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SCIATICA & DISC HERNIATION

Sciatica treatment disc herniation nerve compression low back pain disc bulge lumbar spine leg pain foot pain calf pain leg numbness groin pain Sydney Jannali Healthcare Centre Sutherland Shire Healthcare Chiropractor chiropractic Sutherland remedial massage therapy physiotherapy family chiropractor baby chiropractor sports exercise natural care treatment dry needling acupuncture cupping neck low back pain shoulder arm tennis elbow headache migraine TMJ toothache TMD Temporomandibular jaw pain painful chewing HICAPS healthfund  chronic disease management plan GPMP medical doctor Bangor Barden Ridge Bonnet Bay Bundeena Burraneer Caringbah South Como Cronulla Engadine Grays Point Greenhills Gymea Bay Heathcote Illawong Jannali Kareela Kirrawee Kurnell Lilli Pilli Loftus Lucas Heights Menai Miranda Oyster Bay Sutherland Sylvania Waters Taren Point Waterfall Woolooware Woronora Yowie Bay physiotherapy physio chiro osteo osteopath occupational therapist OT  exercise rehab rehabilitation

DO WE MANAGE SCIATICA CONDITIONS? 

Yes, our chiropractors does!

However, if you experience any of the below symptoms, please seek immediate evaluation by an orthopaedic surgeon.

  • Increasing numbness in your leg and foot

  • Inability to lift your foot or toes

  • Increasing loss of muscle strength

  • Loss of sensation, especially around your buttocks area

  • Loss of bladder or bowel control

  • Unbearable pain

SCIATICA OR FALSE SCIATICA?

 

Sciatica refers to pain caused by the compression or irritation of the sciatic nerve. In contrary, false sciatica means that the pain comes from structures other than the sciatic nerve but resembling sciatica. A skilled clinician can often diagnose actual sciatica from false sciatica with good certainty without additional MRI images and provide you with the right advice and treatment to reduce the duration of your symptoms and your condition.

Navigating the different causes of sciatica can be hard, and it is recommended that you consult with one of our chiropractors for further assessment and treatment.

SCIATICA
 

The sciatic nerve is the body's longest and thickest nerve, originating from several branches (roots) in the lower back and winding down the back of the thigh and knee until it divides into two in the upper part of the leg. One part of the nerve goes to the outside of the leg, while the other goes down the back of the leg to the sole of the foot. Pain felt in the gluteal muscles, back of the thigh or knee, outside or back of the calf, and under the foot may therefore be a symptom of your nerve being pinched or irritated. Pressure on the sciatic nerve can also cause symptoms such as weakness in muscles or numbness in parts of the leg that the nerve supplies.

The most common cause of true sciatica are lumbar disc herniations, which typically presents with symptoms such as lower back pain with radiating pain and numbness into the legs.

Disc Herniation or Discogenic Pain
 

Between spinal segments are the intervertebral discs which serve as cushions for our spine and are composed of a gel-filled core surrounded by a fibrous ring called the annulus fibrosus. The annulus fibrosus is formed by several layers of very strong collagen fibers. Each layer of fibers is oriented in its own direction so that the fibrous ring can withstand as much as possible.

As the intervertebral disc wears out, small or large tearing may occur, and a gel-like liquid from inside the disc can leak out and compress the spinal nerves. When this happens, a considerable amount of pain may be experienced in the lower back and may radiate into the buttock area, thigh or leg, and may be accompanied by tingling and numbness in the feet. This is what we call sciatica. However, it is also common for people to have these tears without ever experiencing pain or knowing it has happened.

In the outermost layers of the intervertebral disc, there are quite a few pain nerves attached and when the disc degenerate over time, potentially after disc herniations, there is less disc liquid and the intervertebral disc become more narrow and provide less cushioning and support, which can leads to what we call discogenic pain. This pain often manifests as aching in the lower back, exacerbated by sitting, coughing, or sneezing, and may radiate into the buttock area and upper thigh, accompanied by tingling and numbness in the feet. Discogenic pain may or may not present with sciatica, i.e. pain along the sciatic nerve. 

It is estimated that up to 40% of all back pain comes from the intervertebral discs, i.e., discogenic pain.

Sciatica treatment disc herniation nerve compression low back pain disc bulge lumbar spine leg pain foot pain calf pain leg numbness groin pain Sydney Jannali Healthcare Centre Sutherland Shire Healthcare Chiropractor chiropractic Sutherland remedial massage therapy physiotherapy family chiropractor baby chiropractor sports exercise natural care treatment dry needling acupuncture cupping neck low back pain shoulder arm tennis elbow headache migraine TMJ toothache TMD Temporomandibular jaw pain painful chewing HICAPS healthfund  chronic disease management plan GPMP medical doctor Bangor Barden Ridge Bonnet Bay Bundeena Burraneer Caringbah South Como Cronulla Engadine Grays Point Greenhills Gymea Bay Heathcote Illawong Jannali Kareela Kirrawee Kurnell Lilli Pilli Loftus Lucas Heights Menai Miranda Oyster Bay Sutherland Sylvania Waters Taren Point Waterfall Woolooware Woronora Yowie Bay physiotherapy physio chiro osteo osteopath occupational therapist OT  exercise rehab rehabilitation

FALSE SCIATICA?

 

Several pain conditions have many of the same symptoms as disc herniation or discogenic pain, but can often be treated more simply. Popularly, we use the term "false sciatica" for these conditions. There are several conditions with both back pain and radiating pain, so it is very common for patients with these complaints to be misdiagnosed with lumbar disc herniation. To the untrained eye, it can be difficult to distinguish between the different conditions that cause sciatica-like pain without it being true sciatica.


Facet Joint Syndrome
 

The facet joints are small joints, two between each of the vertebrae, which guide and limit the movement of the spine. The facet joints prevent, among other things, the vertebrae from sliding forward relative to the one below. Sometimes, there may be minor sprains in ligaments or tension in the muscles around these joints. This can, in turn, create irritation and pain in the back. The pain from facet joint syndrome will normally be localised to the back, but often we see that the pain radiates into the buttocks and often also to the back of the thigh. It is rare to have pain below the knee when the pain comes from facet joints.


Piriformis Syndrome
 

Piriformis syndrome is a condition where the sciatic nerve gets pinched or irritated on its way through the gluteal muscles and causing symptom of sciatica. Because it is a muscular diagnosis, it is often categorised under false sciatica. The condition is usually recognised by pain in the buttocks/gluteal muscles and shooting, burning, or aching pain down the back of the leg. Additionally, you may experience numbness or tingling along the sciatic nerve. It is not always easy to distinguish between sciatica and piriformis syndrome since the conditions are very similar and both involve the sciatic nerve.

 

Gluteal Tendinopathy
 

Gluteal tendinopathy is an irritation of the gluteal tendon where it attaches to the hip bone. Pain is usually located in the buttocks and may radiate to the outside (but also occasionally the back) of the thigh and knee. The pain usually does not extend beyond the knee and can often be excluded if you have symptoms below the knee. It is also not common to experience numbness or tingling with gluteal tendinopathy.


Sacroiliac Joint Dysfunction

 

A condition often seen by chiropractors is reduced mobility of the sacroiliac joint, which often is experienced as a locking or stiffness sensation in the sacroiliac joint (pelvic joint) with associated local pain, or cause similar pain to sciatica, with pain in the buttocks, down the back of the thigh and calf, but rarely numbness or tingling. It is also rare for sacroiliac joint locking to cause weakness in the foot, but it can often cause a feeling of weakness in the thigh and hip. Chiropractic treatment of sacroiliac dysfunction is often effective, in combination with strength exercises and stretching.

Reference List

Alexander, C. E., Cascio, M. A., & Varacallo, M. (2023, August 4). Lumbosacral Facet Syndrome. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK541078/
 

Peng, B.-G. (2013). Pathophysiology, diagnosis, and treatment of discogenic low back pain. World Journal of Orthopedics, 4(2), 42–52. https://doi.org/10.5312/wjo.v4.i2.42

Shim, D. M., Kim, T. G., Koo, J. S., Kwon, Y. H., & Kim, C. S. (2019). Is It Radiculopathy or Referred Pain? Buttock Pain in Spinal Stenosis Patients. Clinical Orthopaedics and Related Research, 11(1), 89–94. https://doi.org/10.4055/cios.2019.11.1.89

 

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