Whiplash-associated disorders, or WAD, describe injuries sustained from sudden acceleration/deceleration movements. It is a common outcome after a motor vehicle collision but can also be caused by sports injuries, falls, or assaults. Whiplash refers to the mechanism of the injury, while WAD refers to the presence of symptoms like pain, stiffness, muscle spasm, and headaches. A WAD prognosis is unpredictable, with some cases remaining acute with a full recovery, while others progress to chronic conditions with long-term symptoms and disability. Early intervention recommendations include rest, chiropractic care and physical rehabilitation, massaging and stretching exercises, and an anti-inflammatory diet.
Whiplash Associated Disorders
Cervical hyperextension injuries happen to drivers and passengers of moving, slow-moving (less than 14 miles per hour), and stationary vehicles when struck from behind.
The individual’s body is thrown forward, but the head does not follow the body and instead whips forward, resulting in hyperflexion or extreme forward movement of the neck.
The chin limits forward flexion, but the momentum can be sufficient to cause cervical distraction and neurological injuries.
When the head and neck have reached maximum flexion, the neck snaps back, resulting in hyperextension or extreme backward movement of the neck.
Pathology
Most WADs are considered soft tissue-based injuries with no fractures.
Stages
The injury goes through stages:
Stage 1
The upper and lower spine experiences flexion in stage one.
Stage 2
The spine takes on an S-shape while extending and eventually straightens, causing lordosis.
Stage 3
The entire spine is hyperextending with an intense force that causes the facet joint capsules to compress.
Symptoms
Whiplash-associated disorders can be classified through grades by the severity of symptoms, including neck pain, stiffness, occipital headache, cervical, thoracic, and lumbar back pain, upper-limb pain, and paraesthesia.
Grade 0
No complaints or physical symptoms.
Grade 1
Neck complaints but no physical symptoms.
Grade 2
Neck complaints and musculoskeletal symptoms.
Grade 3
Neck complaints and neurological symptoms.
Grade 4
Neck complaints and fracture and/or dislocation.
Most cervical fractures occur predominantly at C2 or C6, or C7.
A chiropractor will identify areas of restricted joint motion, muscle tension, muscle spasm, intervertebral disc injury, and ligament injury.
They will analyze posture, and spinal alignment, check for tenderness, tightness, and how well the spinal joints move.
This will allow the chiropractic physical therapy team to understand the injured body mechanics and how the spine is operating to make a thorough diagnosis.
The doctor will order imaging tests like an x-ray or an MRI to evaluate any degenerative changes that may have existed before the whiplash injury.
Once the injury has been accurately diagnosed, the chiropractor will design a personalized treatment plan.
Spinal Adjustments
Spinal manipulation is applied to areas of the spine that are out of alignment to realign the spine and activate the healing process.
Flexion-distraction technique is a gentle technique that uses slower, less intense pushing motions on the discs used to treat disc herniations that often occur after a whiplash injury.
Instrument-assisted manipulation utilizes special instruments to apply various forces or massage settings to the area.
Targeted spinal manipulation targets specific areas to rework, release, and rebuild the structures.
Massage Therapy stimulates the affected muscles to relax them from their tense state.
A treatment plan may utilize:
Instrument-assisted therapy
Trigger point therapy
Resistance-based stretches to rehabilitate soft tissue damage.
Our chiropractic team is ready to help you feel your best so you can return to normal activities and get on with your life.
Ritchie, C., Ehrlich, C. & Sterling, M. Living with ongoing whiplash-associated disorders: a qualitative study of individual perceptions and experiences. BMC Musculoskelet Disord 18, 531 (2017). https://doi.org/10.1186/s12891-017-1882-9
Sterling, Michele. “Whiplash-associated disorder: musculoskeletal pain and related clinical findings.” The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949
Wong, Jessica J et al. “Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration.” The spine journal: official Journal of the North American Spine Society vol. 16,12 (2016): 1598-1630. doi:10.1016/j.spinee.2015.08.024
Woodward, M N et al. “Chiropractic treatment of chronic ‘whiplash’ injuries.” Injury vol. 27,9 (1996): 643-5. doi:10.1016/s0020-1383(96)00096-4
The spine is the body’s central highway, with the spinal canal as the main lane that handles all the traffic. There are entrances and exits, or spinal cavities, that allow the nerves to branch off the spinal cord and run throughout the body. A traffic jam develops during lane closures, accidents, or construction at an entrance or exit. Lateral recess stenosis causes the narrowing of the spine’s lateral recess/Lee’s entrance, which can compress nerves, impede nerve circulation, and cause painful symptoms.
Lateral Recess Stenosis
The spinal column provides a strong and flexible structure for the spinal cord. The nerves travel from the spinal cord through various openings and passageways to the rest of the body. One of the openings is known as the lateral recess. Stenosis means narrowing. When a lateral recess in a vertebra develops stenosis, the nerve in that area can get jammed/pinched with no room to move, causing varying symptoms and sensations.
Symptoms
Depending on where the stenosis is taking place (neck, middle or low back), common symptoms of lateral recess stenosis can include:
Back pain that can spread out to other areas.
Cramping that can spread out to other sites.
Radiating pain that worsens with movement and eases with rest.
Numbness or weakness of the legs or arms.
Electrical tingling sensations down the leg or arm.
Muscle groups around the stenosis area are built up to take the pressure off of the area, alleviating symptoms.
Medications
A doctor or spine specialist may recommend or prescribe medication to ease symptoms. These include:
Tylenol – acetaminophen.
NSAIDS – Advil/ibuprofen or Aleve/naproxen.
Muscle relaxers
Steroid Injections
According to a study, neurogenic claudication is the main reason for disability and loss of independence in the elderly.
Neurogenic claudication describes pain and weakness in the buttocks and legs during physical activity that originates from the nerves, not the vessels.
This can happen from inflammation and swelling around a compressed nerve.
A steroid injection can decrease inflammation for several months.
Surgery
If activity modification, NSAIDs, bracing, and physical therapy don’t work or provide adequate relief, a doctor or specialist could recommend surgery.
Fusion is reserved when there is instability combined with the condition.
Back Problems Chiropractor
References
American College of Rheumatology (n.d.) “Spinal Stenosis” https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Spinal-Stenosis
Arthritis Foundation (n.d.) “Corticosteroids” https://www.arthritis.org/drug-guide/corticosteroids/corticosteroids
Drug Design, Development and Therapy (2014) “Steroid for epidural injection in spinal stenosis: a systematic review and meta-analysis” https://doi.org/10.2147/DDDT.S78070
Lee, Seung Yeop, et al. “Lumbar Stenosis: A Recent Update by Review of Literature.” Asian spine journal vol. 9,5 (2015): 818-28. doi:10.4184/asj.2015.9.5.818
Liu, Kuan, et al. “Steroid for epidural injection in spinal stenosis: a systematic review and meta-analysis.” Drug design, development, and therapy vol. 9 707-16. Jan 30, 2015, doi:10.2147/DDDT.S78070
Medline Plus (n.d.) “Achondroplasia” https://medlineplus.gov/genetics/condition/achondroplasia/
Aging Arthritis: How the body changes as the years go by is determined by an individual’s diet, physical activity/exercise, genetics, stress levels, sleep patterns, and self-care. As the body ages, natural degeneration from everyday wear and tear will present. The focus is on understanding how age-related degeneration can affect the body and what to do to prevent and treat it.
The condition can cause long-term joint damage that can lead to disability.
Aging Arthritis and Chiropractic Care
Chiropractic care is recommended for the treatment of any form of arthritis. Chiropractic care can work with other therapies to reduce swelling and inflammation, alleviate pain, and improve mobility and flexibility.
A chiropractor will utilize body imagery before beginning treatment.
Imaging gives insight into the condition of the joints, and the visual, combined with a self-report from the individual, allows the chiropractor to create a personalized treatment plan.
Once a chiropractor has identified which techniques the body can handle, treatment will commence that can include:
Therapeutic massage
Percussive massage
Ultrasound
Electrotherapy
Low-level cold laser therapy
Infrared heat
A chiropractor’s objective is to rebalance, realign and strengthen the body, relieve pressure or stress at the junction of the joints, and expedite healing and rehabilitation.
LLT Laser Therapy
References
Abyad, A, and J T Boyer. “Arthritis and aging.” Current opinion in rheumatology vol. 4,2 (1992): 153-9. doi:10.1097/00002281-199204000-00004
Chalan, Paulina, et al. “Rheumatoid Arthritis, Immunosenescence and the Hallmarks of Aging.” Current aging science vol. 8,2 (2015): 131-46. doi:10.2174/1874609808666150727110744
Goronzy, Jorg J et al. “Immune aging, and rheumatoid arthritis.” Rheumatic diseases clinics of North America vol. 36,2 (2010): 297-310. doi:10.1016/j.rdc.2010.03.001
Greene, M A, and R F Loeser. “Aging-related inflammation in osteoarthritis.” Osteoarthritis and cartilage vol. 23,11 (2015): 1966-71. doi:10.1016/j.joca.2015.01.008
Back discomfort symptoms include stiffness, spasms, tenderness, and headaches often caused by unhealthy posture and overuse muscle strain. Breathing back discomfort can be caused by injuries to the spinal musculoskeletal system, conditions and/or disease in the back, lungs, or heart, and other conditions unrelated to the back. When taking a breath, the intercostal muscles surrounding the rib cage contract, expanding the chest and allowing the lungs to fill with air. These muscles directly affect the spine, which is why back issues can present when breathing. Chiropractic care, decompression, and massage therapy, combined with a functional medicine approach, can realign the spine, release tight muscles, and restore function.
Breathing Back Discomfort
A problem in the back could be a root cause for discomfort and back problems while breathing.
Spinal Conditions
Scoliosis
Scoliosis causes the spine to curve sideways, either in one direction, creating a C shape, or generating an S shape in two directions.
The curvature can be so minimal that it cannot be seen or so severe that it can be life-threatening. Most scoliosis cases fall in between.
Taking deep breaths can cause discomfort and pain because the spine curvature puts extra strain on certain muscles meant to support the body’s weight in tandem with other muscles that have limited function or are no longer functioning.
The condition normally begins in adolescence but can start later in life.
Scoliosis treatment varies depending on the severity.
Monitor
A spinal physician will monitor the individual for mild curvature, as sometimes the process stops before it becomes serious. This is known as the wait-and-see, what-happens approach.
Kyphosis is another curve in the back that is supposed to be there.
Instead of curving like scoliosis, kyphosis causes a curve forward in the thoracic spine/upper back.
Problems arise when the curve is too pronounced.
This curve can come from unhealthy posture, Scheuermann’s disease, or being born with it.
Kyphosis causes breathing back discomfort by straining the muscles in the upper back, which are used for each breath.
Treatment often involves chiropractic and/or physical therapy to restore proper curvature and reduce inflammation.
A back brace could be prescribed if discomfort and pain continue.
Spinal fusion could be recommended for severe cases.
Lungs
The lungs and the spine are close to each other, which is why back discomfort and problems with breathing are connected.
Pneumonia
Pneumonia is an infection in the lungs that causes the tiny sacks known as alveoli to fill with fluid.
This is where the body takes oxygen from the inhaled air to the bloodstream.
The infection causes inflammation and discomfort symptoms in and around the chest and back while taking deep breaths.
Lung Cancer
Lung cancer can cause back issues and pain.
Frequently coughing causes the muscles around the ribs and back to become overused and strained from the jerking and heaving.
The strained muscles cause discomfort and pain when taking a breath.
Tumors can push on sensitive nerves in the back, causing inflammation and pain.
Pleurisy
There is a thin layer of protective tissue surrounding the lungs called pleura.
Pleurisy describes the layer becoming infected and/or inflamed, which causes discomfort symptoms in the back when breathing.
Pleurisy can be caused by injury, infection, or cancer.
Individuals with autoimmune disorders are more at risk of developing the condition.
Pneumothorax
Pneumothorax describes a full or partial lung collapse, usually on one side.
The lung can collapse as a result of severe illness or injury.
The lung collapses because air gets between the pleura and the lung and not allowing the lung to expand.
Pain with breathing is a common indicator of pneumothorax.
Individuals with this condition also experience severe shortness of breath and chest pain on one side.
Pulmonary Embolism
A pulmonary embolism occurs when a blood clot gets stuck in an artery, blocking blood flow to part of the lung.
The lungs will display signs of distress through back pain when trying to take a deep breath.
This is a life-threatening condition that causes chest pain, coughing up blood, a heart rate over 100 beats per minute, dizziness or leg swelling, and painful breathing; get to an emergency room immediately.
Heart
Heart Attack
The nerves associated with pain in the muscles and bones differ from those surrounding the organs, including the heart.
However, a heart attack can cause back pain as the nerves of the heart travel along the same path as spinal nerves, specifically in the upper back.
The brain can misinterpret pain signals from the same roots that supply peripheral nerves in the chest, arm, jaw, and back.
Because they share nerve pathways, the upper back can present with pain during a heart attack.
Aortic Dissection
The largest artery in the body is called the aorta.
It comes off the top of the heart and then drops to supply blood to the rest of the body.
Sometimes, the vessel can get a small tear in the chest area, which grows from the blood circulation pressure.
Aortic dissection can cause intense back pain while breathing.
Chiropractic care, decompression, and massage therapy combined with functional medicine can help realign the spine, stretch and loosen the overused and strained muscles, and provide postural training and nutritional planning to help alleviate symptoms and restore function.
Deep Breathing Back Pain
References
Costumbrado J, Ghassemzadeh S. Spontaneous Pneumothorax. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459302/
Floman, Y., Burnei, G., Gavriliu, S. et al. Surgical management of moderate adolescent idiopathic scoliosis with ApiFix®: a short peri- apical fixation followed by post-operative curve reduction with exercises. Scoliosis 10, 4 (2015). https://doi.org/10.1186/s13013-015-0028-9
Hunter MP, Regunath H. Pleurisy. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558958/
Mansfield JT, Bennett M. Scheuermann Disease. [Updated 2022 Aug 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499966/
Raitio A, Syvänen J, Helenius I. Vertebral Body Tethering: Indications, Surgical Technique, and a Systematic Review of Published Results. Journal of Clinical Medicine. 2022; 11(9):2576. https://doi.org/10.3390/jcm11092576
Herniated disc injuries and the time it takes to heal depend on the injury’s cause, the severity, and where it occurred along the spine. Symptoms can last a few days to months. Chiropractic treatment, massage therapy, and decompression realign the spine and return the disc to its correct position. Still, the herniated disc signs it is returning to normal can take time as the rest of the spine and body adjust to the realignment.
Herniated Disc Signs It Is Returning To Normal
Most cases take a few weeks with healing time depending on health conditions, physical activity level, and age. However, in severe cases, a herniated disc can take up to several months to fully heal, but discomfort symptoms usually resolve sooner.
Expectations From a Healing Disc
Resting the spine and taking it easy after the injury is recommended.
Too much rest is not recommended as it can cause muscle stiffness.
While the herniated disc is healing, a primary doctor may prescribe anti-inflammatories or muscle relaxants to help ease discomfort.
A chiropractor and/or physical therapist can teach exercises and stretches to relieve pressure on nerves, loosen tight muscles, and improve circulation.
Signs The Herniated Disc Is Healing
Most herniated discs cause significant pain in the back and neck from the nervous system, causing some of the muscles of the low back or neck to spasm to protect the area from further damage.
Usually, the muscle spasms relax within the first days of the injury.
After spinal decompression, neurological symptoms like the sharp, shooting pain down a nerve in the arm or leg are the first symptoms to go away.
Then muscle weakness along the path of the nerve goes away.
Numbness in the extremities can linger around longer.
Length of Time
The wear and tear of adult spinal discs, combined with unhealthy posture habits, job occupation, previous injuries, etc., decrease blood circulation.
This is why it can take some time to heal completely, as the entire blood supply needs to reset to optimal circulation.
Nerve compression causing aches and pain sensations down the nerves can also take time.
Regular Activity
Returning to regular activities depends on the individual’s case and condition. It is essential not to overdo things that can cause excessive loading of the spine before the disc has fully healed, which increases the risk of re-herniation and other injuries.
Inactivity can slow the healing process and cause inflammation.
Patients are encouraged to return to activities that generate gentle motion to stimulate the stabilizing muscles to function properly and increase blood circulation to the injured area.
Individuals are recommended to:
Learn posture improvement when walking, sitting, standing, and sleeping.
Adjust sleep patterns.
Incorporate anti-inflammatory nutrition during the healing process.
This provides a mechanical and biological environment that eventually becomes a personalized exercise physical therapy program.
DOC Spinal Decompression
References
Díez Ulloa, Máximo Alberto. “Role of Microangiogenensis in Disc Herniation Healing.” Journal of investigative surgery: the official journal of the Academy of Surgical Research vol. 34,6 (2021): 685. doi:10.1080/08941939.2019.1682725
Factors that influence recovery: Mayo Clinic. February 8, 2022. “Herniated disk.” https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095
Factors that influence recovery: NHS. March 22, 2021. “Slipped Disc.” https://www.nhs.uk/conditions/slipped-disc/
How to speed up healing time: American Academy of Orthopaedic Surgeons. January 2022. “Herniated Disk in the Lower Back” https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/
Keramat, Keramat Ullah, and Aisling Gaughran. “Safe physiotherapy interventions in large cervical disc herniations.” BMJ case reports vol. 2012 bcr2012006864. 18 Aug. 2012, doi:10.1136/bcr-2012-006864
Stoll, T et al. “Physiotherapie bei lumbaler Diskushernie” [Physiotherapy in lumbar disc herniation ]. Therapeutische Umschau. Revue therapeutique vol. 58,8 (2001): 487-92. doi:10.1024/0040-5930.58.8.487
Swartz, Karin R, and Gregory R Trost. “Recurrent lumbar disc herniation.” Neurosurgical focus vol. 15,3 E10. 15 Sep. 2003, doi:10.3171/foc.2003.15.3.10
Nerve damage is also known as peripheral neuropathy. Peripheral nerves transmit information to and from the brain through the spinal cord to the rest of the body. Nerve damage symptoms are common in the neck, arms, hands, low back, legs, and feet. Communication becomes weakened, interrupted, or no longer transmits sensation signals. Nerve damage can be a complication from conditions like diabetes or present after an injury. Injury Medical Chiropractic and Functional Medicine Clinic recognize the symptoms and can treat the injuries rehabilitating the nerves back to functional health.
Nerve Damage Symptoms
Nerve damage symptoms can happen to a single nerve or a group of nerves that can affect the rest of the body. Damage depends on the severity of the condition or injury.
Partially damaged nerves can heal on their own with minimal treatment to ensure they heal correctly.
The fibers are covered with tissues that are a type of insulation.
Sometimes only the fibers get damaged.
Sometimes a nerve gets stuck or jammed inside a tight space, causing irritation and, over time, scarring.
Severe nerve damage can involve the fibers and tissues and often require surgery.
Symptoms can range from mild to severe and depend on which nerve fibers are damaged. These could be the following:
Motor nerves
These nerves regulate all the muscles under conscious control.
These control motor functions like walking, talking, and grabbing and holding objects.
Damage to these nerves usually causes muscle weakness, cramps, and uncontrollable muscle twitching or spasms.
Sensory nerves
These nerves relay sensory information, including touch, taste, smell, vision, temperature, and pain.
Symptoms can include numbness or tingling.
There can also be difficulties:
Sensing pain
Sensing temperature changes.
Walking
Maintaining balance with your eyes closed.
Working with the hands.
Autonomic nerves
This group of nerves regulates unconscious actions, including breathing, heart and thyroid function, and digestion.
Symptoms include excessive sweating, blood pressure variations, inability to tolerate heat, and gastrointestinal issues.
Various symptoms can be experienced as many peripheral nerve injuries affect more than one type of nerve.
Signs
Improperly functioning nerves can cause uncomfortable or painful sensations because the nerves cannot carry the correct signals from the brain to the spinal cord. The signs of nerve damage include the following:
Feeling like you’re wearing an overly tight glove or sock constricting circulation and movement.
Numbness or tingling.
Pins and needles or what feels like mild electrical sensations.
Specific body/limb positions can cause or decrease numbness, tingling, or pins and needles.
Muscle weakness.
Dropping objects regularly.
Sharp pains in the hands, arms, low back, legs, or feet.
Restoring Function
Chiropractic treatments can help restore function and include:
Therapeutic Massage
Therapeutic massage will promote circulation to relieve numbness and tightness and help restore function and feeling.
Chiropractic
Chiropractic adjustments will realign the body and keep affected muscles and joints active.
Electrical Stimulation
Stimulators can activate injured nerves and muscles while the nerve regenerates and recovers.
Braces or Splints
These devices could be used to maintain the position of the affected limb, fingers, hand, or foot to improve muscle function and promote healing.
Exercise
Specifically, prescribed exercises will improve muscle strength, help to maintain range of motion, and reduce muscle cramps.
Diet
A nutritionist will develop a personalized anti-inflammatory diet to expedite healing.
Peripheral Therapy
References
Chen, Zhengrong. “Progress of peripheral nerve repair.” Chinese Journal of traumatology = Zhonghua Chuang Shang za Zhi vol. 5,6 (2002): 323-5.
Gordon, Tessa. “Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans.” Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics vol. 13,2 (2016): 295-310. doi:10.1007/s13311-015-0415-1
WEBB, E M. “Peripheral nerve injuries; early surgical treatment.” California medicine vol. 80,3 (1954): 151-3.
Welch, J A. “Peripheral nerve injury.” Seminars in veterinary medicine and surgery (small animal) vol. 11,4 (1996): 273-84. doi:10.1016/s1096-2867(96)80020-x
Sciatica is common and affects up to 40% of the general population. Different types include acute, chronic, alternating, and bilateral sciatica. The sciatic nerve comprises three specific nerve roots in the lower back. The three nerves originate in the L4 and L5 vertebrae and the sacrum, just below the vertebrae. The nerve then branches off and runs through the back of each thigh. Injury, compression, or irritation of these nerves can cause various symptoms, including numbness, tingling, electrical shooting pain, and muscle spasms in the low back, the leg, and the foot. Chiropractic care can realign the spine, relax the muscles, release compression and relieve sciatica.
Acute, Chronic, Alternating, and Bilateral Sciatica
Acute
Acute pain can be brought on by sudden irritation to the nerves that have become pinched, compressed, or a combination.
Causes a constant burning or shooting sensation through the low back, buttocks, down the leg, and possible hip discomfort.
It becomes worse when sitting.
It can cause immediate and short-term pain lasting for 1-2 weeks.
Chronic
Chronic sciatica can last for months or years on and off or continuously.
It can be caused or worsened by inflammatory conditions like rheumatoid arthritis, injuries, infections, and spinal misalignment issues.
It can resolve but will come back without treatment or lifestyle and activity adjustments.
Bilateral
Sciatica typically takes place in one leg; it has been known to be bilateral and experienced in both legs.
This type of sciatica is rare but can occur from degenerative changes in the vertebrae and/or the discs at several spinal levels.
If there is pain in both legs, it is likely not a herniation but degenerative changes like spinal stenosis.
The symptoms can range from infrequent to irritating to severe and debilitating.
Weakness may be felt in the leg and foot, or a feeling of heaviness, making it difficult to lift the foot off the floor.
Alternating
Alternating sciatica affects both legs alternately. It is usually connected to bilateral sciatica that switches sides.
This type is rare and can result from degenerative problems in the sacroiliac joint, the joint connecting the spine to the hips, or sacroiliac arthritis.
Spinal Sources
Sciatica occurs when L4, L5, and/or S1 nerve roots are affected.
L4 Nerve Root
Pain in the hip, thigh, inner medial areas or the knee, and the calf.
Weakness in the thigh and hip muscles.
Reduced knee-jerk reflex.
Loss of sensation around the calf.
L5 Nerve Root
Pain in the buttock and the outer area of the thigh.
Weakness in the buttock and leg muscles.
Difficulty moving the ankle and lifting the big toe upward.
Loss of sensation between the big toe and the second toe.
S1 Nerve Root
Known as classic sciatica.
Pain in the buttock, back of the calf, and side of the foot.
Fatigue in the buttock and foot muscles.
Difficulty and discomfort raising the heel off the ground or walking on tiptoes.
Loss of sensation in the foot’s outer side, including the third, fourth, and fifth toes.
Chiropractic care can directly address the root cause of the problem, treat the cause, and alleviate the symptoms. Chiropractic manipulation is recommended by the American College of Physiciansas a first line of treatment for back pain before medication, muscle relaxants, injections, and surgery. Treatments to address sciatic nerve impingement:
Ice/Cold Therapy
Reduces inflammation and swelling.
Prepares the patient for massage and adjustments.
Therapeutic Tissue Massage
This therapy promotes muscle relaxation and lessens the muscle spasm/recoil response.
Ultrasound
Soothing heat created by sound waves penetrates the muscles, increases circulation, and relaxes the muscles to alleviate spasms, stiffness, and pain.
Transcutaneous Electrical Nerve Stimulation/Tens Unit
A muscle stimulation machine applies electrical impulses to relax the muscles and untangle muscle knots.
Spinal Manipulation
This process realigns the spine to move properly and restores vertebral health.
Stretches and Exercises
This ensures treatment will last once treatment has or is coming to an end.
Spinal Decompression
Pulls and stretches the body to release any compression on the nerve roots and infuse circulation back into the discs.
The pressure is taken off the sciatic nerve, and routine adjustments will retrain the muscles to maintain their re-alignment. The duration of treatment will vary based on the root cause of sciatica. Each treatment plan is tailored to the individual patient’s situation.
Severe and Complex Sciatica Syndromes
References
Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
Hernández C.P., Sanchez N., Navarro-Siguero A., Saldaña M.T. (2013) What is Sciatica and Radicular Pain?. In: Laroche F., Perrot S. (eds) Managing Sciatica and Radicular Pain in Primary Care Practice. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-907673-56-6_1
Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.
Ngnitewe Massa R, Mesfin FB. Herniation, Disc. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/
Ombregt L. The dural concept. In: A System of Orthopaedic Medicine. Elsevier; 2013:447-472.e4. doi:10.1016/b978-0-7020-3145-8.00033-8
Witenko, Corey, et al. “Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low-back pain.” P & T : a peer-reviewed journal for formulary management vol. 39,6 (2014): 427-35.
Wright R, Inbody SB. Radiculopathy and Degenerative Spine Disease. In: Neurology Secrets. Elsevier; 2010:121-130. doi:10.1016/b978-0-323-05712-7.00007-6
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