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
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.
Sciatica or Aneurysm? Knowing how a missed diagnosis could be potentially fatal if not diagnosed accurately could be a deadly mistake! Doctors must not fall for a sciatica diagnosis when a possibly fatal iliac artery aneurysm lies looming and progressing.
Sciatica or Aneurysm
An example is a patient who visited an emergency clinic after a few weeks for a non-painful pulsing mass on the buttock. There was no:
Trauma
Injury
Back pain
Leg pain
Prior presentations of pain or sciatica issues
A physical examination found a small pulsing mass on the right buttock. Palpation around the site found no issues with the sensory and motor nerves.
An ultrasound scan of the affected area revealed a developing aneurysm. This was followed by a CT scan of the abdomen along with the pelvis using a contrast dye found the aneurysm developing from the left internal iliac artery. If the mass was not present a doctor could easily diagnose sciatica or persistent sciatic artery. If the iliac artery presents with pulsating lesions is a tip-off that a vascular issue could be impinging on the sciatic nerve. Vascular surgery was discussed with the patient. Surgery was necessary, and the patient underwent sciatic aneurysm repair. The patient was discharged without any complications.
Persistent Sciatic Artery
This is a very rare congenital vascular condition. The sciatic artery runs along the sciatic nerve and functions as the major blood supply to the lower extremities. During human embryo development, the femoral artery begins to form while the sciatic arteries start to return to a less developed state. The process continues until the femoral artery takes over as the major blood supply, with only bits of the sciatic artery left.
Persistent sciatic artery can happen either from the sciatic artery not returning to its original size or during normal development the femoral artery developing properly. Most cases of persistent sciatic artery go unknown and are usually detected from another examination for another ailment. Aneurysms often develop based on the arteries/vessel’s tendency for minor trauma/injury when sitting or some form of pressure is applied on the site. Complications include:
Vascular Conditions In The Leg/s That Can Present As Sciatica
The legs’ blood vessels can get infected, bulged, ruptured, or blocked. This can cause sciatica symptoms, like leg pain, weakness, tingling, and numbness. Severe cases could require medical emergency surgery to save the affected limb.
Acute Limb Ischemia
This condition occurs from a decrease or loss of blood supply to the legs. If there is leg pain, it could feel similar to sciatica pain. However, symptoms can progress rapidly and become severe. That’s when it is not sciatica. Acute limb ischemia present one or more of the following symptoms:
Pain and/or numbness in the leg while walking and when resting
Severe pain at night
Sleep problems
Pain relief when sitting on a chair with the feet hanging down
Feet and ankles become swollen
A pale color and lowered skin temperature over the toes and feet when compared to the legs
Acute limb ischemia can develop from an aneurysm, blood clot, or from the thickening of the vessel walls. Treatment should be prompt in order to preserve leg function. Differentiation diagnosis between vascular and other causes like spinal problems that can cause leg pain. A doctor may perform an Ankle/Brachial Index which is a comparison of blood flow in the arms versus the legs. This can be critical in determining if there is vascular insufficiency.
Acute Compartment Syndrome
This places increased pressure in the muscle tissues of the leg. It can lead to loss of blood supply in and around the affected area. The sciatic nerve can also get compressed from the increased pressure in the buttock, thigh, or leg. The condition can cause pain, numbness, and weakness in the buttock, thigh, and leg. Individuals have also reported an unusual/altered sensation in the web of the great toe. This is similar to sciatica, as well as one or both legs can be affected. Differentiating symptoms include:
Leg becomes swollen
Pain and tenderness present when touching the leg
A pale color and lowered skin temperature over the leg
Acute compartment syndrome is a serious condition that is considered a medical emergency. It is possible for the condition to cause complete dysfunction of the limb if not addressed in time. There are risk factors that increase the chances of developing limb ischemia or compartment syndrome. These are:
Diabetes
Heart conditions
High cholesterol
Smoking
History of having the condition can also cause a recurrence. This can be from an injury or poor health.
Kidney stones, renal failure, or cysts in the kidney can also cause back and leg pain. Other symptoms can include blood in the urine or difficulty urinating. Any sign of distressing symptoms that present with sciatica can indicate the need for medical attention. This is to check for the possibility of a serious underlying condition or medical emergency. Medical emergencies that are treated in time can help preserve the tissue/s, restore function, and save an individual�s life.
It is essential for a chiropractor or physical therapist to be familiar with diagnosing in a way that will help identify sciatica or aneurysm in individuals presenting with musculoskeletal issues/problems. Knowledge of these risk factors, understanding how to screen for non-musculoskeletal symptoms, basic competence in palpation, and how to interpret findings will help discover sciatica or aneurysm if it is there and begin timely treatment. And if it is not there then a sciatica treatment plan can be developed before it worsens.
Sciatic Nerve Pain
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
Javdanfar A, Celentano C. Sciatic artery aneurysm. West J Emerg Med. 2010;11(5):516-517.
Finding the right sciatica chiropractic specialist to diagnose the cause especially, when it is an abdominal aortic aneurysm can be a challenge. There can cause diagnostic confusion with the root cause never being discovered or identified. Fortunately, Dr. Jimenez is a sciatica specialist with over 30 years of experience in differential sciatica diagnosis, and treatment.
Sciatica Chiropractic Specialist Diagnosis
Diagnostic Tools
Abdominal aneurysms are usually discovered for another ailment like a hernia or for routine tests like an ultrasound of the heart or stomach.Diagnosis of an abdominal aneurysm depends on the condition, medical and family history, and the physical examination. If a doctor or sciatica chiropractic specialist suspects an aortic aneurysm, then specialized tests will help with a confirmation.
Ultrasonography
The simplest and most used diagnostic test is ultrasonography. It utilizes sound waves for diagnostic purposes that send the recorded images to a monitor. It gives an accurate assessment of the size and location of the aneurysm. The patient will lie on a table while a technician moves a wand around the abdomen.
Computed tomography CT scan
This test is often used in conjunction with ultrasonography if more data/info is needed. Usually, this is to determine the exact location of the aneurysm in relation to the visceral or renal arteries. It provides cross-sectional detail with clear images of the aorta and can detect the size and shape. The patient lies on a table inside a machine. A contrast dye could be injected into the blood vessels to make the arteries more visible on the images known as CT angiography.
Magnetic Resonance Imaging
Magnetic resonance imaging or MRI uses a magnetic field and radio wave energy pulses to record images of the body. The patient lies on a table that slides into the imaging compartment. Contrast dye can also be injected into the blood vessels to make the images more visible known as magnetic resonance angiography.
Emergency Symptoms
Certain symptoms can indicate an emergency. The conditions are rare, but it is very important to seek medical attention should any of these symptoms present with back pain:
Severe abdominal pain
Fever out of nowhere
Bowel and/or bladder incontinence
Loss of or an unusual sensation in the groin, as well as the legs and possibly into the foot
If back pain presents after an injury medical care is recommended to check for damage/injury to the spine.
Abdominal Aneurysm Symptoms
Abdominal aneurysms often don�t present any symptoms, which is why individuals go through their days unaware, and when back pain does present a doctor may only focus on the back pain symptoms and not the cause, leaving the aneurysm to continue to develop and worsen. Aneurysms do occur in women but are more common in men and those ages 65 and older. The main cause is atherosclerosis which is a hardening of the arteries. But injury and infection can also cause an aneurysm. Those with symptoms can include:
Throbbing pain around the back or side
Deep pain in the back or side
Pain in the buttocks, groin, or legs
Sciatica symptoms
The Sciatic Connection
A diagnosis of the root cause of the sciatica is crucial for developing an effective treatment plan to alleviate the sciatic pain. If an aneurysm is present then referring the individual to the proper aortic aneurysm repair specialist is a top priority. If sciatica is suspected, a doctor or chiropractor will review medical history and perform a physical examination. Medical imaging tests and diagnostic nerve blocks could be used if necessary. Sciatica pain usually follows the dermatome or areas of the skin that is supplied by the sciatic nerve. The pain can also include deeper tissues called dynatomes.
Physical examination
During a physical examination, the sciatica chiropractic specialist will look for various responses when:
Straightening the leg with movements that elongate the nerve
Gently pressing the toes or calf area
Seeing if there is any type of pain associated with these movements in the low back, buttock, thigh, leg, and foot
Sciatica Clinical Tests
Two examples of clinical tests for sciatica include:
Straight leg raise – SLR
The patient lies on their back and the chiropractor lifts one leg at a time with the other leg remaining flat or bent at the knee. If pain presents while lifting the affected leg this is usually an indication of sciatica.
Slump
The patient sits upright with their hands behind their back. The patient then bends/slumps forward at the hips. The neck bends down with the chin touching the chest and one knee is extended as far as possible. If pain occurs in this position, sciatica could be present.
These tests could possibly be positive only when the nerve is mechanically compressed. Other causes like inflammation or chemical irritation of the nerve might not cause pain when performing these tests. This test could also help reveal a possible abdominal aneurysm as abdominal pain could present.
Chiropractic Sciatica Treatment
Manual manipulation improves the alignment of the spine. This technique helps address the underlying condition/s that can cause sciatic nerve pain, like herniated discs or spinal stenosis. Manual manipulation also creates an optimal healing environment. An aortic aneurysm specialist could work with a sciatica chiropractic specialist to help with spinal realignment if the aneurysm caused any kind of shifting or slipping of the discs along with releasing the sciatic nerve if it is compressed.
Massage Therapy
Massage therapy like deep tissue massage can also have benefits. Massage:
Improves blood circulation, which also creates an optimal healing response in the body
Releases toxins in the low back muscles that spasmed or knotted up
Relaxes tight muscles that could be contributing to the pain
Releases endorphins or the hormones that function as the body’s natural pain relievers
Sciatica Pain Chiropractor
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*
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
