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
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*
Underlying causes for an abdominal aortic aneurysm can be challenging to diagnose and identify. Combined with sciatica symptoms, doctors could misdiagnose the ailment and prescribe the wrong treatment protocol. Then an individual has to deal with two conditions that were not properly diagnosed, continue to develop, and worsen. This is why finding the right sciatica specialist that can also identify an abdominal aneurysm is so crucial to developing the right treatment plan. There can be a variety of factors that can lead to the development of an abdominal aneurysm. They include:
Health conditions associated with an increased risk for an abdominal aneurysm include:
Atherosclerosis
This condition occurs when there is a buildup of fats, cholesterol, and other substances that create plaque buildup in the bloodstream. This causes vessels to harden and narrow. Atherosclerosis can develop during the young adult stage and becomes an issue later in life.
High Cholesterol
Cholesterol is a waxy, fat-type substance that is found in all the cells in the body. The body needs some cholesterol for the production of hormones, vitamin D, and substances to help digest foods. The body makes all the cholesterol it needs. Too much can build up in the blood vessels, which narrows the bloodstream and hardens the arterial walls.
High Blood Pressure
High blood pressure or hypertension refers to a sustained increased force of blood moving through the aorta that can weaken artery walls. It is a common condition that is widespread among individuals that are older, those that smoke, and those that are overweight. There is an estimated 60-70% of individuals over 60 that are diagnosed with high blood pressure.
Inflamed Arteries
When the arteries become inflamed, it can cause blood flow constriction and cause the arterial walls to weaken. This increases the risk of an aneurysm. Arteries can get inflamed through:
There are hereditary conditions that can weaken the body�s connective tissues. This can lead to degeneration of the aortic walls and raise an individual�s risk for an aneurysm. Two of the most common connective tissue disorders are Ehlers-Danlos syndrome, which affects collagen production, and Marfan Syndrome. This condition increases the production of fibrillin, which is a protein that helps to build the elastic fibers in connective tissue.
Other Risk Factors
Additional health factors can strain the cardiovascular system. This increases the risk of weakening or damaging blood vessels. This significantly raises the chances of developing an abdominal aortic aneurysm. Risk factors include:
Smoking and Tobacco
All types of tobacco use can contribute to diminished cardiovascular health. Individuals that smoke or use some tobacco product pose a significantly higher risk of developing an abdominal aneurysm.
Age
Aneurysms occur most often in older adults. This is because they are more likely to have cardiovascular issues and are more likely to have higher levels of plaque buildup.
Genetics and Family History
Immediate relatives of an individual with an abdominal aneurysm often have a 12-19% chance of developing the condition.
Lack of Physical Activity
Not getting adequate physical activity puts an individual at a higher risk for heart and cardiovascular disease. Aerobic activity done on a regular basis increases the heart rate and blood flow through the body. This keeps the tissues and blood vessels strong and flowing properly.
Gender
Both men and women can develop an abdominal aortic aneurysm. However, the majority of those that do develop the condition are men. This is because men are more likely to go through the heart and cardiovascular issues.
Diagnosis
Underlying conditions that can cause sciatic pain can vary or be a combination of several conditions. The most important action to take is to consult a doctor or chiropractic sciatica specialist for a clinical diagnosis. While rare, sciatica-type pain could be caused by medical conditions like:
Spinal tumor
Spinal infection
Cauda equina syndrome
These factors can contribute to an increased chance of developing an abdominal aortic aneurysm. However, individuals can have unknown risk factors and still develop the condition. Treatments may range from regular monitoring, lifestyle changes, and physical therapy/chiropractic to urgent or emergency surgery. If you feel symptoms of pain in the buttocks, leg, numbness, tingling, or other neurological symptoms in the back and/or leg, it is very important to see a doctor or chiropractor for clinical diagnosis that identifies the cause of the symptoms.
Sciatic Nerve 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*
An abdominal aortic aneurysm is an enlarging of the lower portion of the aortic artery that resides in the abdomen. The aorta is the body�s main artery that supplies blood to the body and stretches from the heart down into and through the abdomen. The abdominal aorta is the part that sits within the abdomen. It is below the kidneys and in close proximity to the front of the spine. Because of this closeness sudden intense pain can be felt in the lower back along with sciatica symptoms.
Abdominal Aorta Function
Its function is to deliver blood from the heart throughout the body. It circulates blood down through the chest and abdomen. Smaller arteries branch off the artery to the different organs and systems of the body.
Enlargement/Weakening
If it becomes weak or expands in size, the condition is known as an aortic aneurysm. This condition can cause severe abdominal pain, back pain, sciatica and can lead to artery leakage or rupture. This is when it becomes an emergency. Being the largest blood vessel in the body means that a rupture can cause life-threatening bleeding.
Aneurysms can develop anywhere on the artery, but most occur in the abdomen portion. Depending on the size and growth rate, treatment/therapies can vary from observation to emergency surgery. Abdominal aneurysms usually progress slowly without symptoms, making them difficult to detect. However, some abdominal aneurysms never rupture. They can start small and remain the same size while others can expand over time, and others faster.
Rupture
A weakened aorta can develop a leak known as a rupture. Blood can also begin to accumulate and pool up between layers in the arterial walls can also lead to rupture known as a dissection. Internal bleeding is the primary complication of an abdominal aneurysm. Loss of blood is considered a potentially fatal medical emergency. Mortality rates increase when the artery leaks. The risk for rupture depends on the:
Size
Aneurysms that are smaller than 5 cm in diameter are considered a low risk for rupture. Aneurysms larger than 5 cm are considered high risk. The size is often the best predictor for predicting the chance of rupture.
Growth Rate
Expansion of more than half a centimeter over 6 months is considered accelerated growth and is a high risk. A faster growth rate has been seen in individuals that smoke or have high blood pressure. Abdominal pain, lower back pain, sciatica, or other symptoms usually do not present until the artery has ruptured. However, in a significantly expanded aneurysm, symptoms similar to a rupture can occur.
Symptoms
In most cases, the aneurysm develops slowly with no symptoms or minor symptoms like a nagging/gnawing or throbbing sensation in or around the abdomen. This type of aneurysm can be detected from a standard physical exam or from the monitoring of another condition. Symptoms depend on the location and can include some combination of the following:
Deep, constant pain in the abdomen or on the side. It could also be a stabbing pain deep inside that is felt between the sternum and the belly button. The pain can be continuous with no relief from rest or adjusting positions. Severe pain can cause individuals to bend over and down.
Difficulty standing or the ability to straighten the upper body.
Low back pain caused by the abdominal pain radiating/spreading out into the lower spine from the aorta�s closeness to the spine. The pain can also spread to the groin, pelvis, and legs.
Sciatica symptoms typically come from low back pain.
A pulse near or around the bellybutton. Tenderness, along with a pulsing sensation can be felt. The pulse can be felt through the skin and could be sensitive to touch or pressure.
Blood loss will result in low blood pressure, known as hypotension. This causes lightheadedness, dizziness, nausea/vomiting, blurred vision, and confusion. Symptoms are exacerbated when standing generating the feeling of the need to sit or lie down.
Shock symptoms from the internal bleeding. This includes:
Sudden and rapid heartbeat
Shallow breathing
Clammy skin
Cold sweats
General weakness
Confusion
Agitation
Anxiety
Loss of consciousness
Causes
Various causes can be involved in developing an abdominal aneurysm, including:
Hardening of the arteries known as atherosclerosis. It happens when fat along with other substances build up on the lining of blood vessel/s.
High blood pressure can damage and weaken the walls of the aorta.
Aortic infection is rare but a bacterial or fungal infection could cause an abdominal aneurysm.
Trauma like being in an automobile accident can cause an aneurysm.
Risk Factors
The pathology principally stays asymptomatic until a rupture occurs. This pathology affects mostly men with quite a few risk factors. Risk factors include:
Men develop abdominal aneurysms more often than women.
Smoking is the strongest risk factor. It weakens the aortic walls and increases the risk of developing an aneurysm, and rupture. The longer an individual smokes or chews tobacco, the higher the chances.
Individuals aged 65 and older are the most targeted group for this condition.
A family history of abdominal aneurysms increases the risk.
Aneurysm in another blood vessel, like the artery behind the knee or the chest aortic region, could increase the risk.
Sciatic Nerve Compression
Sciatica is usually caused by compression on the nerve. Spinal and non-spinal disorders are known to cause pain include:
Low back misaligned vertebral body/s
Herniated/bulging/slipped discs
Pregnancy/childbirth
Spinal tumors
Diabetes
Constipation
Sitting too long
Sciatic nerve compression can cause a loss of feeling known as sensory loss, paralysis of a limb, or group of muscles known as monoplegia, and insomnia.
Proper Diagnosis Is Essential
Because of the many disorders that can cause sciatica, a doctor’s first step is to determine the cause. This involves forming a diagnosis based on a thorough review of an individual’s medical history, a physical and neurological examination. The sciatic nerve has several smaller nerves that branch off. These smaller nerves enable movement motor function and feeling sensory functions in the thighs, knees, calves, ankles, feet, and toes.
If a chiropractor determines the patient’s disorder requires treatment by another specialist, then the individual will be referred to the proper doctor. In some cases, the chiropractor could be called upon to continue spinal therapy and help manage the individual’s treatment plan with the other specialist/s.
Sciatica Pain 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*
Finding the right surgeon that specializes in an individual’s specific spinal conditions and physical health means doing some research. There are several types of procedures for spinal problems. The type of surgery depends on the condition and an individual’s medical history. If surgery is recommended for a lumbar herniated disc or LHD combined with sciatica here are a few things to think about.
Devotes at least 50% of their practice to spinal conditions
Specializes in treating herniated disc/s and sciatica. This means they will have added/specialized knowledge and expertise.
It is extremely important that an individual feels comfortable and feels they are able to communicate freely with the surgeon. A professionally qualified surgeon should:
Spend adequate time with the individual
Answer all questions
Provide all information needed about the condition and treatment
Listen to what the individual has to say
Is open-minded
Is not hard to get in contact with
Has experience in the latest methods and techniques
What to look at and think about
Individuals can feel uncomfortable asking questions, but thorough communication is key. Remember, it is your body, and it is your right to know the details of the spinal disorder, along with non-surgical and surgical approaches to treatment that are available. There is time to consider the options and make an informed decision about the treatment plan as most spinal procedures are elective. Ask the surgeon all the questions you have to help decide wisely and with confidence. Make sure they address all concerns, and any others not listed.
The surgeon’s specialization/focus
Orthopedic surgeons and neurosurgeons perform spinal procedures. Each will have a specific interest and expertise in certain spinal condition/s. For example, some surgeons may specialize in treating adult or pediatric patients, and some may only treat either lumbar/low back or cervical/neck conditions. Within those groups, some focus on:
Spinal deformities
Tumors
Myelopathy a spinal cord disease
Specific spinal cord diseases
Minimal invasive surgery option
Minimally invasive spine involves tiny incisions, that reduces the recovery time needed to heal. With this type, individuals can be up and walking within hours after surgery. Unfortunately, not all conditions can take this approach.
Is the surgery absolutely necessary, or can it be treated non-surgically?
Sciatica and herniated discs can be quite painful and cause disability. Never rush into surgery just to relieve symptoms. As surgery can cause other types of pain symptoms and issues. Herniation and sciatica can be resolved with:
Chiropractic
Physical therapy
Medications
Injections
Lifestyle changes
Diet adjustments
Regular exercise
Weight loss
However, if there are neurologic symptoms, like weakness in the leg, foot, numbness, or loss of bladder or bowel control – this is considered a medical emergency – then surgery is absolutely needed.
The number of similar procedures performed
The surgeon�s experience is very important. The more experienced, the better. Ask if they can refer to other patients who have had similar procedures.
Recovery time
Every patient is unique, as is the type of surgery, and recovery times. They all vary accordingly. General health, physical condition, and the severity of the disorder play a role in how long and how involved recovery time will be. Experienced surgeons can provide more specific answers concerning recovery/healing time.
Complication rate
All surgeries carry some risk of complication. Complication rates that are more than 10% is a red flag. Possible post-surgery complications.
Infection rate
Surgeons should have an infection rate lower than 10%. However higher rates do not always mean that surgeon is at fault as higher rates can come from performing highly complex procedures. Another reason for high infection rates could be the patients themselves like smokers or individuals with diabetes have increased risks for infection. However, do not feel uncomfortable asking the surgeon to explain a high infection rate.
Decide to not opt for spine surgery
As a surgeon produces a diagnosis, they should present a recommended treatment plan, including alternative treatments/therapies. Ask for another explanation of any part of the evaluation, diagnosis, or available treatment options.
Get a second opinion
A second opinion should be encouraged. A second opinion can reinforce the surgeon�s recommendations and offers a new perspective. The surgeon should be comfortable with a second opinion. This does not mean that the individual does not trust the surgeon. It does mean that there is considerable interest in achieving optimal health and making sure that surgery is the absolute right thing to do. Pass on surgeons that discourage or disapprove of second opinions and continue looking.
Whiplash Chiropractic Massage Therapy
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*
Lumbar stenosis surgery for sciatica, like any type of surgical procedure does not always yield the most successful results. This is why it�s important to carefully and methodically assess all of the personal risk factors.
Sciatica causes severe pain and surgery could be an option and hopefully of last resort. However, it� is important to first attempt non-surgical/non-pharmacological treatment/s for six to twelve weeks before surgery to relieve symptoms and root cause. A full course of conservative treatment could include:
Physical therapy
Chiropractic
Aerobic exercise
Pain meds
Epidural steroid injection
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Sciatica and Stenosis
Sciatica can be caused by stenosis. This is when the spinal canal narrows, constricting, and pinching the nerves specifically the sciatic. Around ninety percent of cases stem from a herniated disccompressing the nerve roots. The damaged disc extends out and pinches the roots of the sciatic nerve. This pinching causes: �
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Pain
Numbness
Tingling
Muscle weakness
If it stays like this for a long time an individual can experience incontinence, along with permanent nerve and muscle damage.
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Lumbar Stenosis Surgery Options
Lumbar stenosis surgery depends on the cause of sciatica: A single herniated disc could be pressing the nerve, which would only require the removal of just that portion of the disc that�s causing the compression. This procedure is known as a discectomy or microdiscectomy.
If the stenosis is caused by a bone problem like an arthritic bone spur, then space has to be made in the canal. This means a portion of the lamina or the back of the spinal column. This is called a hemilaminectomy. Sometimes the whole lamina has to be removed. This is known as a laminectomy.
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If there is the instability of the spinal column, some of the lumbar vertebrae will be fused together to prevent further instability and added nerve compression.
A non-operative treatment course lasting a few weeks to months could reduce swelling in the nerve and improve sciatica symptoms. What happens is sometimes the disc gets reabsorbed over time and does not irritate the sciatic nerve.
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Surgical Success
If the non-surgical options yielded minimal positive results or completely failed and surgery is the last resort talk with your surgeon to discuss the risks and benefits. The discussion will focus on factors like:
Individuals sixty-five and older, multiple health problems, being overweight or a smoker will place an individual at a higher risk of post complications from surgery. Studies found individuals who underwent surgery for sciatica from lumbar stenosis, identified added risk factors that could affect the outcome including:
Depression: this was because there were patients that continued to have sciatica symptoms after surgery. This means they are more likely to take antidepressants or anticonvulsants.
Quality of life from health perspective was low.
Previous spine surgery
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Knowing about these factors and the possible success of sciatica surgery is something to keep in mind. The best way to understand what and how the surgery will be beneficial is to understand the risks and to remember that the risks are not the same for everybody.
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Optimization
Surgical success depends on making sure patients are optimized before surgery. Increasing the chances of successful surgery after conservative treatment/s a surgeon will ask the patient to take these steps:
Weight loss is difficult, but it has been shown to improve surgical outcomes.
Light aerobic exercise, such as stationary or recumbent cycling can help keep the body’s blood flowing properly.
Exercising with pain is difficult but it will increase the cardiovascular system along with keeping the heart and lungs healthy enough to undergo surgical stress.
If the exercising causes too much pain ask the doctor about anti-inflammatory, muscle relaxants, or steroid medication along with the non-surgical treatment that can provide relief allowing exercise to resume.
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Quit smoking
Smoking increases the rate of spinal degeneration and impairs the body�s ability to heal properly and optimally after surgery. If the surgery is elective, meaning it is not a medical emergency, then it is strongly encouraged to quit smoking before surgery. This will increase the chances of eliminating the habit. Don’t be afraid to get support. cancer.org/smokeout.
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Pro-activeness
If taking antidepressant/s for depression, do not quit taking the medication thinking it will improve sciatica surgery success. Mental health is extremely important. The same goes for anticonvulsant meds as well. Stopping anticonvulsant medication for spinal surgery will more than likely cause extended damage or pre/post-surgical complications. Pre-existing conditions like depression means bringing the mental health provider and other specialists into the pre-surgical discussion.
Chiropractor Sciatica Symptoms
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*
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