Sciatica is an irritation to the sciatic nerve caused by direct pressure on the nerve or by pressure on the nerve roots (from the fifth lumbar and first two sacral nerve roots) that give rise to the sciatic nerve. Pressure on the nerve roots can be a result of a subluxation (a misalignment of the vertebrae in the spine) or from a herniated disc. Direct pressure can may stem from pressure on the sciatic nerve by the piriformis muscle (a hip rotator deep to the buttock muscles).
The pain associated with sciatica is described as a pain radiating from the low back into the buttock radiating down the posterior of the leg. It may radiate all the way down into the ankle or cause numbness or tingling.
In determining where the irritation is originating from through a thorough examination, our office can recommend a course of treatment to usually resolve this condition easily and fairly quickly. In more complicated cases where there is disc involvement the patient is generally referred out for an MRI (a non-invasive diagnostic imaging procedure that produces a three dimensional image of the spine).
Spinal manipulation, flexion distraction therapy and Active Release Technique are typically used to address the sciatic irritation. As the patient improves, progressive resistance exercises are given to the patient. Patient's who do respond within the expected time period (typically less than 3 weeks) are evaluated by an orthopedist, physiatrist or neurologist our office works with to give us a second opinion. In our office we take a team approach to healthcare.
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