Back Pain and Sciatica Relief
Back pain can emanate from any of the structural elements in the lumbar spine and organic referrals. Constipation, diarrhea, appendix or ileocecal valve problems, ovarian cysts etc., can all create back pain.
The sciatic nerve is the longest and largest nerve in the body. It emanates from the spine spinal cord at lumbar vertebra L4 and L5 (there are 5 lumbar vertebra). It travels down to the legs.
There are only a few different causes of sciatica. Sciatica usually happens on only one side but can be on both. The nerve has to become irritated and it swells which cuts the blood supply of the nerve causing a loss of oxygen known as hypoxia. It can become irritated by lumbar disc degeneration, spinal stenosis, disc herniation, sacroiliac joint instability and piriformis muscle imbalances. Stenosis is the most difficult to treat since the spinal cord is being completely crushed. This type of severe back pain or sciatica often requires surgery. Disc herniation and disc degeneration are handled in a similar way. First of all we must address the foot weakness that is always present in sciatic cases. The foot must be treated, the nerves to the feet must be treated usually with Class IV laser therapy, the foot can be kinesiotaped for long term stability and then all pelvic imbalances must be addressed. Once the sacroiliac joint is corrected and the stabilizing tissue of the lumbar fascia, iliolumar ligaments and interspinous ligaments (usually with laser) then you can decompress the side of involvement by utilizing spinal decompression techniques. If the sciatica is on the left then we utilize right lateral bending traction to open the left side and vice versa. If spinal flexion (bending forward) aggravates the nerve, then neutral or extension traction is utilized. Kinesiotape may be utilized to stabilize the lumbar fascia, extensors or sacroiliac joint. These are simple mechanical procedures but require a skillful analysis and application for best results. Results are seen within two weeks if the case is able to handled without surgery. But stabilization of the structures that allowed the sciatic inflammation in the first place may take significantly longer. The piriformis syndrome occurs when there is an imbalance in the piriformis muscle and it constricts the sciatic nerve in the pelvis and not the lumbar spine. These cases are the easiest to correct.
became much more effective when they started using a guided procedure. In the old days the doctors simply tried to blindly get the injection to the right spot. Once guided injections became the norm the procedure became much more effective. What the injection does is get the ani inflammatory fluid to the site of the swelling and it reduces the swelling within a week if it is successful. Sometimes more than one injection is required. We sometimes utilize epidural injections in difficult cases because we can proceed with rehab quicker.