When a patient comes in and complains of shooting leg pain, we want to get to the bottom of it. We start by taking a medical history and examine them thoroughly so we can diagnose the problem. We start with what may be a large bucket of possible problems and work to narrow it down or empty the bucket.
One problem in the bucket – sciatica. The sciatica is the largest nerve in the body and it runs down your leg. It’s made up of a handful of nerves in your low back. When someone tells me they have a shooting, tingling kind of throbbing numbness down their leg, that’s the first problem I look for. A common form of sciatica is a bulging or herniated disc. The disc is the spongy material between back vertebrae and when it gets damaged can protrude and create some mechanical pressure on that nerve. This also creates that radiating pain down into the leg. Conservative treatments such as physical therapy or chiropractic or possibly even interventional pain management injections can help. In a few cases, surgery is needed.
Second, it could be an orthopedic type injury. If there is tendinitis in the hamstring it can give referred pain. It could be musculature where a little neural traction in the nerve in the lower leg that is aggravated. It could be piriformis syndrome. That’s where the deep muscle below your glute muscle runs over the sciatic nerve. The muscle can become tight and reproduce shooting type symptoms into the leg as well.
We start by asking when does the pain bother you? Nine times out of ten they are going to tell me it really hurts when I sit for extended periods. There is a disc problem that irritating that nerve, prolonged sitting or sitting in that compressive load will actually aggravate the disc and irritate the nerve even more. And that will reproduce the leg pain.
It’s rarely associated with trauma. In rarer cases, there are really nasty things like tumors. But it’s typically going to be a disc problem that’s aggravated by sitting. Or it could be for flexion – a joint problem. This might increase some of the pressure in their low back, which therefore could irritate the nerve. So sitting and bending are two top activities or movements or things that we’re going to see that they are going to reproduce more of the leg pain.
Conservative treatment may include an anti inflammatory from your physician and possibly a steroid. What we’re trying to do with medication is reduce that inflammation in that disc to reduce pressure on the nerve.
Chiropractic at Tulsa Spine and Rehab is a good treatment modality. We don’t want to manipulate or move around that area where there potentially may be a disc problem but try to address other areas. Like in the thoracic spine or the mid back and below into the hips. Try to pick up some movement in those areas.
Probably one of the most effective treatments or forms of care for disc problems is physical therapy. We all need to work on core stability. The more strength and stability that we can bring around that will take a little pressure of that disc. And in turn, lessen some of the leg pain.
Tulsa Spine and Rehab’s goal when we’re treating sciatic type injuries or leg pain, we just want to become more centralized. So if a patient comes in and the pain is shooting all the way down into the foot or the calf. After a couple of weeks we can get it localized to the back of the thigh or just into the glutes. It will be much more manageable from there.
If you’re experiencing leg, you need to check in with Tulsa, Oklahoma’s Tulsa Spine and Rehab.
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