Why do so many patients go from doctor to doctor and clinic to clinic in search of a cure for recurrent episodes of back pain and in particular sciatica? At CanadaPhysio, a week does not go by without encountering a patient seeking treatment for painful, persistent and recurrent Sciatica. What is it about Sciatica, or rather conventional treatment of Sciatica that makes it come back so often? Why do patients have such difficulty obtaining effective treatment for Sciatica?
Emily is a 34 year old woman in pretty good physical shape that had experienced several bouts of sciatica over the last 3 years. The first time it happened, Emily went to her family doctor who prescribed anti-inflammatory medication and told her to rest in bed for several days until the pain went away. Emily followed these instructions and after a week or so, she could start to move around with less pain. Emily was relieved when she could go return to work and resume her work out program at the gym. A few months later it happened again only this time medication and bed rest did not seem to do the trick so muscle relaxants and even more rest was prescribed. After two more similar episodes and outcomes, Emily turned to CanadaPhysio for help. Emily wanted to know what was causing her sciatica and what treatment options were available to her.
Impingement (compression) of the Sciatic nerve coming through the lower back vertebrae creates pain that affects the hip, back, buttock and leg. This compression is often caused by degeneration of a vertebral disc which is commonly referred to as a bulging, herniated or slipped disc. Many just refer to it as a pinched nerve and it usually features pain, burning and numbness. Sciatic nerve impingement can be part of a much larger issue like spinal stenosis, spondylolisthesis or degenerative disc disease. These conditions typically originate as part of a degenerative arthritic condition or trauma and demonstrate the classic feature of “radiculopathy” which is pain extending down the leg.
True Sciatica is part of a larger condition and its origin and underlying cause must be accurately determined before it can be properly treated.
What Emily and many others with these symptoms actually experienced, while similar enough to true impingement of the Sciatic nerve are instead brought on by an “irritation” of the nerve as it runs through a tight piriformis (hip rotator muscle) or equally mistaken with a dysfunction of the nearby sacro-iliac joint affecting nerves running very near the path of the sciatic nerve which makes diagnosis difficult at times.
Pregnancy, internal scar tissue, muscular strain, infection, or even a fracture in the pelvic hip area can give rise to inflammation near the nerve which can create the painful symptoms.
Conventional treatment for this type of pain recommends that the patient rest until the painful episode passes. Pain and anti-inflammatory medication are usually prescribed to help things along. However, many newer studies have shown that movement instead of just rest actually improves circulation and cellular nutrition which promotes faster and improved healing.
High impact activity is to be avoided but gentle exercise can stretch and relax tight muscles and disperse inflammation away from the irritated nerve. In very rare cases where movement is impossible a brief period of rest may be necessary but the patient should be encouraged to return to activity after a day or two. Hot/cold packs, strengthening and stretching exercises, chiropractic manipulation, acupuncture, and massage therapy are helpful in healing sciatica and sciatica like symptoms.
Spinal Decompression is a very effective treatment in cases of true discogenic Sciatica. The treatment utilizes a computer assisted personalized program of care to progressively “decompresses” the impingement of the sciatic nerve occurring at the level of the verterbral disc. This special treatment along with a course of strengthening and stretching exercise restores vascular nutrition to promote remarkable spinal healing.
CanadaPhysio is here to help. With many locations to serve your needs across Ontario, in Toronto, Scarborough, Whitby, Mississauga and London, our trained professionals can help you get back on track.