Sciatica is the most complaint and problem that I treat. What is it? Sciatica is pain in the distribution of the sciatic nerve. Where is the distribution of the sciatic nerve? The sciatic nerve begins in the buttock and goes down the back and outside of the thigh, and the back, outside and front of the leg, below the knee, and the top, outside and bottom of the foot.
When the sciatic nerve is pinched, it will start to cause pain in the buttock, and the more it is pinched, the farther down the leg it goes.
Where does the sciatic nerve get pinched? Usually, the sciatic nerve gets pinched in the lowermost back area.
What pinches the sciatic nerve? Many things can pinch the nerve, but the most common cause of pinching, in about 95% of cases, is a herniated disc in the low back. Less common causes of pinching can be stenosis, i.e. narrowing of the spinal canal by several tissues in combination, including disc, ligament, a congenitally small canal, and instability, e.g. spondylolisthesis.
How common is sciatica? I would estimate that about 60% of people will have at least one episode of sciatica in their lifetime. An episode of sciatica can last from days to years. It can occur once, or recur for decades.
How is sciatica treated? The first treatment recommended is either physical therapy or chiropractic. Some people may try massage or accupuncture, but those don’t usually work. And massage can make the pain worse, because massage will push your low back into extension, which can make it better or worse.
If physical therapy or chiropractic treatment fail, the next thing to try is injections, such as joint injections, or epidural steroid injections.
In my clinical experience, spinal decompression treatment is the most effective, non-surgical treatment for most people with Sciatica treatment Decatur. In fact, it is much more effective for most people. And it has been my first treatment of choice, since 2006, for anyone with sciatica.
How is sciatica diagnosed? Sciatica is so common, and its symptoms and signs so readily recognized, that anyone with pain in the sciatic nerve distribution, and the usual provocative and palliative factors can be diagnosed, at least, presumptively.
The major diagnostic tool for sciatica is the MRI scan, which typically shows the causative herniated disc. But not always. In fact, about 10-15% of the time, spine specialists will encounter a patient with sciatica or other back pain, and not be sure of why. The diagnostic imaging will not show the cause with certainty, or at all.
There are variable examination findings with sciatica, but often, classic findings are not present.
Is sciatica dangerous? Rarely, sciatica is caused by something dangerous, like tumor, cancer, or infection. More than 98% of the time, the cause is benign, i.e. a herniated disc, but can be extremely painful. The pain severity is only loosely correlated with the severity of the lesion on MRI scan.
When is surgery indicated? Rarely, a pinched sciatic nerve will involve the nerves to the bowel or bladder, and cause loss of bowel or bladder function. This is a medical emergency which happens less than 1% of the time, and needs surgery immediately, or the loss of function can be permanent.
The common reason to do surgery is when all non-surgical methods fail, and the quality of life is bad, and not improving, or the pain is severe and incapacitating. This is probably 2% of the time with cases of sciatica.
Can sciatica get better without treatment? Yes, sometimes. The only way to know is to forego treatment, but many cases of sciatica will not improve without medical treatment. When medical treatment is effective, it can resolve the problem, or help enough until the body helps heal itself.
In a specific person, it is impossible to know exactly what will happen. So we try the most conservative, safe treatments first, and proceed to more aggressive treatments later, if necessary, depending upon the patient’s progress.
Why do spinal decompression treatment for sciatica? The usual cause, more than 95% of the time, is a herniated disc. The disc is sticking out, from between the vertebrae, and is pinching the nerve.
Spinal decompression treatment pulls the vertebrae apart, reducing the pressure in the disc, and encourages the disc to go back from whence it came. This is a simple conceptual model of how, and why, it helps sciatica. In my clinical experience since 1987, with more than 45,000 patients, in orthopedics, physical medicine, physical therapy, and neurosurgery, it is the most effective, non-surgical treatment I have seen or used.
If you’re searching for sciatica treatment Decatur or Decatur sciatica treatment or treatment for sciatica Decatur, call me at 404-558-4015. To learn more, go to my website or go to my YouTube channel, by searching for Craig Castanet.
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