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The Sciatica Pain Relief Program
In response to seeing patients suffer from sciatica, low back pain, and radiating leg pain, the medical staff at Axis Chiropractic and Health designed and implemented a program to specifically address the underlying cause of these symptoms. Research has shown that ninety percent of the time, patients can fully recover from sciatic pain, and avoid surgery with a conservative course of treatment. The Sciatica Pain Relief Program was created to give patients a conservative approach in addressing their pain; but more importantly an approach that achieved results.
What is Sciatica?
Sciatica is an inflammation of the longest nerve in the body- the sciatic nerve. The sciatic nerve runs from the spinal cord, across the buttock and hip area and down the back of each leg. Sciatica and sciatic nerve pain are actually secondary symptoms and indications of a problem in the lumbar region of your back placing pressure on the sciatic nerve. Sciatica is usually described as mild to very intense pain in one leg or the other. The pain is a direct result of compression on the nerve roots in the lower back. Sciatica can also be referred to as radiculopathy, the medical term that is used to describe pain, numbness, tingling, and weakness in the arms or legs caused by a nerve root problem.
Examination and Tests for Sciatica
Your spine specialist will start with your medical history and assess the start of your nerve pain. He will also ask the location of your pain. Is it in your lower back, or your buttocks, or does it radiate down one or both legs? You will be asked to rate your pain on a pain scale as well as its frequency. He will also ask about any muscle weakness, tingling, or numbness in your legs. Can you still work or participate in daily activities and go to work? What have you do to this point to alleviate the pain? Do certain activities make the pain better or worse? Your spine specialist will then conduct a physical exam that observes your range of motion and physical well-being. He will exam your spine and look for any misalignments or muscle spasms. During the neurological exam, he will test your reflexes, muscle strength, and any changes in nerve function.
The Leading Causes of Sciatica
Bulging or Herniated Disc
In a bulging disc the gel-like center (nucleus pulposus) remains “contained” within the tire-like outer wall (annulus fibrosus) of the disc. A herniated disc is when that gel-like center breaks through the outer wall. It is then called a “non-contained” disc disorder. Whether a disc bulges or herniates, disc material can press against an adjacent nerve root and compress delicate nerve tissue and cause sciatica.
The piriformis muscle is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome develops when muscle spasms develop in the piriformis muscle thereby compressing the sciatic nerve.
Lumbar spinal stenosis
Lumbar spinal stenosis is a condition whereby either the spinal canal (central stenosis) or one or more of the vertebral foramina (foraminal stenosis) becomes narrowed.
Spondylolisthesis is the forward displacement of a vertebra, especially the fifth lumbar vertebra, most commonly occurring after a break or fracture. Backward displacement is referred to as retrolisthesis.
Bone spurs are smooth structures that form over a prolonged period of time. The medical term is osteophytes, and they represent an enlargement of the normal bony structure. Osteophytes are a sign of spinal degeneration (aging), and are quite common in people over the age of sixty.
External forces such as auto accidents, sports injuries, and falls are a few ways that the sciatic nerve can become compressed or traumatized.
The Sciatica Pain Relief Program
Approximately 1 in every 30 Americans will experience the pain of a herniated disk in their lifetime. Of these, less than 10%, will require surgery to eliminate their sciatica or sciatic nerve pain. For patients who follow a non-surgical treatment plan, 60-70% recover within 6 weeks. By week 12 of the conservative, non-surgical treatment plan, 90% of patients have fully recovered. The Axis Chiropractic and Health Sciatic Pain Relief Program is a conservative, non-surgical treatment plan designed so that you can eliminate your pain as soon as possible. Our approach utilizes several modalities, but is ultimately designed around your specific situation. We accept all major insurance, and have payment plans for those without insurance coverage. Here are a few of the treatments included in our Sciatic Pain Relief Program:
Nonsurgical decompression therapy (as opposed to surgical decompression) is a type of motorized traction that works by gently stretching the spine. This changes the force and position of the spine, taking pressure off the spinal discs, and your sciatic nerve root. The negative pressure from the decompression cause the bulging or herniated discs to retract, and takes pressure off the nerves and other structures in your spine. As a result, your discs receive more oxygen, water, and vital fluids so they can heal. A vast amount of research has been conducted as to the outcomes when using nonsurgical decompression, and the results are impressive. In a recent study, 85% of patients who had sciatic nerve pain, reported a satisfactory and pain free recovery within six months.
Integrative Dry Needling (IDN) is not acupuncture (traditional Chinese medicine) which is based on meridians. IDN is founded on neuro-anatomy and modern scientific study of the musculoskeletal and neuromuscular systems. A very fine filament needle is inserted through the skin and into the deeper tissues that are considered the generators of your pain. The proposed mechanism of action for Dry Needling is the creation of a micro lesion within the pathological (damaged) tissue, breaking up shortened tissues, adhesions and scar tissue, inhibiting the reflex arc from the nervous system to the tissue, creating a mild inflammatory response, which brings in white blood cells and endorphins (the body’s natural pain relievers). This mechanical and neuromuscular effect provides an environment that enhances the body’s ability to heal which ultimately reduces pain.
Chiropractic and Manual Manipulation
Spinal adjustments and manual manipulation performed by licensed chiropractors are used to realign the spine, correcting problems resulting from the misalignment, and thereby improving nerve transmission. Gentle touches of varying pressure are used to reduce the nerve irritability responsible for causing inflammation, muscle spasms, pain and other symptoms associated with sciatica. This in turn helps to address a number of underlying conditions that can cause sciatic nerve pain.
Strengthening and Stretching Exercises
Strengthening exercises are used to help stabilize the spinal column and the supporting muscles, ligaments and tendons attached to it. Most of these exercises focus not only on the lower back, but also on the abdominal (stomach) muscles, and gluteus (buttocks) and hip muscles. Stretching exercises are designed to target muscles that cause pain when they are tight and inflexible. Hamstring stretching is an important part of a sciatica exercise program.
Ultrasound therapy is used to sends sound waves deep into your muscle tissues and creates a gentle heat that enhances circulation and helps to speed healing. Increased circulation helps to reduce muscle spasms, cramping, swelling, stiffness, and pain.
Physical therapy includes both passive and active treatments. Passive treatments help to relax you and your body. They also prepare your body for therapeutic exercise and more active physical therapy treatments. Extensive research has shown that maintaining physical activity (without bending or twisting) is vital to a quick recovery.
Massage therapy targets muscle tension that is putting pressure on your sciatic nerve or related nerve roots. The direct pressure and friction of massage releases the tension in your soft tissues (ligaments, tendons, muscles). Massage therapy has also been shown to increase blood circulation and release endorphins (the body’s natural pain relievers).
Hot and Cold Therapy
Heat therapy is used to promote more blood flow to the target area, which in turn increases the amount of oxygen and nutrients. For example, a heat pack placed on your piriformis muscle may help to reduce muscle spasms that are antagonizing your sciatica. Cold therapy slows circulation, helping to reduce inflammation, muscle spasms, and pain. A combination of alternating hot and cold therapy is often implemented, based on improvement.
Acupressure is a non-invasive, safe, and gentle therapy whereby trigger points (localized areas of muscle spasm) are targeted until the muscle tension subsides. For sciatic nerve pain, the trigger points that are often responsible for the nerve irritation are located in the gluteus medius, minimus muscles, and the gluteus maximus (aka. Butt muscles), piriformis, and the lumbar paraspinal muscles.
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