Help! My lower back pain and sciatica are killing me!

Help! My lower back pain and sciatica are killing me!

The pain in your lower back causes you to fall back to your knees. All you did was bend down to pick up the pen that you dropped on the floor. However, this time it is different. It's worse than in the past. This time you feel pain shooting down the back of your leg. A white-hot dagger stabs you in the rear end and you feel numbness and tingling down your leg, perhaps down to your foot. You can't get up to walk and you limp along like you've been shot. You stay still and pray for the pain to go away... but it doesn't go away. In fact, it's getting worse. Your thoughts come in rapid succession: “What is happening to me, what should I do, who do I call, should I go to the emergency room, do I need surgery?” Good questions.

If you experience a combination of these symptoms, there is a possibility that you have a herniated disc in your lower back, one of the causes of mechanical back pain. The swelling from inflammation or the disc itself can cause impingement or “pinching” of the spinal nerve root. The roots of the lower lumbar nerve eventually form the sciatic nerve in your leg. Inflammation of this nerve is commonly known as sciatica. "Mechanical low back pain is one of the most common patient complaints presented to emergency physicians in the United States. It accounts for more than 6 million cases annually. Approximately two-thirds of adults are affected by mechanical low back pain at some point in their lives, making it the second most common complaint in outpatient medicine and the third most expensive disorder in terms of health care spending, surpassed only by cancer and heart disease." 1

But just because you have these symptoms doesn't necessarily mean you need to rush to the surgeon. According to a landmark study published in the medical journalspine,"Surgery should not be performed if other treatment produces equivalent results within an acceptable time period. The patient with low back pain and sciatica should not be automatically referred to the surgeon." 2 If this is the case, then what other options are available to you? If you're like most people, the first place you'll want to go is your primary care doctor's office (or an emergency room if you're really panicking). Traditionally, doctors prescribe medications such as painkillers, muscle relaxants, anti-inflammatories, or any combination thereof. There are three problems with taking medication if that is all that is done.

1. Medikamente behandeln nur die Symptome.
2. Medikamente bieten nur vorübergehende Linderung.
3. Medikamente haben viele ungesunde Nebenwirkungen. Nehmen Sie sich Zeit, um die Warnbeilage mit einem dieser Medikamente zu lesen, und Sie werden wissen, wovon ich spreche.

In contrast, chiropractic care has been shown to be more effective than traditional medical care in treating chronic low back pain. A study published in the Journal of Manipulative Physiological Therapeutics (JMPT) concluded that “…the improvement was for chiropractic patients5 times bigger[than for medical patients]. Patients with chronic back pain treated by chiropractors show greater improvement and satisfaction after 1 month than patients treated by primary care physicians. “3

Are there times when surgery is necessary? The answer is definitely yes. Absolute indications for surgical intervention include patients with cauda equina syndrome (which is rare), severe motor deficits secondary to a large extruded or migrated disc fragment, and patients with intractable pain. Unless these conditions are present, chiropractic care has been shown to be safe and effective for the treatment of discogenic or mild to moderate sciatica pain due to a herniated disc. One study shows that chiropractic treatment (in this case in the cervical spine) is 100 times safer than the use of non-steroidal anti-inflammatory drugs such as Asprin, Ibuprofen, Naproxen, etc. 4 Another study shows that patients had an 86% improvement in chronic low back pain after chiropractic care. 5

As a side note, let me also say that medical care and chiropractic care are not mutually exclusive for treating mechanical low back pain and sciatica. In my experience, I have had great results in the most serious cases when treating these conditions in collaboration with a patient's primary care physician or pain specialist. In these cases, the medication is useful or necessary for the patient to tolerate conservative treatment. For example, when it is extremely difficult for the patient to move or be moved.

Finally, not every case of sciatica is caused by a herniated disc. A condition called piriformis syndrome can cause the sciatic nerve to impinge as it exits the pelvis. Basically, the piriformis muscle attaches to the sacrum, passes through the greater sciatic notch of the pelvis, and attaches to the top of the femur (the thigh bone). Athletes who participate in sports where they sit, such as rowing or cycling, are particularly susceptible to piriformis strains. Runners who overpronate are also prone to piriformis injuries. When the muscle is injured, it causes swelling due to inflammation, which can irritate or compress the sciatic nerve as it exits the pelvis. It is important to rule out spinal injury as a cause of sciatica. However, the following video shows a Stretching for the piriformis muscle. If your symptoms improve after one to two weeks of stretching, you likely had piriformis syndrome and should continue this stretching as part of your daily routine to avoid future injury. However, if you still have the same symptoms or if they worsen, seek professional help as soon as possible.

1. Kinkade S. Bewertung und Behandlung von akuten Schmerzen im unteren Rückenbereich. Bin Fam Arzt. 15. April 2007; 74 (8): 1181-8.
2. Weber H. Bandscheibenvorfall: Eine kontrollierte prospektive Studie mit zehnjähriger Beobachtung. Wirbelsäule 1983; 8: 131 & ndash; 40.
3. Nyiendo J., Haas M., Goodwin P. Patienteneigenschaften, Praxistätigkeiten und einmonatige Ergebnisse für chronische, wiederkehrende Schmerzen im unteren Rückenbereich, die von Chiropraktikern und Hausärzten behandelt werden: Eine praxisorientierte Machbarkeitsstudie. JMPT 2000 May; 23 (4): 239 & ndash; 245.
4. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation und Mobilisierung der Halswirbelsäule. Eine systematische Überprüfung der Literatur. Wirbelsäule 1996 Aug 1/21 (15): 1746 & ndash; 59.
5. Harrison DE, Cailliet R., Harrison DD, Janik TJ, Holland B. Änderungen in der sagittalen Lumbalkonfiguration mit einer neuen Methode der Extensionstraktion: nicht randomisierte klinisch kontrollierte Studie. Archiv für Physikalische Medizin und Rehabilitation 2002 Nov; 83 (11): 1585 & ndash; 91.

Inspired by Dana C Williamson, D.C.