Understanding Back Pain and Sciatica

One of my friends recommended me, over and over, and just extended how good he (Dr. Alex Jimenez, D.C.) was. So I gave it a shot. I had really bad sciatica and it was killing me, I couldn’t walk, but he has been helping me out, I can walk now… I couldn’t walk more than 25 yards, it (sciatica) was really affecting me. I had to get some help. I can’t say enough about Dr. Jimenez, he’s been helping me out, I can walk.

 

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Edgar M. Reyes

According to the American Association of Neurological Surgeons, approximately 75 to 85 percent of individuals in the United States alone will experience some form of back pain throughout their lifetime, where 50 percent will suffer more than one episode within a year. Back pain is one of the most common complaints frequently reported among the general population and it is often a symptom which could indicate the presence of another underlying condition. Back pain can be caused by a variety of factors, some due to bad habits, such as improper posture, and others due to injuries from accidents. Other health issues, such as degenerative disc disease, or DDD, and arthritis can also result in back pain. While the causes can vary, they share the same symptoms.

Bak pain can include upper back pain, middle back pain and lower back pain, often connected to sciatica, or sciatic nerve pain, a condition characterized by the compression or impingement of the sciatic nerve found in the low back. Back pain and sciatica have been closely associated with several common health issues. Often times, sciatica, or sciatic nerve pain, is caused by an underlying health issue along the lumbar spine. The sciatic nerve is the longest nerve in the human body, which connects to nerve roots in the region of the lower back and runs through the buttocks, down along the hips and into the back of each leg. Further sections of this nerve then branch out from the calf to the foot and into the toes. Sciatica can be identified by the following symptoms.

• Low back pain which radiates down one or both legs
• Leg and/or foot pain along with tingling and burning sensations
• Numbness in the leg, feet and/or toes
• Persistent pain and discomfort on one or both sides of the buttocks
• Intense painful symptoms in the lower extremities
• Having difficulties when sitting and while getting up

It’s essential to understand that back pain and sciatica are not generally considered to be a specific health issue themselves but rather, they are usually only considered to be a collection of several symptoms associated with an underlying injury and/or condition. A proper diagnosis of the root cause of your symptoms is additionally important in order to safely and effectively treat back pain and sciatica. As mentioned above, numerous factors can cause back pain and sciatica symptoms. Below, we will discuss some of the most common spine health issues which can cause back pain and sciatica, including degenerative disc disease, lumbar spinal stenosis, lumbar herniated disc and spondylolisthesis. Approximately 90 percent of sciatica cases are due to disc herniations.

Degenerative Disc Disease

The degeneration of the intervertebral discs, found between each vertebrae of the spine, is a natural process which often occurs with age, while for some individuals, however, it can begin to develop earlier than usual. In a healthy spine, the intervertebral discs function as shock absorbers between the bones of the spine, which ultimately provide height and allow the back to remain flexible while resisting forces. As we begin to get older, these rubbery discs begin to shrink and lose integrity. Almost everyone will demonstrate signs of wear-and-tear along their spinal discs over time, but not everyone will experience degenerative disc disease, or DDD. Although not actually a disease, DDD refers to a condition in which pain with the degeneration of the intervertebral discs.

One or more degenerated discs along the length of the spine may irritate a nerve root and cause sciatica. This condition is commonly characterized when a reduced disc becomes exposed. Bone spurs can also develop with disc degeneration and can lead to sciatica. Symptoms of degenerative disc disease, or DDD, frequently occur along the lower back, however, they can also develop in the neck, depending on the location of the degenerated discs. Common symptoms of DDD include, pain and discomfort, particularly when sitting, bending, lifting or twisting, tingling sensations and/or numbness in the extremities, and lessened symptoms when walking and moving, as in with changing positions or lying down. Weakness in the leg muscles or foot drop may be a sign that there is damage to the nerve root.

Lumbar Spinal Stenosis

Another common cause of back pain and sciatica is lumbar spinal stenosis. The natural degeneration of the spine which occurs with age can cause a variety of changes to the spine. Lumbar spinal stenosis is brought on by a gradual narrowing of the spinal canal that is common in the aging process and it generally affects people over the age of 50. When the space around the spinal cord narrows, it can place unnecessary amounts of pressure on the spinal cord and nerve roots. Additionally, it can be the result of a bulging disk, enlarged aspect joints, or an overgrowth of tissue. Only a small number of individuals are born with spine health issues which can develop into lumbar spinal stenosis. This is known as congenital spinal stenosis and it is frequently diagnosed in men.

Arthritis, or the degeneration of any joint in the body, has been attributed to be the most common cause of spinal stenosis. As the intervertebral discs begin to wear-and-tear naturally begin, they can lose water content and eventually dry out, ultimately losing height and even collapsing. This can place pressure on the facet joints, the joints which provide flexibility and movement to the spine, resulting in arthritis. As a result, the ligaments around the structures of the spine can increase in size, lessening the space for the nerves. Also, the human body may respond by growing new bone, additionally narrowing the space for the nerves to pass through. Symptoms of lumbar spinal stenosis may include, pain, tingling or burning sensations, numbness and weakness, as well as less painful symptoms when leaning forward or sitting.

Lumbar Herniated Disc

A herniated disc is a condition which can occur anywhere along the length of the spine, however, it most commonly affects the lower back or lumbar spine. It may also be referred to as a bulging, protruding or ruptured disc. A lumbar herniated disc is considered to be one of the most common causes of back pain in the lower back, as well as sciatica. An intervertebral disc begins to herniate when the soft, jelly-like nucleus, known as the nucleus pulposus, pushes against its outer ring, known as the annulus fibrosus, due to wear-and-tear or a sudden injury. With persistent pressure, the jelly-like nucleus may push through the disc’s outer ring or it may cause the ring to bulge, putting additional pressure on the spinal chord and its surrounding nerve roots.

Moreover, the intervertebral disc material can release chemicals and/or substances which may ultimately irritate the surrounding structures of the spine, contributing to nerve inflammation. When a nerve root becomes irritated, it can potentially lead to symptoms of pain and discomfort, numbness and weakness in one or both legs, otherwise referred to as sciatica, or sciatic nerve pain. An individual may also develop a herniated disc without ever experiencing any symptoms. A lumbar herniated disc is generally caused by the natural degeneration of the spine and discs, however, trauma and/or injury may also result in lumbar disc herniations. Symptoms of a lumbar herniated disc includes sciatica, tingling sensations, numbness, weakness, and loss of bladder or bowel control in severe cases. This last symptoms will require immediate medical attention.

Spondylolisthesis

Spondylolisthesis is another common cause of back pain and sciatica, particularly in young athletes. Repeated stress on the lower back, or lumbar spine, can create a crack or stress fracture in one of the vertebrae. In these cases, however, the stress fracture can often weaken the bone so much, to the point where it is unable to maintain its proper position in the spine, ultimately causing the vertebra to begin to shift or slip out of place. This condition is what is commonly known as spondylolisthesis. In children and adolescents, spondylolisthesis can occur through periods of rapid growth, by way of instance, during an adolescent growth spurt. This condition frequently occurs as a result of overuse, overstretching, or hyperextension, and even due to genetics.

Many healthcare professionals characterize spondylolisthesis as either low grade or high grade, depending on how much the vertebrae have shifted or slipped out of place. A high grade slip is generally identified when more than 50 percent of the width of the fractured vertebra slips forwards onto the vertebra beneath it. Individuals with high grade cases of spondylolisthesis will commonly describe experiencing significant levels of pain and discomfort as well as nerve injury. In the majority of instances, however, individuals with spondylolisthesis will not experience any obvious symptoms, as a matter of fact, most are unaware of the condition till an x-ray is taken for an unrelated injury and/or condition. Individuals with spondylolisthesis may experience back pain and sciatica, including muscle spasms, back stiffness and tight hamstrings.

Dr. Alex Jimenez’s Insight

Back pain is one of the most common reasons why individuals often miss days from work or go to the doctor, as it has also become one of the leading causes of disability worldwide. As a matter of fact, it has been statistically determined that approximately 80 percent of people will or have experienced back pain at least once throughout their life. Fortunately, a variety of treatments are available which can help ease the symptoms of back pain. It’s essential to understand back pain and sciatica, a collection of symptoms commonly associated with spine health issues along the lower back, in order to seek proper diagnosis and continue with an appropriate treatment plan in order to relieve your symptoms of back pain and sciatica.

Treatment for Back Pain and Sciatica

Chiropractic care is a well-known, alternative treatment option commonly utilized to help diagnose, treat and prevent back pain and sciatica. Since there are many factors which can contribute to symptoms of back pain and sciatic nerve pain, a doctor of chiropractic’s, or chiropractor’s, initial step would be to determine the root cause of the patient’s symptoms. Determining a diagnosis involves a thoughtful review of the patient’s health history, and a physical and neurological examination. Diagnostic testing may involve an x-ray, MRI, CT scan and/or electrodiagnostic tests, such as a nerve conduction speed evaluation or an electromyography. These examinations and tests help determine possible contraindications to treatment.

The aim of chiropractic care is to help promote the human body’s potential to heal itself. It is based on the scientific principle that limited spinal motion results in pain and reduced function and performance. Chiropractic care is non-invasive, or non-surgical, and drug-free. The type of chiropractic treatment provided is dependent upon the cause of the individual’s back pain and sciatica. A treatment program may include many distinct treatments and therapies, like ice/cold therapies, ultrasound, TENS, and spinal adjustments or manual manipulations. If the doctor of chiropractic decides that the patient’s spinal health issue requires treatment by a different kind of physician, then the individual may be referred to another healthcare professional.

Physical therapeutics for these conditions is also effective and generally has two components: active and passive. Passive physical therapeutics consist of ultrasound, electric stimulation, heat and ice packs as well as iontophoresis. Active physical therapeutics modalities include stretching exercises, back exercises and low-impact aerobic conditioning. Manual physical therapeutics, such as spinal adjustments and/or manual manipulations, might be integrated in part by a chiropractor. Physical therapists normally recommend 20 minutes of dynamic lumbar stabilization exercises every day. Core muscle strengthening is also important in treating back pain. Low-impact aerobics are also important and include water therapy, biking, and walking.

Physical therapeutics are an important element of treating spinal health issues. If you meet with a physical therapist, there will be a full assessment. Tests will be performed and an individualized treatment plan will be developed based on the patient’s goals. If you’re experiencing back pain or sciatica, don’t wait any longer for relief. Contact a healthcare professional to establish a one-on-one consultation and complete evaluation. Many chiropractors and physical therapists are certified, experienced and dedicated to helping you feel better. They have helped many others recover from spinal health issues and can help you too. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

Curated by Dr. Alex Jimenez

Additional Topics: Back Pain

Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.

EXTRA IMPORTANT TOPIC: Sciatic Pain Treatment