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What are the two main classifications of Sciatica?

There are two main classifications of sciatica: 1. Neurogenic pain, and 2. Referred pain:

Sciatica from neurogenic pain, pain from the nerve. It is usually a sharp, burning, shooting pain with a constant background ache that never goes completely. It is often associated with a feeling of ‘pins and needles’, hot and cold sensation, numbness and muscle weakness.

The leg pain is usually worse than the back pain. In addition, there are abnormal neurological findings. Such as reflex changes, objective weakness and sensory changes, and abnormal nerve tension tests. Sciatica from referred pain is pain due to a muscle and joint problem in the back. It is usually a dull, achy pain, but can also be sharp in nature. It does not usually cause a feeling of ‘pins and needles’, hot and cold sensation, numbness or muscle weakness. The pain is usually worse in the back than it is in the leg. In addition, there are no abnormal neurological findings. Such as reflex changes, objective weakness and sensory changes, or abnormal nerve tension tests.

How is referred pain generated?

Many of the nerve endings converge and share the same nerve cell-pool in the spinal cord and as the signal travels up the spinal cord to the brain the signal ‘lands’ on the same area as pain signals from another part of the body.

It is important to know this when you attempt to diagnose a problem, because without an accurate diagnosis the treatment is bound to fail.

One of the most well known examples of referred pain is having left arm pain during a heart attack.

Treatment of Sciatica

It always pays to be proactive, if you use the wait and see approach you are more likely to have long term pain.

Some advisers suggest that he should wait for 6 weeks and hope that you will be one of the lucky ones who do not need surgery. And they suggest you should rely on painkillers, swimming and walking as a treatment method.

Considering that you have any functional, mechanical problem that has led to the disc injury, it makes sense that you approach it from a functional perspective.

First of all a diagnosis has to be made before any treatment can start.

A chiropractic examination, which includes a neurological examination, can find out what the cause of your leg pain is, so the most appropriate treatment can be given.

The first step in the treatment is to stop injuring the disc by making sure you avoid bending, lifting and sitting. You can walk as an exercise, but be careful with swimming. Read more about disc injuries here and what you can do to prevent disc injuries.

Restoring the function and to deal with the inflammation are the most important things to do to get you back on your feet.

Co-management with your doctor is the best way forward. You are most likely going to need some painkillers and anti-inflammatory medication, and probably some time off work.

Once you have reached a certain level of improvement, your Chiropractor can help you with an appropriate exercise programme.

Surgery should be a last resort and is sometimes necessary, especially if bowel and bladder control is affected.

These may be symptoms of a rare but important complication causing a, so-called, cauda equina syndrome.

If you experience any changes in your bowel or bladder control, or numbness in the ‘saddle’ area, you should consult the hospital as soon as possible. The symptoms are reversible when treated quickly.

How long will it take to get better?

Your Chiropractor will discuss with you the frequency of visits required for treatment.

The healing process takes time and varies from person to person, often depending on the severity of the condition and the history of the complaint. However, how active and compliant you are in your own treatment will influence your recovery time.

We suggest that you expect a couple of months rather than a couple of weeks, but this varies from person to person.

Chiropractic Treatment

Chiropractors do treat disc herniations and scientific studies have shown that a high proportion of patients find relief with this kind of treatment.

It has also been shown that Chiropractic treatment is superior to the application of heat, exercises, postural education and also conventional physiotherapy.

Research has also shown that patients that do not have surgery do better in the long term.

We use a combination of highly specific manual techniques, followed by a rehabilitation exercise programme.

If you are interested in more research about the best treatment for disc injuries, click here.

Disc Injuries – What should I do to help myself?

There are different degrees of injury ranging from mild tears on the outside of the disc to the more severe disc herniation.

A disc injury can potentially be a very serious injury. It is the sort of injury that sometimes requires surgery but fortunately only in a small number of more serious cases.

We want to make sure that you do not become one of them. There are a number of things that you can do to help yourself. Please read Self help for Disc Injuries.

 

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