Sciatica: What is the Source?

sciatica_legpainSciatica: What is the Source?

One of the most common things that I see in my office is Sciatica.  In fact, many patients come to their first visit and tell me straight away that they have sciatica.  Self diagnosis is common today as you can find anything you want on the internet.  However, what most people don’t understand is that sciatic symptoms can have multiple different causes.  This means that sciatica treatment can vary depending on the primary cause.  The real trick is to uncover the true source.  Is is stemming from poor soft tissue health in the low back?  Scar tissue build-up in the hips and glutes? Poor pelvis function?  Poor lumbar spine function?  A herniated disc in the lower back?  Poor postural position of the low back and pelvis?  Or more commonly, is it a combination of many of these?  Many times therapists take a cookie-cutter approach to sciatica.  Adjusting the lumbar spine and pelvis, stretches for the piriformis, and maybe some electrical stimulation to the area.  This can sometimes help overcome the pain and symptoms, but most of the times function is never addressed.  This is the real source of the problem.  Some dysfunction in postural positions or movement has taken place that led to the problem.  Unless this is addressed the problem is likely to return.

The other issue I see is that people many times have an MRI that is done because of nerve symptoms that are present.  While this is not a bad idea you always have to remember that the pain is not always caused by what is found in the MRI.  For example, if you take an MRI of someone’s low back, many times you are likely to find that is does not look perfect.  You may find some mild narrowing of spaces or even some mild disc bulging.  This does not mean that you can automatically assign these findings to the source of all the patient’s pain.  This is why many times surgery to the lumbar spine fails to resolve the patients complaints.  The surgeon did a great job at making the MRI look ‘normal’, but it may not have been the actual thing that was causing the symptoms in the first place.  In fact, in the vast majority of cases conservative care will be enough to take care of the symptoms and restore function without pain.  However, there needs to be a comprehensive approach to this care.  You must address the soft tissue health, the proper joint function, the nerve health, postural positions, strength capacity, AND movement patterns.  You cannot just pick one and roll the dice.  If you fail to correct postural and movement patterns then treatment will likely fail or the problem will shortly reoccur.  We see this many times in our office as patients come to us after numerous other practitioners have failed to resolve the problem.  This is not because they are bad at the services they provide, it is simply because they did not address all of the problems at the same time.

Understand the basic premise behind sciatica treatment is taking pressure off of the sciatic nerve, wherever the compression may be happening.  Whether this is caused by scar tissue, poor joint movement, or poor functional patterns, it doesn’t really matter.  All we have to do is uncover all the dysfunctions, restore normal function, and then let the body heal on its own.  If you are suffering from sciatica, just make sure that your sciatica treatment program is comprehensive and addressing all these areas to ensure you the best chance for success.

14 Medications to Zero

pillsA few weeks ago I heard a great story about a lady’s return to health that made me both happy and frustrated all at the same time. While checking out at Nordstrom’s the woman that was assisting me took down my email address and noticed that ‘Dr.’ was in the spelling. She continued to ask what kind of doctor I was and when I told her I was a chiropractor her face lit up as she told me how her chiropractor was the absolute best and was the only doctor she currently uses. This, of course, makes me smile, but also begs me to get more information. The explanation of her return to health was really summed up in one sentence. She said, “Two years ago I was on 14 medications and now I am on none!”. 14 MEDICATIONS!!!!! It is almost difficult to believe that someone can continue to be handed prescriptions at a rate so high. She said that she finally sought out this chiropractor because she was not satisfied with the direction of her healthcare and didn’t feel right taking that many medications every day. This particular chiropractor took control of her care and in two years she lost 50 pounds and was able to eliminate 14 medications from her life! That is just plain awesome. Can you imagine the negative side effects that 14 medications have on your system? Not only each individual one, but there also must be some negative interactions between these meds. Now, this story is really not to say how chiropractors are the best thing in the world. This could have been any other healthcare professional, like a dietician, a naturopath, an acupuncturist, or even another medical professional. The point is that she was able to turn her life around so drastically and truly control her own health.
This really made me smile as I walked out of the store, but this satisfaction was quickly joined by a feeling of frustration. Clearing 14 medications from the system and returning the body to a healthy state is a massive victory, but it begs the question of how someone can possibly be instructed to take all these medications in the first place. Was this really the direction that her previous healthcare provider(s) thought was in her best interest?? Surely there were multiple medical professionals who each lent a hand in boosting her prescription numbers. And maybe even 3 or 4 of these medications were given temporarily and not meant for long term use. However, this would still leave the patient with at least 10 daily medications and potentially no planned date for ending their use. Unfortunately, this has become a common scenario in today’s healthcare system; partly because multiple doctors are used to control a patient’s health and partly because many medical professionals rely on medications as their primary tool for ‘health’. Luckily, this patient decided to seek out advice from another health professional whose goal would be to fix things without using a prescription pad. My hope is not that we eliminate the use of all medications as there are extremely useful and necessary in many instances. My hope is that we use them only when other methods fail to provide solutions or if the body just cannot sustain health without them. I’m sure there are many stories just like this, but probably even more people that COULD have stories like this if they decided to finally take control of their own health.