Wednesday, 18 February 2015

Sciatica is not the only condition that’s a pain in the ar•e

Sciatic pain is a common presentation to any chiropractic clinic and one of the commonest complications of low back pain… but, for every ten patients who think they have sciatica, probably only two or three actually do.

Part of the problem is that sciatica is used in everyday terms to describe pretty much any pain that runs down the leg; however, to a back specialist, such as a chiropractor, it refers very specifically to pain that arises from the sciatic nerve or its branches and it has a very specific pattern of distribution: down the buttock and the back of the thigh, often into the back of the calf and the sole of the foot. If it’s down the side or the front of your leg, then it’s not sciatica – but don’t worry, a chiropractor can probably tell you what it is !

Even if it is running down the back of your leg, sciatica still isn’t a definite diagnosis as sciatica isn’t the only thing that can cause pain in the back of your leg. Identical symptoms can arise from the ligaments, joints, muscles and bones in your spine or buttock – in much the same way that pain from the heart refers to your left arm in angina.

Even if it is really sciatica, this is only a symptom – it is important to work out which of the dozens of possible causes is responsible for the pressure on the sciatic nerve, from benign causes such as tightness in surrounding muscles; through bulging or ‘slipped’ discs; to more sinister, less common causes, which require urgent investigation.  Detailed orthopaedic and neurological testing can often pin point the site and nature of the fault; x-rays or magnetic resonance imaging can help confirm the diagnosis: chiropractors spend years learning how to interpret all of the evidence in order to arrive at a precise diagnosis (most middle-aged people have bulges in their discs; it doesn’t means that they’re necessarily the cause of the leg pain).

One of our patients (Dave) had suffered from worsening bouts of Sciatica for three years when he visited the clinic, “I was told that I would eventually need an operation,” he said, “but after 30 minutes of examination and testing, my chiropractor pinned the cause to a problem in my pelvis and put it right with a handful of treatments over a couple of weeks.”

So remember: Not all leg pain is sciatica; not all sciatica is due to disc problems and most disc problems don't need surgery!

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