Do you have pain in one or both legs?
Pain that is worse when sitting? Is your leg pain burning, tingling, numb or searing (versus a dull ache)? Do you have weakness, numbness, or difficulty moving the leg, foot, and/or toes? Are you experiencing sharp pains that may make it difficult to stand up or walk? Do you have pain that radiates down the leg and possibly into the foot and toes? You may be experiencing Sciatica.
What Is Sciatica?
Sciatica is NOT a diagnosis. It is a symptom. The term sciatica describes the symptoms of leg pain (and possibly tingling, numbness, or weakness) that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of each leg. it is a symptom of an underlying medical condition. Common lower back problems that can cause sciatica symptoms include a lumbar herniated disc, degenerative disc disease, spondylolisthesis, or spinal stenosis. Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Symptoms are usually based on the location of the pinched nerve. While symptoms can be painful and potentially debilitating, it is rare that permanent sciatic nerve damage (tissue damage) will result, and spinal cord involvement is possible but rare.
The sciatic nerve is the largest single nerve in the body and is made up of individual nerve roots that start by branching out from the spine in the lower back and then combine to form the “sciatic nerve.” Sciatica symptoms occur when the large sciatic nerve is irritated or compressed at or near its point of origin.
The sciatic nerve starts in the lower back, typically at lumbar segment 3 (L3). At each level of the lower spine a nerve root exits from the inside of the spinal canal, and each of these respective nerve roots then come together to form the large sciatic nerve. The sciatic nerve runs from the lower back, through the buttock, and down the back of each leg. Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg—the thigh, calf, foot, and toes. The specific sciatica symptoms (leg pain, numbness, tingling, weakness, and possibly symptoms that radiate into the foot) depend on where the nerve is pinched.
What Is The Cause Of Sciatica?
Sciatica is usually the result of an injury or disorder of a lumbar intervertebral disc. An intervertebral disc is like a shock absorber between each of the vertebrae in the spinal column. The Disc acts by keeping the vertebrae separated when there is impact from activity, and also serve to protect the nerves that run down the middle of the spine and intervertebral discs.
There are a total of 24 discs in the human spine. The discs are made of fibrocartilaginous material. The outside of the disc is made of a strong material called the annulus fibrosis. The annulus is made of strong layers of collagen fibers woven together at varying angles, the annulus fibrosis gives structure to the disc and allows for even weight distribution of surrounding vertebrae. Inside this protective covering is a jelly-like substance known as the nucleus pulposus. As the spine receives pressure, the gel moves inside the annulus fibrosis and redistributes itself to absorb the impact of the pressure. As we age, the nucleus pulposus dries out (desiccation), this causes the disc to lose height and absorb less shock. The outer layer of annulus fibrosis on the intervertebral disk also deteriorates with age and can begin to rip or fray.
What Is Going On?
Disc injuries can be classified into several basic groups: Internal disc derangement, disc bulge and disc herniation. We are constantly subjecting our spine to compression and twisting forces as we go about our active lives. Gravity is constantly pulling on us and our discs begin to show signs of aging much like the rest of our body does. The dehydration of our intervertebral discs makes them more brittle and susceptible to injury. We develop micro tears in the annulus fibrosis, loss of disc height and changes in the curvature of our spines.
Often times, disc derangement presents as neck or back stiffness. It may cause a constant, deep, dull achy feeling and may cause muscles to become very tight or go into spasm. This typically lasts a few days to a week and then subsides until we “tweak” our back or neck again.
A disc bulge is a more severe form of the degeneration process. As the outer part of the disc experiences more and more tears it weakens. The compressive and twisting forces applied to our spines as we go about our lives squeezes the soft nucleus pulposus out causing a bulge. The discs begin to pancake out and lose their original height. This process may compress the spinal cord or spinal nerves resulting in a condition known as stenosis. This presents as a burning, tingling, numbness (pins & needles) into parts of the body such as the arms, hand, thighs, legs and feet.
If further degeneration / damage occurs, the nucleus will push through the outer annulus. This is what is known as a disc herniation. Herniated discs take a very long time to heal (like any cartilaginous injury) due to a lack of blood supplying the oxygen and nutrients necessary for healing. Oddly enough, the larger the disc herniation, the faster it tends to reabsorb and heal.
A disc herniation can be a very serious condition. If you experience an inability to go to the bathroom, GO TO THE ER RIGHT AWAY!
How Dr. Fuhrmann Can Help?
- Spinal Decompression
- Spinal Manipulation
- Soft Tissue Therapy /KT tape / Trigger point Therapy
- Instrument Assisted Soft Tissue Mobilization
- Cold Laser / Low Level Laser
- Rehabilitative Exercises
- Patient Education