I have shooting pain that’s running down my leg. After doing a Google search to find out more about my problem, I think I might have sciatica.
Sciatica (pronounced sigh-attic-uh) is irritation of a nerve in the low back that potentially relates to leg pain. The sciatic nerve runs down the spine and all the way down the back of the leg. This nerve then branches off into other nerves that travel down into the bottom of the foot.
These are the four most common causes of sciatica:
Disc Herniation – The spongy discus between the vertebrae are called the intervertebral discs. They function like a shock absorber, providing space between each vertebrae. These discs can herniate or bulge due to trauma, an accident, daily activity, or overuse. The herniated or bulged disc will then put compressive force on one or both of the nerves that travel down each side of the spine. This is the most common cause of shooting leg pain.
Spinal Stenosis – Stenosis essentially means the narrowing of a canal. The nerves on each side of the spine exit through a hole at the bottom, which can become closed down. Since there’s not as much room in the hole for the nerve to exit, pressure is exerted on the nerve. The spinal canal with the cord in the middle can also begin to narrow. Once again, this results in mechanical pressure on a nerve. The pressure will then relate to another part of the body (likely the leg).
Piriformis Syndrome – The piriformis is a muscle located deep down in the buttocks. This muscle is responsible for external rotation of the leg. The sciatic nerve runs right underneath the piriformis muscle. After being seated for long periods of time, the muscle can become irritated, resulting in tightness. Mechanical pressure is being put on the nerve, which can potentially result in leg pain.
Changes During Pregnancy – Pregnant women tend to develop sciatica due to the biomechanical changes in the pelvis. They will experience irritation on the nerve which relates to leg pain.
Etiology
The etiology (cause) of sciatica could come from several different issues. It might be chemically enhanced sciatica, meaning there is an associated inflammatory response. It could also be more of a chronic problem where excessive pressure is being exerted on the nerve and interfering with its function. Patients with a history of cancer should be wary of potentially serious causes of sciatica such as tumor growth.
Sciatica is a condition that chiropractors, primary care physicians, orthopedists, and neurosurgeons see very often. Exams that we do here in the clinic will help us shed light on the issue. Sometimes your reflex might be somewhat diminished. There may also be some sensory loss or numbness in one part of the leg.
Does it hurt when you sit, and does it feel better when you stand up? The answers to these questions will typically indicate where the dysfunction lies. If the patient is uncomfortable being seated, compressive load is likely irritating the back. Once they get up and move around, the area decompresses and the pain is reduced.
If we are still uncertain about the underlying cause, we may recommend MRI or CT scans.
Treatment
Medications can be a front-line defense if they are needed. Epidural steroid injections could also potentially reduce irritation. Chiropractic care is another conservative, noninvasive measure. It’s a good idea to find a chiropractor that utilizes some type of exercise, stretching, self-management, and activity modification.
In our experience, manipulation isn’t the best treatment modality for disc herniations and bulges. Instead, we’ll focus primarily on modifying the patient’s activity, resetting their stabilizers, and getting them stronger through their core. It’s also extremely important to educate the patient about how they can do things differently throughout the day to take some pressure off of the affected area.
Significant leg pain with motor loss is a serious issue that needs relatively quick attention. If the patient has a foot drop or limited strength, we might make a referral to an orthopedist or a neurosurgeon. Most commonly, however, we tend to see general leg pain that resolves itself within 4 to 6 weeks.
If you’re experiencing leg pain, we’re here to help. Contact us online or give us a call at (918) 743-3737.
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