Sciatica Pain – What is It? How Can it be Prevented and Treated?

Back Pain WomanWhat are the symptoms of sciatica? Why does a pain in your back affect your leg and foot?

What are sciatica symptoms?
Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down through the leg. Sciatica can sometimes be misdiagnosed.  Sometimes people experience numbness or weakness.  Sometimes it is a tingling sensation. Depending on where the sciatic nerve is affected, the pain may also travel down to the foot or toes. Some of the symptoms are:

  • one-sided pain
  • weakness or numbness of the thigh and leg
  • tingling sensations
  • pain, tingling or weakness of the foot or toes
  • lower back sharp pain when bending
  • continuous or intermittent pain
  • disabling pain

For some people, the pain or weakness from ssciatic nerveciatica can be continuous, quite severe and disabling. For others, the sciatica pain might be infrequent and irritating, but it is possible that it may get worse over time.  The severity of the symptoms depends on the cause of the sciatica.

What causes sciatica?
Sciatica is often a result of a lumbar disc herniation.   However, any inflammation of the sciatic nerve can result in sciatica pain symptoms, such as radiculopathy.  Causes of sciatica include:

  1. a pinched nerve from a disc
  2. irritation of the nerve from adjacent bones
  3. muscle inflammation
  4. internal bleeding, infections
  5. tumors
  6. injury
  7. and other causes.

 

Sciatica Pain CausesSometimes sciatica  occurs because of compression on the nerve during pregnancy. Sciatica pain can also be caused from long-term carrying of an oversized wallet on one side of the hip. This would cause compression upon the nerve and result in sciatica pain.

 

A herniated disk, spinal stenosis, degenerative disc disease, spondylolisthesis, or other abnormalities of vertebrae can all cause pressure on the sciatic nerve.   Sciatica pain may also result from the piriformis muscle located deep in the buttocks, pinching the sciatic nerve. This is known as piriformis syndrome and usually develops after an injury or overuse. It can be difficult to diagnose.

Sciatica Piriformis SyndromePiriformis syndrome has been estimated to cause 6% of sciatica, but recent studies show that it is most likely more common. This is due to electrodiagnostic and imaging techniques. It has been underdiagnosed and undertreated.

A person with piriformis syndrome typically complains of sciatic pain, tenderness in the buttock, and more difficulty sitting than standing. The pain usually occurs from overuse or muscle strain such as overworking at a health club, athletics, heavy work, running, high-performance athletics such as tennis, fencing, pole-vaulting, or sitting for hours at a time, and physical trauma or accident.


How is sciatica treated?
Sciatica can be treated by the following methods:

  1. physical therapy
  2. ice pack
  3. elevation
  4. surgery for treatment of a herniated disc
  5. acupuncture
  6. massage
  7. yoga
  8. chiropractic adjustments
  9. pain medications

 

Many people choose to use drugs or injections to help manage severe pain.  Others have found that meditation, alternative therapies, and change of lifestyle are effective.  Always check with your trusted doctor or health care practitioner before engaging in a physical therapy or exercise program for sciatic. However, the following exercises might be used to treat back pain or sciatica.

Sciatica Back Pain Exercises

Yoga as been more successful than most other alternative therapies in helping those with back pain.  According to a study published in the Annals of Internal Medicine, entitled, “Yoga for Chronic Low Back Pain: A Randomized Trial 313 adults with chronic or recurrent low back pain were studied.  93 (60%) patients offered yoga attended at least 3 of the first 6 sessions and at least 3 other sessions. The yoga group had better back function at 3, 6, and 12 months than the usual care group.  Researchers concluded that “Offering a 12-week yoga program to adults with chronic or recurrent low back pain led to greater improvements in back function than did usual care.”

Yoga Class SitIn a similar study also published by the Annals of Internal Medicine, 101 adults with low back pain were randomly assigned to one of three groups. One group attended yoga classes and lessons; the second engaged in aerobics, weight training, and stretching; the third group read a self-help book about back pain.  After 12 weeks, those who took yoga could better perform daily activities requiring the back than those in the other two groups.  After 26 weeks, those who took yoga had less pain and better back function, and used fewer pain relievers than those in the other two groups.

In a study by L.M. Fishman entitled, “Yoga for Osteoporosis – A Pilot Study,” published in the 2009, Topics in Geriatric Rehabilitation, yoga practitioners working with 19 osteoporosis patients with an average age of 68, gained 0.76 and 0.93 points for spine and hips, respectively, on the T-scale when compared with controls (P =.01). Five patients with osteopenia were reclassified as normal; 2 patients with osteoporosis are now osteopenic. There were no injuries. Fishman concluded that yoga appears to be an effective way to build bone mineral density after menopause and that the study supported the hypothesis that practicing yoga for as little as 8 to 10 minutes daily will raise T-scale ranking in older patients.

More research is needed to determine whether these alternative therapies are helpful for sciatica pain.  Check with your trusted doctor or health care provider before started a new regimen.

Resources
L.M. Fishman,  “Yoga for Osteoporosis – A Pilot Study,” Topics in Geriatric Rehabilitation, Vol. 25, No. 3, pp. 244–250, 2009

Helen E. Tilbrook, BSc, MSc; Helen Cox, and others, “Yoga for Chronic Low Back Pain: A Randomized Trial” Annals of Internal Medicine, 1 November 2011, Vol 155, No. 9

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Jean E. DartThis article is written by Jean Voice Dart,  M.S. Special Education from Illinois State University.
  Jean is a published author and has written hundreds of health articles as well as hosting a local television program, “Making Miracles Happen.”  She is a Registered Music Therapist, Sound Therapist, and Master Level Energetic Teacher, and is the Executive Director, founder and Health and Wellness Educator of the Monterey Bay Holistic Alliance.  The Monterey Bay Holistic Alliance is a registered 501 (c) 3  nonprofit health and wellness education organization.  For more information about  the Monterey Bay Holistic Alliance contact us or visit our website at www.montereybayholistic.com.

Disclaimer: The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)3 organization and does not endorse any particular products or practices. We exist as an educational organization dedicated to providing free access to health education resources, products and services. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. The statements about organizations, practitioners, methods of treatment, and products listed on this website are not meant to diagnose, treat, cure, or prevent any disease. This information is intended for educational purposes only. The MBHA strongly recommends that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition.

What is Subluxation? How does it affect the body?

Vertebral Subluxation

Vertebral Subluxation

What Causes Vertebral Subluxation? What are the most effective treatments?

Vertebral subluxation is a condition of the spinal column. Chiropractors and Medical doctors have differing definitions of subluxation. Medical doctors refer to “significant structural displacements” as subluxations, whereas chiropractors suggest that any disfunctional displacement of the spinal column should be referred to as a subluxation, whether or not it is “significant.” 

Spinal NerveSimply stated, vertebral subluxation occurs when one or more of the bones of your spine (vertebrae) move out of position and create pressure on, or irritate spinal nerves. The nerves that come out from between each of the bones in your spine are referred to as spinal nerves. The pressure on the nerves can cause the nerves to malfunction and might interfere with the signals traveling over those nerves.

The World Health Organization, WHO, definines chiropractic vertebral subluxation as:

“A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.”

Spinal or vertebral subluxation has been controversial since 1895 when the phrase was first introduced.  Some chiropractors claim that subluxation affects many other systems of the body (physical, mental, emotional) and has dramatic effects on health and disease. However, others in the chiropractic profession reject this concept and do not use subluxation as a diagnositc tool.  Nonallopathic lesion is a phrase that has been commonly used in the United States and Canada instead of subluxation as a diagnosis.

What Areas of the Body are Affected with Vertebral Subluxation?

Vertebral Subluxation

Chart showing the corresponding body parts and organs effected by vertebral subluxation and possible symptoms (eg, croup, diarrhea, bladder problems, bronchitis, migraines, constipation, etc.)

According to Chiropractors who agree with the dramatic effects of subluxation on the body, multiple symptoms can occur as a result of the pressure placed on the spinal nerves.

For example, some chiropractors profess that subluxation pressure on the nerves in the cervical spine can result in headaches, migraines, allergies, head colds, arm pain, hand and finger numbness, vision problems, stiff neck and others.  For some it is believed that subluxation pressure on the thoracic vertebrae spinal nerves can result in middle back pain, difficulty breathing, asthma, liver conditions, stomach problems, gastritis, and other syndromes. Subluxation of the lumbar vertebrae, is thought by some to result in constipation, diarrhea, gas pain, menstrual problems, and pain or numbness in the legs, for example.

 

Spine Xray

Chiropractors use Xrays and spinal manipulation to correct spinal subluxations

What Do Chiropractors Claim to Do to Help Remedy Subluxation?
Chiropractors try to locate subluxations and reduce or correct them. They generally use X-rays to determine and make a diagnosis. The physical exam typically includes a variety of assessments, such as range of motion tests, palpation, reflex testing, muscle strength comparisons, and neurological and orthopedic tests focused on your complaint or goal.

Cervical Spine AdjustmentTreatment is generally done through a series of chiropractic adjustments specifically designed to correct the vertebral subluxations in your spine.  The chiropractic adjustment is a therapeutic manipulation that uses controlled force, leverage, direction, amplitude, and velocity directed at specific joints. With subluxation, the goal is to free the pressure that is placed upon the spinal nerve by moving the displaced bone, to bring the vertebrae into normal alignment.

 

Are Vertebral Subluxation Charts an Effective Diagnostic and Prescriptive Tool?
Research studies show chiropractic treatment can sometimes be a statistically significant method of treatment for relieving musculoskeletal pain, although more studies are needed. A 2004 Cochrane review by Bronfort and others found evidence that suggests spinal manipulation may be effective for migraine, tension headache and cervicogenic headaches.  Other similar studies found chiropractic care to be helpful in lower back pain and neck and shoulder pain, directly related to spinal or postural misalignment.

chiropractic subluxation

There is a controversy over the accuracy of subluxation theory and the use of charts as a diagnostic tool.

Although studies exist to show chiropractic treatment effective in relieving pain, at this time, there is no significant evidence to support the effectiveness of  subluxation theory as a diagnostic tool, and no evidence that using spinal manipulation and vertebral alignment is an effective treatment for other non-musculoskeletal syndromes or illnesses (such as cough, diarrhea, constipation, allergies, etc). Multiple studies show that using subluxation to cure illness or disease is not successful at a statistically significant level. Mirtz, and other researchers (2009) in a study entitled, “An epidemiological examination of the subluxation construct using Hill’s criteria of causation,” concluded:

“There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.”

chiropractic adjustmentAccording to Professor Philip S. Bolton of the School of Biomedical Sciences at University of Newcastle, Australia in the Journal of Manipulative and Physiological Therapeutics,

“The traditional chiropractic vertebral subluxation hypothesis proposes that vertebral misalignment cause illness, disease, or both. This hypothesis remains controversial…. Animal models suggest that vertebral displacements and putative vertebral subluxations may modulate activity in group I to IV afferent nerves. However, it is not clear whether these afferent nerves are modulated during normal day-to-day activities of living and, if so, what segmental or whole-body reflex effects they may have.”


Keating and others (2005) concluded,

“The dogma of subluxation is perhaps the greatest single barrier to professional development for chiropractors. It skews the practice of the art in directions that bring ridicule from the scientific community and uncertainty among the public. Failure to challenge subluxation dogma perpetuates a marketing tradition that inevitably prompts charges of quackery. Subluxation dogma leads to legal and political strategies that may amount to a house of cards and warp the profession’s sense of self and of mission. Commitment to this dogma undermines the motivation for scientific investigation of subluxation as hypothesis, and so perpetuates the cycle.”

 

Conclusion and Summary
Vertebral subluxation or a nonallopathic lesion is a condition where one or more bones of the spine are out of alignment and are putting pressure on the spinal nerves.  This can be treated by spinal manipulation, physical therapy, or even surgery.  Traditional subluxation theory professes that subluxation can create other illnesses. chiropractic neckAlthough traditional chiropractic vertebral subluxation theory is popular, whether or not vertebral misalignment causes illness, disease, or both, in other areas of the body and whether chiropractic vertebral adjustment can eliminate this disease or condition, still remains uncertain, and not yet statistically significant and proven by scientific data.  It may very well be true, but currently there is no evidence to support traditional chiropractic subluxation theory.  However, a limited number of studies on chiropractic spinal manipulation have proven chiropractic treatment to be a  significant and cost-effective treatment for many cases of lower back pain, neck pain, migraines, tension headache and cervicogenic headaches. These studies were limited, however, and more studies are needed.

References
Bolton P (2000). “Reflex effects of vertebral subluxations: the peripheral nervous system. An update”. J Manipulative Physiol Ther 23 (2): 101–3. 

Bronfort G, Nilsson N, Haas M, et al. (2004). “Non-invasive physical treatments for chronic/recurrent headache”. In Brønfort, Gert. Cochrane Database Syst Rev (3): CD001878.

Brown R. President, British Chiropractic Association. BCA Statement on Vertebral Subluxation Complex. May 24, 2010. General Chiropractic Council Guidance on Claims Made for the Chiropractic Vertebral Subluxation Complex.

Hart, J, Reduction of Resting Pulse Rate Following Chiropractic Adjustment of Atlas Subluxation,  Annals of Vertebral Subluxation Research, March 3, 2014, pages 16-21.

Keating JC Jr, Charlton KH, Grod JP, Perle SM, Sikorski D, Winterstein JF (2005). “Subluxation: dogma or science?”. Chiropr Osteopat 13 (1): 17.

Gatterman, M. “The vertebral subluxation syndrome: is a rose by another name less thorny? The Journal of the CCA/Volume 36, No. 2/June, 1992, pages 102-104

Gatterman, M.,  One Step Further: The Vertebral Subluxation Syndrome. Dynamic Chiropractic, March 27, 1992, Volume 10, Issue 07.

Mirtz TA, Morgan L, Wyatt LH, Greene L. An epidemiological examination of the subluxation construct using Hill’s criteria of causation. Chiropractic & Osteopathy. 2009;17:13.

Zielinski E, & Blume N,  An Epidemiological Approach to the Effects Subluxation-Based Chiropractic Care Has on Managing CVD Risk Factors: A Case Study and Review of the Literature,  Annals of Vertebral Subluxation Research, November 4, 2013, pages 77- 99


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Jean E. DartThis article is written by Jean Voice Dart, M.S. Special Education from Illinois State University. Jean is a published author and has written hundreds of health articles as well as hosting a local television program, “Making Miracles Happen.” She is a Registered Music Therapist, Sound Therapist, and Master Level Energetic Teacher, and is the Executive Director, founder and Health and Wellness Educator of the Monterey Bay Holistic Alliance. The Monterey Bay Holistic Alliance is a registered 501 (c) 3 nonprofit health and wellness education organization. For more information about the Monterey Bay Holistic Alliance contact us or visit our website at www.montereybayholistic.com.

Disclaimer:  The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)3 organization and does not endorse any particular products or practices. We exist as an educational organization dedicated to providing free access to health education resources, products and services. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. The statements about organizations, practitioners, methods of treatment, and products listed on this website are not meant to diagnose, treat, cure, or prevent any disease. This information is intended for educational purposes only. The MBHA strongly recommends that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition.