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The Sciatic Nerve is the largest nerve in the body. Solutions are often overlooked by not finding the true cause (or causes, there are often more than one) of the nerve irritation. It may come from disc compression, degeneration, spinal misalignment, leg length discrepancies, etc.. Most get better within a few weeks with usual treatments or rest. If yours isn’t, we need to find the cause and solution for your condition.

The pain starts in between the vertebrae in your lower back, travels through a group of muscles in your buttocks, and can defer pain down the back of your thigh and even all the way to your foot. It often starts from an injury to your lower back (usually L4 thru S1) and is usually worse when you’re bending over, running or sitting.

What Is Causing My Pain?

If your leg pain is worse with standing and walking and relieved by bringing your knees to your chest, it’s often due to Spinal Stenosis. If it’s worse with sitting, it’s often caused by a herniated, bulged or damaged disc. Occasionally the nerve is trapped by the muscles in your buttocks and sometimes, in more difficult cases, two or more causes are occurring at the same time.

In the picture above, notice the Sciatic Nerve leaving under the Piriformis Muscle. The Gluteal Muscles lie on top of the Piriformis Muscle. Either can squeeze the sciatic nerve and are often overlooked. In fact, when the Piriformis Muscle compresses the Sciatic Nerve (as shown in the picture on the left), it’s called a Piriformis Syndrome. Treatment to elongate the spastic or shortened muscle away from the nerve is very effective and responds, when properly done, quite quickly.

Sciatica Treatment Options

Minor cases of Sciatica are often treated effectively with gentle stretching and routine Chiropractic or Physical Therapy approaches. But, complex and severe cases often require a more detailed exam and treatment approach.. Obviously, surgery should be your very last treatment option and often carries significant side effects.

The Spinal Stenosis and Disc Center, Inc. treat the most difficult and resistant cases of Sciatica. Please see us if your pain has gone on for over two months, is especially severe or is accompanied by numbness, tingling or weakness to either of your legs or when surgery has been recommended to you. Most of our patients have been told that surgery was their best or only option. We’ve usually determined that wasn’t the case. When it is, we work with excellent surgeons, but our job is to try and avoid high risk methods when other approaches will work that are safer and more effective. This is not an exaggerated statement. Please see the research performed at our office that supports this claim.

What If My Case Is Difficult?

Sciatica is often caused by the lower back vertebrae moving slightly out of alignment due to a fall, asymmetrical postures or a minor structural fault from birth (often missed by most doctors) that pinches the Sciatic Nerve directly or by causing the nearby disc to herniate or bulge into it.

As we said earlier, many cases of Sciatica respond well to physical therapy, chiropractic, and rest, but of course there are cases when this isn’t enough. The spinal adjustments need to be more exact, the exercises more specific to your asymmetry, the disc may need to be non-surgically decompressed and the congenital fault may need to be addressed with a heel lift or asymmetrical posture to correct it.

This is a side view of your low back. Notice the Sciatic Nerve travelling through the “normal canal” on the top. The narrowed canal on the bottom is much smaller and is far more likely to irritate the Sciatic Nerve, which travels through it. Spinal misalignments and muscular asymmetry can narrow this canal, irritate the sciatic nerve (even damage it) and lead to Sciatica. Careful and deliberate treatment must be designed, in difficult cases, to restore its proper position and size.

As mentioned earlier, a “Double Crush” of the Sciatic nerve occurs when it is compressed in more than one place. These cases will only partially resolve when only one of the sites of compression have been treated. These are the types of cases that may need to come to our center to be fully helped.

What About Disc Herniations, Disc Degeneration and Synovial Cysts? How Do They Cause Sciatica and How Can I Treat It?

Discs are fibrous shock absorbers and spacers between each spinal segment. If they weaken, often due to injury or asymmetry, they can tear or bulge into the nearby nerve. If it’s in your lower back, between L4 and S1, it will commonly compress the Sciatic Nerve and shoot pain and/or numbness to the back of your thigh, below your knee and/or possibly to your foot. It may cause weakness in your leg as well. The Spinal Stenosis and Disc Center, Inc. is unmatched at finding the exact structural cause and answer to this problem. Call our office today for a FREE consultation with our director Dr. Peter Le at 310-451-5851

Article written by Rick H. Morris DC

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