Atlantic Ave Magazine September 2018

health & beauty | pain relief
By dr. john conde
Sciatica…
Exploring Cutting Edge Treatments and Addressing Misconceptions
A shocking 80% of all Americans will experience low back
pain at some point in their life. Its epidemic status continues
to grow and sufferers seek the most cutting edge approaches
to not only ensuring relief but also restoring function.
Quite often individuals may also develop associated thigh or
lower leg pain termed sciatica. The clinical term sciatica requires
clarification. Sciatica simply means “pain in the leg.”
It does not mean that the sciatic nerve has been “pinched.” In fact,
the sciatic nerve is not involved in most cases of thigh or gluteal
pain because it does not supply sensation from this area.
What Is The Cause Of Sciatica?
Sciatica can be caused by irritation or trauma to nerve roots
within the spinal canal or to peripheral nerves outside of
the canal anywhere from the pelvis to the lower leg. Space
occupying lesions within the spinal canal such as a bone
spur, disc herniation, congenitally narrow canal, infection,
metastasis, or mass can be the causative agent. Outside of
the canal we find the instigators to be a femur head
fracture, incorrectly placed intra-muscular injection,
fixation of the sacroiliac joint,
and primary bone cancer of
the pelvis.
The two most common
and least diagnosed
causes are
facet joint syndrome
and piriformis contracture.
Facet joints
help to guide motion of
the spine letting us bend
forward and back and side to
side. They also relieve some of the
weight bearing burden of the rest of the
spine. Quite often they are irritated due to
an injury, arthritis, or misalignment. This irritation
produces referred pain into the gluteal
region and back of the thigh.
Piriformis contracture occurs when the
piriformis muscle tightens and shortens for
a prolonged period of time compressing peripheral
nerves that provide sensation from
the gluteal region and thigh. The tightening
can occur due to repetitive use such as
is seen in runners and tennis players, injury, and misalignment
of the pelvis. The pain pattern is typically represented as severe
buttock pain and mild thigh pain.
How Is It Diagnosed?
A comprehensive neurological and orthopedic examination
should be performed checking reflexes, strength, sensation,
posture, gait, muscle tone, and evaluating pain
production from different positions. X-rays help
to narrow down the diagnosis. Further imaging
studies such as MRI and CT should only be
necessary after a lack of improvement from
conservative treatment or a progression of
symptoms.
Cutting Edge, Conservative
Treatments
The treatment of sciatica is aimed at removing
the cause and restoring proper function to the
area. Cutting edge maneuvers such as eccentric
fast stretching and cross cord inhibition focus
on reducing tension in tightened and shortened
muscle and joint capsules. Chiropractic
manipulations focus on removing the irritation
and restoring proper motion in the
facet joints. Flexion-distraction therapy
helps to reposition some of the herniated
material and increase the overall health of
the disc. Neurophysiologic rehabilitation
of the part of the brain that directly controls
the tone of the deep spinal muscles
helps to create stability in the spine. Lastly,
a proper nutritional assessment should be
made to promote an anti-inflammatory diet.
The Conde Center For
Chiropractic Neurology
401 West Atlantic Avenue, Suite #014
Delray Beach, FL 33444
561-330-6096
www.thecondecenter.com
46 | september 2018 | www.AtlanticAveMagazine.com