is also known as:
The exercises can be done at home with no equipment and simple instructions. When used in combination with other treatments, like chiropractic and physical therapy the effectiveness is increased. Consult with a doctor or doctor of chiropractic for an accurate diagnosis, because what is causing sciatica helps significantly to determine the best treatment plan.
Guidelines
These are simple exercises but they are still exercises that require following safety guidelines to prevent injury or pain. These include:
The body will need time to adjust to new exercises so individuals should start slow
Only a few repetitions should be done at a time
Gradually increase
Stop if pain presents with any of the exercises and report the pain to a doctor or chiropractic physical therapist to see if there is a problem with how the exercises are being performed or if the exercises should be done later on after further treatment.
Focus on staying relaxed, as tensing up the muscles decreases the effectiveness
Breathing properly is key. Individuals unknowingly stop breathing when doing exercises, which is not healthy. Breathe deep in and out.
Nerve Exercises
True nerve flossing is an active movement with motion otherwise, it is just stretching.
Mobilizing floss
Lie on the floor with both knees bent, feet flat on the floor, and with space at hip-width
A flat pillow can be used for the head if it makes it more comfortable
Tuck the chin in and be sure to keep the upper body relaxed throughout the exercise
Pull the right leg in towards the chest
Keep holding behind the right knee
Slowly straighten the leg until there is a comfortable stretch
Slowly return the knee to the starting position
Breathe deeply, slowly, and try not to press the lower back into the floor
Lower the leg back towards the chest then lower it back to the starting position
Perform with the left leg
Complete five repetitions on each side
Seated nerve floss
Sitting upright in a chair, knees spaced hip-width, feet flat on the floor, and face forward
Extend the left leg
Flex the foot toward the body
Extend the head up and back looking up at the ceiling
Gently lower head and leg down, tucking the chin into the chest while bending the leg slightly backward
Extend and lower head at the same time when extending and lowering the leg
Perform 10 repetitions
Switch legs and repeat the exercise
Perform exercise 2–3 times every day
Hamstring floss
Stand up straight, raise the right leg onto a step or other stable surface while keeping the leg straight and toes pointed up
Keeping the back straight, tilt the head and neck forward until there is a slight pull/stretch in the back
Point the toe and bring the chin to the chest
Flex the foot and return
Repeat five times
Return to starting position
Switch legs
Repeat three sets on each leg
Exercise for Piriformis Syndrome
The piriformis muscle joins the base of the spine to the upper leg. Because this muscle is so close to the sciatic nerve, any type of irritation or compression of the sciatic nerve can also cause piriformis syndrome. Piriformis syndrome can cause radiating pain to the:
Hips
Buttocks
Hamstrings
Pain when sitting down or walking upstairs
Nerve flossing can also help relieve the symptoms increasing flexibility and range of motion.
Mobilizing stretch
Lie flat on the floor on the back
Extend both legs
Bend the right leg and bring it up
Hold the right knee and foot
While holding, gently pull the leg across the right side of the body and up toward the right shoulder
Return to the original position
Repeat five times
Gently lower the right leg
Switch legs
Complete five repetitions on each side two to three times a day
Risks
These exercises are not about pushing the body to its limits or in a way that causes pain. They are designed to rehabilitate, stretch, and strengthen the sciatic nerve making risks for further injury minimal. If there are still concerns about the safety of nerve flossing exercises, check with a doctor, doctor of chiropractic, or physical therapist. If there is severe nerve damage or undiagnosed acute pain, nerve flossing could worsen symptoms.Nerve flossing for acute cases of nerve irritation is not recommended as this can cause nerve root aggravation with the stretching/pulling.
There is a difference between being tired after a long day working, playing, etc, and being tired on a regular daily basis. This can be referred to as Chronic Fatigue Syndrome, a clinical condition where fatigue lasts longer than 6 months. With acute, non-clinical fatigue, it is typical to experience many of the symptoms that hamper an individual’s ability to function. Symptoms can include:
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
References
Anikwe EE, Tella BA, Aiyegbusi AI, Chukwu SC: Influence of Nerve Flossing Technique on acute sciatica and hip range of motion, International Journal of Medicine and Biomedical Research, 4(2) May – August 2015, www.ijmbr.com
Jeong UC, Kim CY, Park YH, Hwang-Bo G, Nam CW. The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain. J Phys Ther Sci. 2016;28(1):46-50. doi:10.1589/jpts.28.46
Sciatica is a very common and painful issue. Keeping it in check can be difficult especially with various causes that can generate flare-ups. Individuals managing sciatica need to pay attention and be vigilant of the negative activities/movements that could cause symptoms to reappear. A few common causes include:
Excessively tight-fitting pants
Improperly lifting heavy objects
Poor posture
Weight gain
Not stretching out
Wearing the wrong shoes
Knowing what not to do is just as effective for helping sciatica flare-ups as knowing what is best.
Sciatica Causes
The sciatic nerve is the longest nerve. It comes out the spine through the pelvis, down the leg to the foot. There is one sciatic nerve on each side of the body, and either can become irritated, injured, and inflamed. However, it�s rare that both are irritated at the same time. The underlying causes can vary. Most of the time the cause is a herniated disc that presses against the nerve, causing the pain. Even though this happens in the lower back, an individual might only feel pain in the buttocks and the back of the leg. Other causes of sciatic nerve pain include:
What makes sciatica worse depends on the underlying cause. For most, this is a herniated or bulging disc that presses against the nerve. With this type of case, any increase in pressure on the discs can worsen the symptoms. Sitting down in fact puts more pressure on the spinal discs, worsening the pain. Lying down can also worsen symptoms. When the pain is peaking, lying down for a little while can help, but for too long can worsen symptoms. Standing with a neutral spine, and walking around a bit, can help with nerve pain relief and the healing process.
Improper/Poor Posture
Poor posture, especially the rounding of the lower back. This usually happens when sitting. The rounded low back becomes a bad habit that individuals think will help with the pain. This can cause a flare-up. The spine has a natural S-curve and the more an individual can maintain that natural curve, the better off they will be.
Weight Gain
Too much weight can cause flare-ups with added stress/pressure on the spine, especially the low back. Maintaining a healthy weight will help relieve the added pressure, however, many who experience sciatica have trouble exercising. This is where a physical therapist and chiropractor can assist an individual with customized exercise and diet programs to overcome this obstacle. Eating is a way that individuals deal with pain, anxiety, and depression. But weight gain and poor health can worsen sciatica. Individuals that are overweight tend to experience more inflammation throughout the body, making sciatica even worse.
Stretching
Not stretching, especially as the body gets older tightens the muscles, ligaments, and tendons. And stretching improperly can injure these areas. There are recommended and non-recommended stretches for individuals dealing/managing sciatica. Stretches that require bending the low back can place added pressure on the lumbar spine, causing sciatica flare-ups.
Lifting Heavy Things
Lifting and improperly lifting heavy objects can worsen sciatica. This has to do with the rounding of the low back. Any time the spine is taken out of its natural S-curve, there is undue pressure on the joints and discs. When lifting heavy objects in this position the problem is worsened. When possible avoid lifting anything heavy while dealing with sciatica. It�s healthy to stay active, but there is no need to do intense workouts at home or the gym, especially heavy lifting.
Tight Pants
Tight pants can contribute to sciatica. Whether shorts, jeans, or skirts, wearing overly-tight, form-fitting pants should be avoided until the sciatica is gone. And even after it is not recommended to wear overly tight-fitting clothing, as this can cause blood and nerve circulation problems.
Shoes
Like tight pants, the wrong shoes without adequate support can cause flare-ups. For example, high heels force weight distribution to the front of the feet. For the body to compensate, it�s normal to push the pelvis and hips forward. When the body is in this position for a long time it starts to place stress on the hamstrings, which will exacerbate sciatica. Shoes without adequate support place added stress on the feet, which gets transferred up the leg to the hamstrings. Customized shoe inserts designed especially for individuals with sciatica can help in preventing symptoms.
Improvement
Sciatica takes time to heal. Avoiding making it worse and taking all the steps to help it heal, can bring the body back to normal within 2 weeks. For most, it takes around 4 weeks for the pain to go away. This depends on various factors. For example, if sciatica develops during pregnancy, it could take longer to get rid of the pain. One sign that shows improvement is called centralization meaning the pain is moving out of the leg and into the spine. This is a good sign that the individual is on the right track.
Body Composition
Meal Planning
The convenience of food delivery is wonderful, but remember that frequently eating food prepared away from home increases the risk of weight gain and obesity. Restaurants tend to serve oversized portions and prepare meals with excessive calories, sodium, and sugar. The benefit of eating from home is that individuals have more control over the ingredients and cooking methods used to prepare the food. It helps to plan meals and snacks in advance to make sure they are balanced. Here are the types of foods that should be included in a balanced meal plan:
A variety of whole fruits
Non-starchy vegetables – leafy greens, red and orange veggies
Starchy vegetables – potatoes, green peas, legumes, winter squash
Grains, with the goal to make at least � from whole-grain sources
Low-fat or fat-free dairy milk, yogurt, cheese
Protein from various sources – lean meats, seafood, eggs, nuts & seeds, and soy products
Healthy cooking oils – olive oil or canola oil
Nuts and nut butter
Fresh or frozen fruits
Dried herbs and spices
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Identification of piriformis syndrome or sciatica requires proper testingand examination. The piriformis muscle begins at the sacrum near the sacroiliac joint and is attached to the femur/thigh bone at the outer area of the hip. The sciatic nerve passes typically under or through the muscle before going down the back of the thigh.
The piriformis helps turn the hip outward and bring the thigh outward to one side while the hip is bent. This could be when raising the knee and bringing the leg out. An example is stepping out of a car. The muscle also helps to stabilize when walking, running, and standing. Individuals with the sciatic nerve passing through the piriformis have an increased chance of developing piriformis syndrome. It can also be called piriformis sciatica since it is not true sciatica.
Symptoms
Piriformis syndrome does not always present the same way. Common symptoms include pain, tingling, and numbness in the buttocks that becomes worse when sitting. Other symptoms can include:
Pain when sitting, standing, or walking.
Pain when getting up from a seated/squatting position
Pain in the sacroiliac joint
Pain and/or pins and needles, burning, tingling, or itching sensation
Movement helps to reduce pain symptoms
Numbness in the foot
Many of these symptoms can be mistaken for sciatica. This is why proper testing is necessary to provide the appropriate treatment; otherwise, the condition could worsen or create new injuries.
Causes
Primary piriformis syndrome happens when splitting the piriformis muscle, the sciatic nerve, and/or the sciatic nerve does not run along the normal path.
Secondary piriformis syndrome is more common and is caused by inflammation of the soft tissues, muscle spasms, etc. And the result is nerve compression.
Direct trauma to the buttock area can definitely cause inflammation, scarring, and contraction of the piriformis muscle. This could be the result of an automobile accident or a fall.
The most common cause is a progressive tightening of the muscle brought on from a weakened piriformis muscle.
Testing
Because of the close relation between piriformis syndrome and sciatica, a chiropractic medical professional will perform various tests to determine if symptoms are spinal disc-related or caused by the sciatic nerve getting pinched or impinged piriformis muscle. A chiropractor will examine the low back, hip, pelvis, sacroiliac joint, walking gait, posture, and leg length. They will test various body reflexes as well. Other tests can include:
Palpation/manipulation of the piriformis muscle
A Straight leg raise will be done to see if there is localized pain when pressure is applied to the piriformis muscle and the tendon. The chiropractor will flex the hip at a 90-degree angle and extend/straighten the knee.
A Freiberg test will be done to see if pain presents around the piriformis or reproduces symptoms.
The Pace maneuver test looks for pain and/or weakness during rotation of the hip when sitting.
The F.A.I.R test stands for flexion, adduction, and internal rotation. This test has the individual lie on the non-affected side while the chiropractor guides the painful leg into hip flexion, turns it in toward the body, and gently turns the lower leg outward.
The Beatty maneuver tests for pain while lying on the non-affected side, and the chiropractor elevates the flexed symptomatic leg.
Testing for pain or weakness in specific positions is usually conducted for one minute or when the individual experiences symptoms.
In addition to a physical exam, a chiropractor will utilize imaging scans to rule out any other causes. This can include X-rays, MRIs, or CT scans. Once the source has been diagnosed, treatment can begin. Many individuals choose to wait and see what happens, hoping the problem will go away. But the sooner the root issue is dealt with, the sooner an individual can get back to living pain-free.
Sciatica Pain Rehabilitation
References
The Journal of the Osteopathic Medical Association. (November 2008) Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach jaoa.org/article.aspx?articleid=2093614
Individuals with neck and back pain should consider adding a few pain-relieving therapeutic tools to the holiday wish list. Spine specialists/experts have some tools for their patients and others who are dealing with back and neck pain. Looking at various points, these therapeutic tools offer the gift of helping to reduce neck and back pain, when unable to see a chiropractor or physical therapist.
Foam Rollers
Foam rolling is effective for different types of aches and pains, especially backaches. Foam rolling benefits include:
Releasing muscle knots and tension
Reduces inflammation
Decreases pain
Improves range of motion
Returns flexibility
Wedge Pillow
A wedge pillow for the back is a necessity. A wedge pillow removes the stress from the spine and neck when lying down. Flipped around will take the tension off the legs also bringing back pain relief.
Deep Percussive Massager
Percussive massagers can provide a deep massage to various areas of the body especially the lower back. There are a variety of brands available with different levels of technology. However, careful use of these instruments must be exercised. This is because the massage can be intense and can exacerbate or cause further injury, and individuals can develop a tolerance making the massage no longer effective.
Seat Cushion
If sitting at a desk throughout the day or working from home a proper seat cushion is mandatory. Many individuals who sit the majority of their day utilize a combination cushion that includes the seat cushion with lower back support. Individual cushions are great because they can be moved easily and adjusted to fit where needed. Therapeutic seat cushions come with various features available, here are a few to keep in mind. Memory foam and air cells offer the most pressure relief. If there is tailbone pain, focus on a seat cushion with the tailbone cut out for extra relief. An office chair with these features should also be considered.
Inversion Table
Inversion tables are available at reasonable prices, starting around $100. Used correctly this therapeutic tool can successfully help relieve back pain. Inversion tables and cervical traction provide decompression and postural alignment for the spine helping with pain relief. These devices offer gentle decompression through the angle used. Wider angles or full inversion provides more decompression on the back. Individual spinal needs should be discussed with a chiropractor, physical therapist, or physician before using this therapeutic tool.
Pain Patches and Topical Agents
Pain-relieving patches like Lidocaine, IcyHot, and Salonpas patches are widely recommended for tight and sore areas of the body.
Sitting Standing Desk
A sitting and standing desk can be highly beneficial to back pain. In addition to burning off bonus calories throughout the day, Changing positions and postures throughout the day are recommended. This is to keep the muscles, ligaments, tendons moving, and not in a static position for too long. Changing every 20 to 30 minutes is the recommended time. Sitting and standing desks can provide positional changes that will help with posture, core stability, and circulation. This will help reduce and alleviate pain in the low back, neck, and shoulders. However, the desk needs to be stable and adjusted to the proper height.
Lower Back Sitting Support
These therapeutic tools help reinforce the low back region when seated. Most of us start to slouch forward with the head and shoulders hunched forward after some time at the computer. This strains the whole body, specifically the low back. Lower back supports can help maintain proper alignment of the spine when seated.
Knee, Thigh, Pelvis Pillow
These pillows have different names but are used in the same way. This is a pillow that can be placed between the legs while sleeping takes the pressure off the pelvis and spine. These types of pillows are great for individuals that sleep on their side. This is because the top leg often shifts down, leading to increased stress on the hips and low back. These pillows help keep the legs aligned during sleep relieving pressure on the low back.
How To Self-Care for Back Pain Books
There are a variety of books that offer tips, and therapies for self-care. These products are not a cure-all. They are intended to help in combination with proper treatment, especially for certain spinal conditions. If pain is limiting daily function, consult a chiropractor, physical therapist, or physician about using the above therapeutic tools.
Doctor of Chiropractic Near Me
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Furlan, Andrea D et al. �Massage for low-back pain.��The Cochrane database of systematic reviews,9 CD001929. 1 Sep. 2015, doi:10.1002/14651858.CD001929.pub3
Osteonecrosis is a condition that causes the death of bone tissue from temporary or permanent loss of blood supply to the affected area. It is commonly known asAvascular necrosis and can lead to miniature/tiny breaks in the bone and the bone/s eventually collapsing. Specifically, it affects the upper part of the femur or femoral head and surrounding joints.
It can occur in any bone however, osteonecrosis typically affects the hip/s. Pain associated with osteonecrosis of the hip can be localized to the center of the groin, thigh, or buttock. Because of the hip joint’s close proximity to the sciatic nerve, misdiagnosis for sciatica is common.
Mimicking Sciatica Symptoms
Unfortunately, many health care providers can misdiagnose osteonecrosis hip pain as sciatica. Whatever the cause of the hip injury, most individuals with hip pathology report pain in the groin, upper thigh, and buttocks.
That is why a trained medical professional that knows the differences in the symptoms of each condition can make all the difference in making a proper diagnosis. And a proper diagnosis leads to proper and complete treatment of whichever condition it may be. With osteonecrosis, misdiagnosis often delays the proper treatment and continues to progress. Common symptoms of sciatica:
Leg pain is the primary symptom can be mild to severe
Low back pain is secondary can be mild to severe
Nerve-related symptoms
Numbness
Tingling
Shooting pain
Pins-and-needles sensation
Muscle weakness
Hip pain especially flexion and internal rotation of the hip.
Leg or foot weakness
Osteonecrosis Symptoms and Similarities
For many, there are no symptoms in the early stages of osteonecrosis. As the condition worsens, the affected joint could present pain symptoms only when weight is placed on it. Eventually, individuals begin to feel the pain even when lying down. Pain can be mild to severe with a gradual development. Other symptoms that mimick sciatica:
Walking Inability
Walking gait is complicated with both conditions which is a major cause behind the misdiagnosis.
Limping
Individuals often limp with osteonecrosis of the hip and spinal disc problems. This is another reason that the condition is misdiagnosed as a spinal disc problem or nerve root compression of the sciatic nerve.
Hip Pain
The tributaries/veins of the sciatic nerve also supply the hip area and often cause confusion between the two conditions.
Differences
Despite all of the similarities. There are differences in both conditions.
Nature of The Pain
With sciatica, the pain is related to the nervous system. Movement can complicate the pain. While rest helps to reduce the pain.
With Osteonecrosis the pain is geared toward the muscular. Rest does not help reduce the pain. In fact, the pain increases at night.
Location
Sciatica pain can radiate through the whole leg from the low back to the toe.
Osteonecrosis pain is confined to the hip joint, groin, and radiates to the knee joint only. Osteonecrosis pain does not radiate below the knee joint.
Restricted Movement
Osteonecrosis of the hip joint, means the movements involving the hip joint are restricted. Individuals cannot rotate the leg to the right and left. Individuals cannot bend or fold from the hip.
With sciatica, the rotation of the leg is not affected. Movements involving stretching the sciatic nerve can cause relief or pain.
Walking Gait Differences
Gait is the way an individual stands and walks.
Osteonecrosis of the hip joint causes individuals to not be able to open the hip joint properly or to step properly.
With sciatica, an individual tends to lean on their side to relax the compression on the nerve.
Risk Factors
More than 20,000 people enter hospitals for the treatment of osteonecrosis of the hip yearly. Other than the hip, areas of the body likely to be affected are the shoulder, knee, hand, and foot. The condition can occur for a variety of reasons. A few of these include:
Fracture – a broken bone can interrupt the blood flow to other sections of the bone.
Dislocation of bone or joint/s
Alcoholism
Trauma
Radiation damage
Steroid use
Some individuals can have more than one condition or injury that contributes to hip flexor pain. An example is that it is possible to have both hip osteoarthritis and hip impingement. Without proper treatment, the condition can worsen, causing joint or hip pain from the degradation of the bone.
Anyone can be affected, but osteonecrosis is most common in individuals aged 30 to 50. Treatment options include a total replacement of the hip known as arthroplasty. And if it is sciatica then chiropractic treatment is a first-line treatment protocol. However, a chiropractor can make the distinction between the two and treat sciatica or refer the patient to the proper specialist.
Lower Back Pain Relief
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Li, Wen-Long et al. �Exploring the Risk Factors for the Misdiagnosis of Osteonecrosis of Femoral Head: A Case-Control Study.��Orthopaedic surgery, 10.1111/os.12821. 16 Oct. 2020, doi:10.1111/os.12821
Thelumbosacral joint is the first place chiropractors start their investigation with individuals presenting with low back pain and possible sciatica. Because of the importance of the sciatic nerve, almost any lumbar condition has the potential to disturb the nerve that can lead to chronic nerve pain. For many low back conditions, the best way to start is from the bottom and work up.
Starting at the lumbosacral joint L5-S1, the chiropractor will palpate and massage the area. This is because the lumbosacral joint is a central nerve center with all kinds of possible sciatic nerve interference because of the proximity to the various nerve bundles and vertebral discs.
When sciatic nerve issues begin to develop, often the problem will be in this region of the spine. Beginning at the lumbosacral joint can generate vast insight into the root cause of radiating pain in the lower back and legs.
The Lumbosacral Joint
This pain typically presents when the nerve is inflamed, compressed, or irritated. Numbness or chronic weakness can also happen in the lower extremities and can cause unbearable discomfort. Some of the reasons that make the joint a prime suspect for sciatic pain include:
The L5 vertebrae are vulnerable to slipping forward over the connecting S1 vertebrae. The sciatic nerve goes through this area, leaving it open to compression.
A disc herniation and/or inflammation can also stress the sciatic nerves.
Deterioration of the lumbosacral facet joints is common with older individuals. This can lead to nerve compression and sciatic nerve irritation.
Piriformis syndrome can affect the area around the lumbosacral joint, causing nerve compression and inflammation.
The lumbosacral joint is frequently used making it a consistently stressed joint. Overuse, poor posture, and improper body mechanics affect this region of the lumbar spine. And, because of the closeness to the sciatic nerve, it is commonly affected.
Other Spinal Conditions
The lumbosacral joint also experiences problems that stem from chronic conditions, which can involve some form of sciatic pain as a symptom. They include:
Degenerative disc disease
Lumbar stenosis
Sacroiliac joint dysfunction
Spondylolisthesis
Sciatica is a condition that represents a series of symptoms. But it is often a symptom of other condition/s that affect the sciatic nerve. If spinal conditions progress, it can bring undue stress and strain to the lumbosacral joint and the sciatic nerve.
Knowing Where To Begin
The key to a proper and successful treatment plan is an accurate diagnosis. Knowing and understanding the symptoms, spinal conditions, and having an idea of the origin of these types of pain promotes a rapid diagnosis. Our chiropractic and physical therapy team thoroughly investigate the pain source using imaging, palpation, observation, and other diagnostic tools to help get individuals back on track and healthy.
Facet Syndrome Chiropractic Treatment
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Grgi?, Vjekoslav. �Lumbosakralni fasetni sindrom: funkcijski i organski poreme?aji lumbosakralnih fasetnih zglobova� [Lumbosacral facet syndrome: functional and organic disorders of lumbosacral facet joints].�Lijecnicki vjesnik�vol. 133,9-10 (2011): 330-6.
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