Some of the most common phrases I hear in practice are
Let's cut to the chase! Have you 'got sciatica?' What really is sciatica, why do we get it, can we fix it and do you 'need' surgery?
There are lot of myths with sciatica - Let's bust some myths…
So what is it?
Sciatica by definition is a pain that is referred into the hip, thigh leg or foot where its origins are from the lower back. Sciatica is actually a symptom with a variety of underlying causes unique to each individual. About 2% of the adult population may experience sciatica in their lifetime.
The most common cause of sciatica can be a disc protrusion or disc bulge pressing on the exiting nerve root that refers pain into the leg, along the course of the nerve or into the area of the leg that the particular nerve supplies sensation to.
Other causes of sciatica include anything that can compress the exiting nerve root. This could be an overgrowth of bone which may cause lateral canal stenosis (narrowing of the hole where the spinal nerve exits or overgrowth of some of the ligaments in the lower back again narrowing the space for the nerve root. Finally and very rarely other causes of nerve compression can be cysts or tumors that grow in the space where the nerve sits although these are extremely rare.
Missed or Misdiagnosed?
Anyone that knows me knows I am a stickler for an accurate diagnosis! It's very common for sciatica to be poorly diagnosed and therefore poorly managed. Common misdiagnoses that I encounter include
Other investigations such as xray (useless) CT (wrong test) and MRI (high chance of false positive) have their shortcomings and do not replace the use of a thorough history and high quality physical examination which employs a combination of orthopaedic and neurological tests to improve the accuracy.
Symptoms of Sciatica
The large variation in symptoms location of pain is related to a few key factors:
These variable disc injuries can have quite different symptoms. We will be discussing this topic in more detail in a future post on disc injuries.
These place you at risk of developing lower back pain and sciatica type symptoms.
Effective Treatment Options
Ineffective Treatment Options
An accurate diagnosis to any ailment or injury is the key starting point. As a Chiropractor my first role is achieving an accurate diagnosis but then once we have identified the injured tissue we must ask the important question - in this case - why is the disc (or other cause) failing to function well.
That is what we aim to achieve with your health at Health Associates.
Dr Chris Bowles
Co-founder of Health Associates
Learn more about Dr Chris Bowles
Dr Chris is available for consultations on Monday, Wednesday, Thursday and Saturday.