Sciatica "The Scourge & The Treatments"

For individuals experiencing or managing low back pain and/or sciatica, can lumbar traction therapy help provide consistent relief?

Lumbar Traction

Lumbar traction therapy for lower back pain and sciatica could be a treatment option to help restore mobility and flexibility and safely support an individual's return to an optimal level of activity. It is often combined with targeted therapeutic exercise. (Yu-Hsuan Cheng, et al., 2020) The technique stretches the space between the vertebrae in the lower spine, relieving lower back pain.

• Lumbar or low back traction helps to separate the spaces between the vertebrae.
• Separating the bones restores circulation and helps relieve the pressure on pinched nerves like the sciatic nerve, decreasing pain and improving mobility.

Research

Researchers say lumbar traction with exercise did not improve individual outcomes compared to physical therapy exercises on their own (Anne Thackeray et al., 2016). The study examined 120 participants with back pain and nerve root impingement who were randomly selected to undergo lumbar traction with exercises or simple exercises for pain. Extension-based exercises focused on bending the spine backward. This movement is considered effective for individuals with back pain and pinched nerves. The results indicated that adding lumbar traction to physical therapy exercises did not offer significant benefits over extension-based exercise alone for back pain. (Anne Thackeray et al., 2016)

A 2022 study found that lumbar traction is helpful for individuals with lower back pain. The study investigated two different lumbar traction techniques and found that variable-force lumbar traction and high-force lumbar traction helped to relieve lower back pain. High-force lumbar traction was also found to reduce functional disability. (Zahra Masood et al., 2022) Another study found lumbar traction improves the range of motion in the straight leg raise test. The study examined different forces of traction on herniated discs. All the levels improved the individuals' range of motion, but the one-half body-weight traction setting was associated with the most significant pain relief. (Anita Kumari et al., 2021)

Treatment

For individuals with only low back pain, exercise, and postural correction may be all that is needed to provide relief. Research confirms physical therapy exercises can help decrease pain and improve mobility (Anita Slomski 2020). Another study revealed the importance of centralizing sciatic symptoms during repetitive movements. Centralization is moving the pain back to the spine, which is a positive sign that the nerves and discs are healing and occurs during therapeutic exercise. (Hanne B. Albert et al., 2012)

A chiropractor and physical therapy team can educate patients on preventing back pain episodes. Chiropractors and physical therapists are body movement experts who can show which exercises are best for your condition. Starting an exercise program that centralizes symptoms can help individuals return to their normal lifestyle quickly and safely. Consult a healthcare provider before starting any exercise program for back pain.

Movement Medicine: Chiropractic

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cheng, Y. H., Hsu, C. Y., & Lin, Y. N. (2020). The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis. Clinical rehabilitation, 34(1), 13–22. https://doi.org/10.1177/0269215519872528

Thackeray, A., Fritz, J. M., Childs, J. D., & Brennan, G. P. (2016). The Effectiveness of Mechanical Traction Among Subgroups of Patients With Low Back Pain and Leg Pain: A Randomized Trial. The Journal of orthopaedic and sports physical therapy, 46(3), 144–154. https://doi.org/10.2519/jospt.2016.6238

Masood, Z., Khan, A. A., Ayyub, A., & Shakeel, R. (2022). Effect of lumbar traction on discogenic low back pain using variable forces. JPMA. The Journal of the Pakistan Medical Association, 72(3), 483–486. https://doi.org/10.47391/JPMA.453

Kumari, A., Quddus, N., Meena, P. R., Alghadir, A. H., & Khan, M. (2021). Effects of One-Fifth, One-Third, and One-Half of the Bodyweight Lumbar Traction on the Straight Leg Raise Test and Pain in Prolapsed Intervertebral Disc Patients: A Randomized Controlled Trial. BioMed research international, 2021, 2561502. https://doi.org/10.1155/2021/2561502

Slomski A. (2020). Early Physical Therapy Relieves Sciatica Disability and Pain. JAMA, 324(24), 2476.

https://doi.org/10.1001/jama.2020.24673

Albert, H. B., Hauge, E., & Manniche, C. (2012). Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 21(4), 630–636. https://doi.org/10.1007/s00586-011-2018-9

Hamstring muscle injuries are common, especially in athletes and individuals with physically demanding jobs. Is there a better chance of full recovery with surgical repair and post-op rehabilitation?

Hamstring Muscle Tear

Most often, hamstring muscle injuries are partial tears of the muscle. These types of injuries are muscle strains that occur when the muscle fibers are stretched beyond their normal limits. Complete tears of the hamstring muscle are unusual, but they do occur in both athletes and non-athletes. Determining the optimal treatment plan depends on:

• The severity of the tendon tear
• The expectations of the injured individual.

1. Incomplete tears are when the hamstring muscle is stretched too far, but not completely detached.
2. If the tear completes, the injury is more significant, as the ends are no longer connected. (American Academy of Orthopaedic Surgeons. 2021)
3. Complete tears usually occur at the top of the muscle where the tendon tears away from the pelvis.
4. A complete tear usually occurs when there is a sudden flexion of the hip and extension of the knee joint - when the muscle contracts in this position, it gets stretched beyond its limits.
5. Complete tears are recognized as different injuries and may require more invasive treatments. (American Academy of Orthopaedic Surgeons. 2021)
6. Individuals who sustain this type of injury describe a sharp stabbing in the back of the thigh.
7. The injury may occur in athletes or middle-aged individuals. (American Academy of Orthopaedic Surgeons. 2021)

Basic hamstring strains can be treated with simple steps - rest, ice, anti-inflammatory medications, and conservative therapies.

Symptoms

Symptoms of a hamstring muscle strain can include pain, bruising, swelling, and movement difficulty. (American Academy of Orthopaedic Surgeons. 2021) Individuals who sustain this injury typically experience sudden sharp pain. Signs of a tear can include

:

• Sharp pain where the buttock and thigh meet.
• Difficulty walking.
• Sitting can be difficult as the edge of a chair can place pressure directly on the injury.
• Spasms and cramping sensations in the back of the thigh.
• Weakness in the leg, specifically when bending the knee or lifting the leg behind the body.
• Numbness or burning sensations as a result of sciatic nerve irritation.
• Swelling and bruising in the back of the thigh - over time it can travel down to the back of the knee and calf and possibly into the foot.
• With a complete hamstring tear, there is usually significant swelling and bruising that develops in the back of the thigh.

Diagnosis

The symptoms can be difficult to spot in the early stages which is why X-rays of the hip or thigh are usually obtained.

In some situations, a fragment of bone can get pulled off the pelvis along with the hamstring muscle attachment. MRI testing can be performed to evaluate the attachment and can define critical features of a complete hamstring muscle tear, including: (American Academy of Orthopaedic Surgeons. 2021)

• The number of tendons involved.
• Complete versus incomplete tearing.
• The amount of retraction - the amount the tendons have pulled back.
• This will guide the development of treatment.

Treatment

The treatment of a complete tear will depend on different factors. The other variable is the patient and their expectations.

• Treatment is more aggressive in younger individuals like high-level athletes.
• Treatment is less aggressive in middle-aged individuals.
• Often a single tendon tear can be treated non-surgically.
• When one tendon is involved, it is typically not pulled very far from its normal attachment and will develop scar tissue in a positive position.
• Conversely, when three tendons have been torn, they usually pull more than a few centimeters away from the bone. These cases have better results with surgical repair. (UW Health. 2017)
• Surgeons will use patient characteristics - high-level athletes or less physically active individuals - to guide treatment recommendations.

Rehabilitation

• Rehabilitation following surgery can take 3-6 months or longer.
• The first six weeks limit weight-bearing with the use of crutches.
• Patients may be recommended to wear a brace to reduce tension on the repaired hamstring tendons.
• Strengthening does not begin until three months post-op, and even light activities are usually delayed. (UW Health. 2017)
• Because this injury can have a long recovery time, some individuals may choose nonsurgical treatment.
• Sometimes these individuals experience symptoms of discomfort from sitting and may exhibit long-term weakness of the hamstring muscle.

Full recovery from a complete hamstring muscle injury takes time. Studies have shown high-level athletes are able to resume competitive sports after the repair and rehabilitation of an acute hamstring muscle injury. (Samuel K. Chu, Monica E. Rho. 2016)

• Delaying surgical treatment may not always lead to optimal results.
• When the tendon is torn away from its normal attachment, it begins to scar around the surrounding soft tissues.
• When there is a delay of more than a few weeks following the initial injury, regaining the full length of the tendon and muscle can be challenging.
• This could delay the rehabilitation process and may limit the potential for full recovery. (Ho Yoon Kwak, et al., 2011)

With severe injuries, there is a better chance of full recovery with surgical repair but could involve a long recovery and commitment to a post-op rehabilitation plan.

Understanding Long-Lasting Injuries

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Academy of Orthopaedic Surgeons. (2021) Hamstring muscle injuries.

UW Health. (2017) Rehabilitation guidelines following proximal hamstring primary repair.

Chu, S. K., & Rho, M. E. (2016). Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Current sports medicine reports, 15(3), 184–190. https://doi.org/10.1249/JSR.0000000000000264

Kwak, H. Y., Bae, S. W., Choi, Y. S., & Jang, M. S. (2011). Early surgical repair of acute complete rupture of the proximal hamstring tendons. Clinics in orthopedic surgery, 3(3), 249–253. https://doi.org/10.4055/cios.2011.3.3.249

Hamstring syndrome is a condition where the sciatic nerve gets pinched between the hamstring muscles and the pelvic bone or by the tissue bands that connect the hamstring muscles causing compression on and around the nerve. It is seen in individuals that play sports that involve running, kicking, or jumping, in middle-aged individuals engaged in daily activities that have suffered falls, and in individuals that sit for many hours. Chiropractic care, massage, and decompression therapy can relieve the symptoms, release the trapped nerve, relax and stretch the muscles, and restore function.

Hamstring Muscles Trapped Sciatic Nerve

Three muscles make up the hamstrings in the back of the thigh. The sciatic nerve runs from the low back down the leg into the foot. A trapped sciatic nerve can cause various symptoms and sensations in the back of the leg, hip, buttock, and foot. It may hurt to sit down or stretch the legs out, and there is usually tightness in and/or around the buttock and back of the leg. The symptoms typically recede when lying on your back.

Cause

• Regular wear and tear on the back muscles and hamstrings can contribute to the condition.
• Often the sciatic nerve and/or the sheath surrounding the sciatic nerve gets trapped and irritated as it travels around the ischial tuberosity. The ischial tuberosities are known as the sit bones.
• The area where the sciatic nerve runs down the back of the leg can become narrowed, leading to nerve irritation and stinging, numbing, and tingling sensations.
• The injury often happens during sudden, quick, forceful movements that overstretch the tendons and/or muscles but can also happen during slow movements.
• Movement agitates the pulling and rubbing of the nerve on the muscles.
• A non-painful pull or pop of the hamstrings can cause the muscles to spasm and wrap around the nerve.

Symptoms

Symptoms usually include the following:

• Leg pain that worsens when sitting.
• Intense electrical shooting pain that makes it hard to stand or move.
• Difficulties moving the leg or foot.
• Numbness and weakness in and around the leg.
• Tingling or burning sensations running down the leg.
• Persistent pain on one side of the lower back.

Chiropractic Care

Chiropractic treatment can relieve the symptoms and release the trapped nerve. Treatment includes:

• Accurate Diagnosis - A chiropractor will examine and review physical activity, work, and medical history.
• Ice and Heat therapies will stop the swelling and increase blood flow.
• Massage therapy relaxes the muscles and increases circulation.
• Decompression therapy incrementally and gently stretches the body.
• Chiropractic adjustments realign and reset the body. 
• Targeted stretches and exercises will keep the muscles loose and increase strength.
• Nutritional recommendations will help reduce inflammation and prevent flare-ups.

Hamstrings and Sciatic Nerve Relationship

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Lohrer, Heinz, et al. "Nerve entrapment after a hamstring injury." Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 22,5 (2012): 443-5. doi:10.1097/JSM.0b013e318257d76c

Mattiussi, Gabriele, and Carlos Moreno. "Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided "Intratissue Percutaneous Electrolysis" application." Muscles, ligaments and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248

McGregor, Catriona, et al. "Traumatic and overuse injuries of the ischial origin of the hamstrings." Disability and rehabilitation vol. 30,20-22 (2008): 1597-601. doi:10.1080/09638280701786138

Saikku, Kari, et al. "Entrapment of the proximal sciatic nerve by the hamstring tendons." Acta orthopaedica Belgica vol. 76,3 (2010): 321-4.

Pinched Nerves and Muscle Spasms: A pinched or compressed nerve can occur in various body regions, from the wrist to the foot. When a nerve is compressed, a pins and needles feeling can present until the pressure is relieved, or there can be no sensation symptoms, but other symptoms like muscle spasms, especially in the arm or leg, can appear. Individuals will feel a repetitive fluttering or twitching when the arm or leg is not in motion. A pinched nerve could be the cause of spasms in the back or extremities. Injury Medical Chiropractic and Functional Medicine Clinic can help if symptoms are not stopping or worsening.

Pinched Nerves and Muscle Spasms

When multiple symptoms appear, individuals may not realize they are connected. Individuals may think aches, pains, and spasms are normal aging processes. Pinched nerves occur when there is an impingement on any one of the numerous nerves of the spine. Impingements can be caused by:

• Repetitive motion injuries
• Disc degeneration
• Herniated/ruptured discs
• Bone spurs
• Arthritis
• Trauma injury

The pain symptoms from the spasm can be quick, sharp, or pulsating and throbbing. The muscles respond by tightening or spasming as the nerve sends interrupted/incomplete signals. In addition to muscle spasms, a pinched nerve can contribute to other symptoms, including the following.

• Tingling
• Numbness
• Pins and needles sensation
• Reduced range of motion
• Muscle weakness

Signs a Pinched Nerve Might Be Causing Spasms

• Sudden shooting pain that radiates down the leg or arm.
• Weak muscles
• Muscle atrophy - shrinking or deteriorating.
• Chronic tingling in the extremities.
• A burning sensation in a specific area; this could but is not necessarily the source of the pinched nerve.
• Electrical shock-type pain accompanies the spasms.

If a pinched nerve is left untreated and continues to generate symptoms, it can affect daily life and lead to uncomfortable long-term issues. Severe nerve compression combined with inflammation can cause damage to nearby soft tissues and muscles, leading to chronic conditions. When the nerves are damaged, it can be harder to control the muscles making certain motions uncomfortable or difficult to move certain body parts.

Chiropractic Care

Chiropractic care, massage, and decompression therapy will relieve pinched nerves and muscle spasms and restore neuromusculoskeletal system function. The body will be realigned, and patients will be trained on stretching exercises, muscle strengthening, posture training, and nutritional support to optimize the body’s natural healing abilities to repair the damaged nerves.

Low Back Pain

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bustamante, S, and P G Houlton. “Swelling of the leg, deep venous thrombosis, and the piriformis syndrome.” Pain research & management vol. 6,4 (2001): 200-3. doi:10.1155/2001/104091

Chu, Eric Chun-Pu, and Robert J Trager. “Thoracic Schwannoma as an Unusual Cause of Sciatic Pain in the Chiropractic Office: A Case Report.” The American journal of case reports vol. 23 e938448. 16 Nov. 2022, doi:10.12659/AJCR.938448

Coletti, Roger H. “The ischemic model of chronic muscle spasm and pain.” European journal of translational myology vol. 32,1 10323. 18 Jan. 2022, doi:10.4081/ejtm.2022.10323

Hirayama, Jiro, et al. “Relationship between low-back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 15,1 (2006): 41-7. doi:10.1007/s00586-004-0813-2

Kennedy, John G, and Donald E Baxter. “Nerve disorders in dancers.” Clinics in sports medicine vol. 27,2 (2008): 329-34. doi:10.1016/j.csm.2008.01.001

Waddell, Roger K. “Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma.” Journal of chiropractic medicine vol. 4,1 (2005): 19-24. doi:10.1016/S0899-3467(07)60108-6

The body experiences physical changes during pregnancy. As the baby grows, the body has to adjust, which can cause unfamiliar aches and pains. A common issue for pregnant women is sciatica symptoms or lumbar radiculopathy, which radiates discomfort sensations that travel down the lower spine, down the back of the thigh, and into the foot. Chiropractic care and massage therapy can realign the spine and hips, therapeutically massage circulation through the body, relieve symptoms, and restore function.

Pregnancy Sciatica

The sciatic nerve is the largest in the body and the main nerve in the legs. In most cases, sciatica happens when this nerve gets compressed by bulging, slipped, or ruptured spinal discs, arthritis, or spinal stenosis.

Symptoms

Aches and pains that result from sciatica range from mild to severe sensations. Symptoms include:

• Pain that travels from the pelvis down the back of the leg.
• A burning sensation in the low back and buttocks.
• Jolting pain that feels like an electric shock.
• Numbness, muscle weakness, or tingling in one leg or foot.
• Tingling sensation in one part of the body and pain in another. 
• Pain that worsens when coughing, sneezing or sitting for long periods.

Causes

Sciatica during pregnancy can be caused by:

• Weight gain is going to pull the spine and muscles down.
• Increased fluid retention can place added pressure on the nerve as it passes through the pelvis.
• The expanding uterus can press down on the nerve in the lower part of the spine.
• The growing belly and breasts shift the center of gravity forward and stretch the lordotic curve causing the muscles in the: 
• Buttocks and pelvis to tighten up and compress the sciatic nerve.
• The baby's head can rest directly on the nerve when settling into the proper birth position in the third trimester.
• A herniated or slipped disc caused by the extra pressure of the growing uterus can be the cause, although this is less common.
• Pregnancy also causes the body to release a hormone called relaxin, designed to relax the ligaments and prepare the pelvis for childbirth.
• Loose ligaments can cause spinal compression and affect the sciatic nerve.

Sciatica will most likely occur during the third trimester when mother and baby are bulking up, but it can develop earlier, although this is less common. Most women experience symptoms on one side, though it can affect both legs. The condition can be constant or intermittent, depending on the amount of pressure placed on the nerve, and can remain for a few months after giving birth when the excess weight and fluid are gone.

Treatment Techniques

Simple home remedies and treatment to help ease the symptoms. These include:

Sleep on Your Side

• Rest on the side of the body that does not present symptoms when lying down.
• This takes the pressure off the compressed nerve.
• Use a full-body pillow to support the hips and legs.

A Hot Shower, Heat, and Ice

• Heat relaxes tight muscles and increases circulation.
• Putting a cold pack on your lower back and rear pelvis can also help.

Consistent Movement

• Consistent gentle movement that does not include too much bending or twisting is helpful to keep the musculoskeletal system active and limber.
• Going for a light walk is recommended.
• A prenatal yoga class can soothe muscles and the mind.
• Low-impact activities like swimming can also be beneficial.

Prenatal Massage

• Prenatal massage can reduce stress, improve blood circulation, and regulate hormones.

Chiropractic and Physical Therapy

• Chiropractic is non-invasive and drug-free, making it a safe and gentle option for mom and baby.
• A professional chiropractor can evaluate the condition. 
• Identify and remove interferences in the nervous system from the source.
• Realign the bones.
• Provide a personalized treatment plan to alleviate symptoms and stretches and strength-building exercises.

Sciatica In Pregnancy

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Pregnancy Association: "Prenatal Massage Therapy.

American Pregnancy Association: "Sciatic Nerve Pain During Pregnancy: Causes and Treatment."

FRIEDMANN, E. "Narrowing of the spinal canal due to thickened lamina a cause of low-back pain and sciatica." Clinical orthopedics vol. 21 (1961): 190-7.

Goldsmith, Laura T, and Gerson Weiss. "Relaxin in human pregnancy." Annals of the New York Academy of Sciences vol. 1160 (2009): 130-5. doi:10.1111/j.1749-6632.2008.03800.x

KULOWSKI, J. "Unusual causes of low back pain and sciatica during pregnancy." American journal of obstetrics and gynecology vol. 84 (1962): 627-30. doi:10.1016/0002-9378(62)90156-4

Trager, Robert J et al. "Ischial osteochondroma as an unusual source of pregnancy-related sciatic pain: a case report." Chiropractic & manual therapies vol. 30,1 45. 17 Oct. 2022, doi:10.1186/s12998-022-00451-3

Sciatica pain can radiate to the knee. Individuals with sciatica do report unique/unusual knee pain that was never there and no past or recent physical injuries. Sciatica is the culprit, as the knee muscles are powered and controlled by nerves in the lower spine. Irritation or compression of these nerves can cause symptoms that can include: random back pain, hamstring tightness, weakness in the hips or quadriceps, the development of bunions, and knee pain and/or weakness. Chiropractic treatment can release the compression, heal the sciatic nerve, and alleviate knee problems.

Sciatica Pain Can Radiate To The Knee

Spine conditions that can cause sciatica include:

• Disc herniation - Where the inside of the discs leak out and compress and/or irritate surrounding nerves.
• Degeneration of the discs - The discs between the vertebrae wears down naturally as the body ages.
• Spinal stenosis - The spinal canal begins to narrow, not allowing enough space for the nerves to rest comfortably, resulting in compressed nerves.
• Spondylolisthesis - A condition that occurs when a vertebrae slips forward onto the vertebrae below it.

Any can cause irritation, inflammation, or compression of the sciatic nerve leading to painful sensations that extends from the lower back down through the leg.

Symptoms

Common knee symptoms that may be experienced with sciatica include:

• A dull ache, warm sensation, or sharp pain around the knee.
• Tightness in the hamstrings.
• Weakness in the hips or quadriceps.
• Unable to put weight on the knee.
• Buckling/Collapsing giving out of the knee.
• Difficulty or inability to straighten the knee.
• Weakness when extending the knee.
• Bunions form from weakened stabilizing muscles that affect walking, running, and standing posture.

As sciatica pain can radiate to the knee, individuals will usually also experience pain in their buttocks, thigh, calf, and/or foot. The nerve sensations and other symptoms in the knee can be felt through a branch of the sciatic nerve known as the peroneal nerve.

Duration

The knee pain will last as long as sciatica does, depending on the type of sciatica, whether it is acute or chronic.

• An acute sciatic episode usually resolves after a few weeks, with possible future flare-ups.
• Chronic sciatica is a long-term condition that does not resolve independently and necessitates intervention by a specialist.

Chiropractic Treatment Plan

Depending on the diagnosis, a chiropractor will develop a personalized treatment plan to address the root cause and heal the injury. The treatment plan will include therapeutic massage, posture training, and at-home self-care to help heal and prevent future sciatica.

Massage Rehabilitation

• Physical therapy and therapeutic massage will loosen and relax the muscles, nerves, tendons, and ligaments.
• Heat and ice, exercises, and stretches will prepare the muscles and nerves for chiropractic decompression adjustments.

Posture Training

• Training will be provided to maintain the back, hips, knees, and feet in proper alignment.
• Training on removing pressure from the lower back and restabilizing the rest of the body.
• Training on proper body mechanics, safe lifting techniques, and injury prevention.

Self-Pain Management

• Training on self-care habits that include healthy weight, core strengthening exercises and stretches for the back muscles, and proper rest for a full recovery.
• Discomfort and pain management skills.

Health Coaching

• An anti-inflammatory diet to reduce/eliminate inflammation and achieve a healthy weight and a nutrition plan to maintain overall health.

Surgery

• Surgery is the final option when conservative treatments are not working.

Treating Severe & Complex Sciatica Syndromes

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Dydyk AM, Khan MZ, Singh P. Radicular Back Pain. [Updated 2021 Nov 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546593/

Hirabayashi, Hiroki, et al. “Characteristics of L3 nerve root radiculopathy.” Surgical neurology vol. 72,1 (2009): 36-40; discussion 40. doi:10.1016/j.surneu.2008.08.073

Jandre Reis, Felipe Jose, and Adriana Ribeiro Macedo. “Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during forwarding Bending.” Asian spine journal vol. 9,4 (2015): 535-40. doi:10.4184/asj.2015.9.4.535

Jeong, Ui-Cheol, et al. “The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain.” Journal of physical therapy science vol. 28,1 (2016): 46-50. doi:10.1589/jpts.28.46

The sciatic nerve is the longest in the body and is the central nerve in the leg. A critical nerve that comes off the spine runs through the pelvis, into the buttocks, down the back of each thigh, and finally into the feet. It is a mixed nerve meaning it is made up of both motor/movement) and sensory/sensation fibers. The nerves merge with the spinal nerve roots before they enter the spinal cord, where the sensory information travels to and from the brain. If the nerve is inflamed, compressed, twisted, damaged, or injured, this can negatively affect the muscles' function, leading to chronic pain conditions. Injury Medical  Function Restoration Chiropractors will do precisely that for the sciatic nerve and the rest of the body. 

Nerve Roots and Branches

Different nerve roots make up the sciatic nerve, with two starting in the lower back and three at the bottom of the spine or sacrum. At the  knees, the nerve splits into two branches:

• The peroneal nerve runs from the knee's outer part to the foot's outer part and splits into two main branches below the knee.
• The tibial nerve goes down the back of the calf, extending to the heel and sole.

There are smaller branches at the:

• Hips
• Inner thighs
• Calves
• Feet

Sciatic Nerve Function

The sciatic nerve's purpose serves motor functions by assisting the muscles in the legs and feet to move, walk, run, and stand. And for the sensory function of feeling sensations in the legs and feet includes pain, numbness, burning, and electrical sensations. 

Motor Functions

The nerve provides motor functions that power movement to the muscles that move the thighs, legs, and feet. Essential motor functions:

Hip adduction

• Bringing the thighs together inward toward the body

Knee flexion

• Bending the knee.

Inversion of the foot

• Movement of the foot inward to the body.

Eversion of the foot

• Movement of the foot away/outward from the body

Dorsiflexion of the foot

• Pointing the foot up.

Plantarflexion

• Pointing the foot down.

Flexion of toes

• Pointing the toes down.

Extension of toes

• Pointing the toes up.

Motor function signs of sciatic nerve problems include difficulty or inability to walk, bend the leg, and/or stand on tiptoe or the heel.

Sensory Functions

The nerve provides sensation to the different areas; when the nerve is injured, the corresponding area may feel unique/abnormal sensations with differing degrees of numbness, pins-and-needles, and pain. Commonly affected areas include:

• Front, back, and outside the thigh.
• Front, back, and outside the lower leg.
• The top and outer side of the foot.
• Bottom of the foot.
• Between the toes.

Like motor function disruption, sensory impairment is determined by where the problems are occurring.

Function Restoration Chiropractor

Affected, reduced, and inhibited motor and sensory functions can lead to muscle weakness, chronic pain, and permanent nerve damage. Function restoration chiropractor and physical therapeutic massage can help manage nerve compression and irritation. Spinal manipulations restore misaligned vertebral discs taking the pressure off the nerve relieving the pain, and regaining nerve signal flow and mobility. Chiropractic will induce deep muscle relaxation to stop muscle spasms, release tension, soothe the nerve, release endorphins, and restore sciatic nerve function.

Spinal Decompression

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bouche, P. “Compression and entrapment neuropathies.” Handbook of clinical neurology vol. 115 (2013): 311-66. doi:10.1016/B978-0-444-52902-2.00019-9

Cook, Chad E et al. “Risk factors for first-time incidence sciatica: a systematic review.” Physiotherapy research international: the journal for researchers and clinicians in physical therapy vol. 19,2 (2014): 65-78. doi:10.1002/pri.1572

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/

Sciatic nerve injury happens from trauma to the nerve and can cause numbness, tingling, loss of muscle power, and pain. The traumatic experience can be a muscle spasm that pulls and/or pinches the sciatic nerve, force/pressure impact injury, over-stretching injury, or a laceration/cutting injury. A slipped disk, or herniated disk, is the most common cause of irritation on the sciatic nerve. A slipped disk occurs when one becomes slightly dislodged, pushing out from the spine. This places pressure/compression on the sciatic nerve.

Sciatic Nerve Injury Causes

Trauma

• Hip dislocation
• Acetabular fracture
• Trauma to the lower back, buttocks, or leg from an automobile accident, sports injury, work injury.

Medical treatment causes:

• Direct surgical trauma.
• Total hip replacement surgery can cause nerve compression and stretch during the procedure, causing damage to the sciatic nerve resulting in dysfunction.
• Faulty positioning during anesthesia.
• Injection of neurotoxic substances.
• Injection injuries via intramuscular injection in the gluteal region. This is a situation where there is a loss of movement and or lack of sensation at the affected lower extremity with or without pain.
• Injection palsy can begin suddenly or hours following damage to the sciatic nerve.
• A misplaced intramuscular injection at the gluteal region is the most common cause of injury. It is attributed to frequent injections or poor techniques resulting from inadequately trained or unqualified staff.
• Tourniquet-Induced Sciatic Nerve Injury.
• Dressings that are too tight.
• Casts that impinge the nerve.
• Faulty fitting orthotics.
• Post radiation treatment can cause acute and delayed muscle damage.

Clinical Presentation Symptoms

The common symptoms are pain and abnormal walking gait. Other clinical symptoms include:

• Muscular weakness/atrophy
• Reflex impairment
• Motor and sensory issues like paraesthesia and numbness
• Foot drop
• External rotation of the hip
• Abduction contracture of the hip
• Equinus deformity

Medical History

• Complaints of radiating pain in the leg, which follows a sensory nerve pattern.
• Pain radiates below the knee, into the foot.
• Complaints of low back pain, which is often less severe than leg pain.
• Report of electrical, burning, numbing sensations.

Diagnosis

A detailed subjective and objective physical examination is necessary to figure out the severity of the sciatic nerve injury. Diagnostic studies include:

• X rays
• Electromyography
• Magnetic Resonance Imaging

Chiropractic and Physical Therapy Management

Conservative treatment is the first-line approach for managing a sciatic nerve injury.

Pain Management

• TENS
• Massage
• Gentle stretching
• Desensitization techniques

Exercise and Stretches

• Chiropractic and physical therapy exercises and stretches improve nerve regeneration after nerve damage.

Electrical Muscle Stimulation

• TENS and Electroacupuncture have been shown to help enhance nerve regrowth.
• Bio-laser stimulation can help with nerve nutrition and regeneration.

Joint or Soft Tissue mobilization

• Helps to retain muscle, nerve, and soft tissue flexibility and prevent deformity.

Balance Training

• Coordination, strength, and flexibility exercises help to restore balance.

Splinting

• In the early stages after a sciatic nerve injury, bracing may be needed to prevent deformity and new injury or re-injury risks.
• Ankle Foot Orthosis - AFO can help prevent foot drop, muscle damage, and falls risk.

Body Composition

Optimize Diet for Fat Loss

Individuals that want to lose fat need to create a calorie deficit. Individuals need to consistently eat less than they need for Total Daily Energy Expenditure - TDEE. The safest way to handle a caloric reduction is to reduce calorie intake in small doses like 200-300 calories, for example. After a week or two, perform a body composition analysis. If Fat Mass numbers begin to drop or not, adjust calorie needs accordingly. Restricting calories is the most common way, a deficit can also be created by increasing calorie needs through exercise.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Kline, D G et al. “Management and results of sciatic nerve injuries: a 24-year experience.” Journal of neurosurgery vol. 89,1 (1998): 13-23. doi:10.3171/jns.1998.89.1.0013

Schmalzried, TP et al. “Update on nerve palsy associated with total hip replacement.” Clinical Orthopedics and related research,344 (1997): 188-206.

Shim, Ho Yong et al. “Sciatic nerve injury caused by a stretching exercise in a trained dancer.” Annals of rehabilitation medicine vol. 37,6 (2013): 886-90. doi:10.5535/arm.2013.37.6.886

Suszyński, Krzysztof et al. “Physiotherapeutic techniques used in the management of patients with peripheral nerve injuries.” Neural regeneration research vol. 10,11 (2015): 1770-2. doi:10.4103/1673-5374.170299

Spinal injections are exactly what the name says. They are administered direct injections of medicine/s in a specific location of the spine. These are used to treat various conditions affecting the spine when non-invasive treatment/s are not working.

This could be an area along the upper cervical/neck spine all the way down to the sacrum. Injections are also utilized in helping to diagnose neck or back pain that radiates or spreads into an individual’s arms and legs. These are known as:

• Cervical radiculopathy
• Lumbar radiculopathy

Spinal injection/s for diagnostic or treatment purposes could be a part of an overall treatment plan along with chiropractic/physical therapy and possible medication.

The medicine in the injection

The medicine could be comprised of a local anesthetic on its own, steroid on its own, or a combination of the two. Steroids are short for corticosteroid, which is a strong anti-inflammatory medication. A contrast dye like an x-ray dye could be added to the injection mix. This dye acts as a guide for precise placement of the needle using image guidance.

Spinal disorders that could benefit

Proceeding with an injection treatment plan is based on an individual's unique factors that apply to their condition/state. This decision will be made after consultation, and diagnosis with your doctor, spine specialist, or chiropractor.

Healthcare providers recommend conservative treatment first. A treatment plan typically runs around 4-6 weeks. If there is no change or improvement in the individual's condition from the conservative therapy then injection treatment/s could be recommended. Conditions, where injection/s are used, include:

• Disc herniation
• Facet joint pain
• Failed back syndrome
• Sacroiliac joint pain
• Sciatica
• Spinal stenosis

Spinal injection and nerve block difference

Spinal injections are a general term that could mean any type of injection involving the spine. Nerve blocks are a precise type of injection that targets a specific nerve. As the medicine is injected into the target nerve/s, it blocks or creates a blockade of the pain signals being sent from the area (ex. neck, low back, etc.) that is generating the pain.

Injection types

Epidural

An epidural means an injection on the dura. The dura is the outermost layer that encloses the spinal cord.

3 types of epidurals. They are named according to the direction and angle the needle takes to get to the dura.

• Caudal epidural:

The spinal canal ends at an opening at the end of the sacrum called the spinal hiatus. The medicine is injected into the epidural space through the sacral hiatus. This is the method that is used to provide anesthesia to pregnant women when they're in labor.

• Transforaminal epidural:

There are nerve roots that come out of the spinal canal at each level through a bony opening called the intervertebral foramen or neuroforamen. The medicine is injected into the epidural space in these areas.

• Interlaminar epidural:

The lamina is a section that forms the arch of each level and forms the spinal canal. The lamina at each level lays on top of the lamina right below. The needle is inserted between the lamina for delivery of the medicine into the epidural space.

Selective Nerve Root Block - SNRB

These involve the injection of a local anesthetic onto a targeted nerve. They are typically used for diagnostic purposes. For individuals with multi-spinal compression/s, these combined with:

• Medical history
• Physical exam
• MRI

These can help identify the pain generator such as spinal stenosis.

Medial Branch Block - MBB

The facet joints are bony projections that connect a vertebral level to the levels above and below. These can become arthritic and is responsible for different forms of back pain.

This type of spinal injection is local anesthetic injected on the medial branch nerves. These are the nerves that send pain signals from the facet joint/s. They are useful in determining if the facet joint is the pain generator.

Facet Joint

These are injections directly into the facet joint itself. Much like injecting anti-inflammatory and pain meds into a knee with arthritis.

Sacroiliac Joint

The two sacroiliac joints help connect either side of the sacrum to the hip joint. Like other joints, these can get inflamed and cause painful symptoms. This is an injection directly into one or both of the sacroiliac joints.

Administration of the spinal injection or nerve block

Injections are only to be performed by doctors trained specifically in spinal injections. Injections are usually performed by an:

• Anesthesiologist
• Neurologist
• Neurosurgeon
• Orthopedic surgeon
• Physiatrist
• Radiologist

Role of these procedures

Reasons why an injection could be used:

• Help as a diagnostic to identify the pain generator
• Therapeutically to provide pain relief
• As a prognostic pain predictor of the relief, an individual could expect from a more invasive procedure like nerve ablation

How often

A maximum of 6 injections for one year is the recommended treatment protocol. Each injection should be based on the effect/s of the previous injection.

Potential benefits

The main benefit is to bring pain relief and the ability to function.

Potential risks

Spinal injections are considered safe with a low rate of complications. The most common include:

• Bleeding
• Headache
• Facial flushing

Major complications include:

• Puncture of the dura
• Infection
• Nerve damage

Major complications happen in less than one percent of those undergoing the treatment. Individuals with diabetes could see a temporary elevation of their blood sugar.

Lasting effects

How long the medicine lasts is different for everyone and comes with variables like:

• Type of injection
• Type of pathology
• Diagnosis
• Cause
• How long the symptoms last

Most can expect to have one and a half to three months of relief. However, with some, they may only provide minimal relief, while others may see improvements for up to a year.

Treating Severe & Complex Sciatica Syndromes

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Sciatica is pain that can be accompanied by numbness, tingling and occasionally weakness along the course of the sciatic nerve. The sciatic nerve is the thickest in the body and is formed from nerve roots exiting the spine, and extend into the buttocks and down the back of the legs to the toes. Common causes of sciatica along with non-surgical treatment options are presented by a chiropractor and a physical therapist.

Causes of Sciatica and Non-Surgical Care

Compressed Lumbar Disc also called lumbar radiculopathy

Probably one of the most common causes of sciatica that I treat. About 90% of patients have a positive response to alternative/conservative treatment. I use x-rays as a guide to follow where the nerve is compressed and where the best manipulation areas are for me to adjust. Spinal manipulation is a very safe procedure and most cases will heal without surgery.

Dr. Alex Jimenez D.C. and a practicing physical therapist  “Combined with chiropractic treatment and massage, we may use a topical steroid combined with electric stimulation or ultrasound to adjust/release the area where the nerve is compressed."

Lumbar traction is also used to reduce the size of the disc herniation and combine this with exercises, which are customized to the patient. Extending back and flexing exercises are also incorporated into the treatment plan and each is made specific to the patient. Patients may experience muscle spasms or joint stiffness, which is also relieved by massage therapy and joint mobilizations. Patients could also be trained on Kinesio tape application to relieve pressure and relax muscles.

Remember that strengthening the core is the key to reduce the risk of worsening the injury and getting new ones.

Lumbar Spinal Stenosis

This is a condition that can be difficult to treat because of the mechanical nature of the compression on the nerves. The cause is often a combination of osteoarthritis, disc bulging and spinal holes that have narrowed called neuroforamen. Physical therapy consists of traction, stretching, exercises, and chiropractic to lessen pain and inflammation.

Spondylolisthesis

This condition can be caused by trauma or degeneration of the spine. Conservative care is highly beneficial.

Extending the spine can worsen symptoms, therefore flexion-based exercises are what we recommend. Therapeutic exercises are utilized for abdominal strengthening and core stabilization. We get the patient to increase hip extension to reduce stress on the lumbar spine.  Manual therapies can also be used to control inflammation and alleviate muscle tightness or spasms.

Piriformis Syndrome

Piriformis syndrome also responds positively to conservative treatment. We look for the main cause when we see piriformis syndrome. This type of injury happens when a patient has a job or play a sport where they shorten and overuse the muscle.

We create a custom treatment/exercise program based on what is found structurally. Most of the time the piriformis muscle gets over-used because the hips are weak, so strengthening the hips and the core is key. Sciatic nerve mobilization can also help increase sciatic nerve mobility. This can be achieved with instrument-assisted soft tissue mobilization/Graston technique along with deep tissue massage will get optimal results.

Pregnancy

Sciatic symptoms often do present in pregnant women, which can make the pregnancy miserable. Our goal is to reduce symptoms and restore normal function with gentle exercise, massage, and hot/cold therapy.

The pelvic girdle is what we focus on, along with core stabilization, and Kinesio tape application to stabilize the girdle because of ligamentous laxity or loosening of the hips.

Trauma

Any kind of trauma that hits the gluteal area can become inflamed and spasm and bind around the sciatic nerve. We focus on relieving the pain and inflammation with manual therapies, and gentle exercises. These are based on what is found from the examination and how intense/extensive the trauma was.

Light spinal mobilization and massage have been proven to activate the body's natural painkillers to alleviate and release the tight muscles. More rigorous exercises are brought in to the treatment plan as the patient gets stronger. These will strengthen their core and get them back to regular activities, job, and their sport.

Get Rid of Sciatica Pain Non-Surgical El Paso, Texas

NCBI Resources

You may be suffering from sciatica if you have ever experienced a shooting, nerve-like pain down one of your legs. The sciatic nerve can be impacted by a number of different things, including injury and degenerative diseases, that can lead to sciatica. Fortunately, chiropractic can be an effective non-surgical treatment for sciatica.

A car accident can easily damage the spine and soft tissues. An auto accident may cause a misalignment of the spine, a herniated disc, or other injuries that cause symptoms of sciatica.

Sciatica is a collection of symptoms commonly characterized by pain and discomfort along the length of the sciatic nerve, which runs down the buttocks, hips, and thighs, into the legs and feet. Also referred to as sciatic nerve pain, sciatica is generally caused by the compression or impingement of the sciatic nerve through injuries and/or conditions such as a herniated disc. The patients in the following video describe how their sciatica has affected their quality of life. After receiving chiropractic care with Dr. Alex Jimenez, chiropractor, patients discuss how treatment has helped them achieve pain relief from their sciatica. Sciatic nerve pain is one of the most common health issues commonly treated utilizing chiropractic care. The patients highly recommend Dr. Alex Jimenez as the non-surgical choice for sciatica. 

Chiropractic Therapy 

We are blessed to present to you El Paso’s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Treatment, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately are focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

We want you to live a life filled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.

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Chiropractic Therapy: Sandra Rubio discusses how Dr. Alex Jimenez and his staff can help relieve your sciatica symptoms. Chiropractic care can improve pain and discomfort as well as reduce irritation and inflammation caused by sciatica. In addition, a chiropractor like Dr. Jimenez can also provide nutritional and fitness advice for sciatic nerve pain. Other treatment methods, like deep-tissue massage, can help relieve sciatica symptoms. Dr. Alex Jimenez is the homeopathic, non surgical choice for sciatic nerve pain and its associated symptoms.

Chiropractic Therapy For Sciatica Pain 

Sciatica is generally caused by the compression of lumbar or sacral nerves or by compression of the sciatic nerve. When sciatica is caused by compression of a dorsal nerve root, it's known as lumbar radiculopathy. This can occur because of a spinal disk bulge or spinal disk herniation (a herniated intervertebral disc), or by roughening, enlarging, or misalignment (spondylolisthesis) of the fascia, or as a consequence of degenerated discs which can reduce the diameter of the lateral foramen by which nerve roots exit the spine.

Our objective is to alleviate your pain and restore freedom, in treating our sciatica sufferers. Employing state of the art x-ray/fluoroscopic and ultrasound helps our experts pinpoint what’s going on. For treating sciatica we believe in the ability of medicine. By stimulating the body’s natural healing response, these procedures let us naturally provide long-term and deep pain relief.

We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life. I have made a life of taking care of each and every one of my patients.

I assure you, I will only accept the best for you…

God Bless You & Your Health ��

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Dr. Alex Jimenez DC, C.C.S.T

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Injury Clinic Extra: Geriatric Fitness

Individuals who have gone through recent low back surgery, like a lumbar laminectomy and discectomy, could they benefit from physical therapy for full recovery? (Johns Hopkins Medicine. 2008)

Rehabilitation Exercise Program

A lumbar laminectomy and discectomy is a surgical procedure performed by an orthopedic or neurologic surgeon to help decrease pain, relieve associated symptoms and sensations, and improve flexibility and mobility. The procedure involves cutting away disc and bone material that presses against, irritates, and damages the spinal nerves. (Johns Hopkins Medicine. 2023)

Post-Surgery

The therapist will work with the individual to develop a rehabilitation exercise program. The objective of a rehabilitation exercise program is to help the individual:

• Relax their muscles to prevent muscle tensing and becoming over-cautious
• Regain full range of motion
• Strengthen their spine
• Prevent injuries

A guide on what to expect in physical therapy.

Postural Retraining

• After back surgery, individuals have to work to maintain proper posture when sitting and standing. (Johns Hopkins Medicine. 2008)
• Postural control is important to learn as it maintains the lower back in the optimal position to protect and expedite the healing of lumbar discs and muscles.
• A physical therapist will teach the individual how to sit with proper posture and use lumbar support.
• Attaining and maintaining proper posture is one of the most important things to help protect the back and prevent future back problems.

Walking Exercise

Walking is one of the best exercises after lumbar surgery. (Johns Hopkins Medicine. 2008)

• Walking helps to improve cardiovascular health and blood circulation throughout the body.
• This helps to provide added oxygen and nutrients to the spinal muscles and tissues as they heal.
• It is an upright exercise that puts the spine in a natural position, which helps to protect the discs.
• The therapist will help set up a program tailored to the individual's condition.

Prone Press Up

One of the exercises to protect the back and lumbar discs is prone press-ups. (Johns Hopkins Medicine. 2008) This exercise helps keep the spinal discs situated in the proper position. It also helps to improve the ability to bend back into lumbar extension.

To perform the exercise:

1. Lie facing down on a yoga/exercise mat and place both hands flat on the floor under the shoulders.
2. Keep the back and hips relaxed.
3. Use the arms to press the upper part of the body up while allowing the lower back to remain against the floor.
4. There should be a slight pressure in the lower back while pressing up.
5. Hold the press-up position for 2 seconds.
6. Slowly lower back down to the starting position.
7. Repeat for 10 to 15 repetitions.

Sciatic Nerve Gliding

Individuals who had leg pain coming from the back prior to surgery may have been diagnosed with sciatica or an irritation of the sciatic nerve. Post-surgery, individuals may notice their leg feels tight whenever straightening it out all the way. This could be a sign of an adhered/trapped sciatic nerve root, a common problem with sciatica.

• After lumbar laminectomy and discectomy surgery, a physical therapist will prescribe targeted exercises called sciatic nerve glides to stretch and improve how the nerve moves. (Richard F. Ellis, Wayne A. Hing, Peter J. McNair. 2012)
• Nerve glides can help free the stuck nerve root and allow for normal motion.

To perform the exercise:

1. Lie on the back and bend one knee up.
2. Grab underneath the knee with the hands.
3. Straighten the knee while supporting it with the hands.
4. Once the knee is fully straightened, flex and extend the ankle about 5 times.
5. Return to the starting position.
6. Repeat the sciatic nerve glide 10 times.
7. The exercise can be performed several times to help improve how the nerve moves and glides in the lower back and leg.

Supine Lumbar Flexion

After surgery, gentle back flexion exercises can help safely stretch the low-back muscles and gently stretch the scar tissue from the surgical incision. Supine lumbar flexion is one of the simplest exercises to improve lumbar flexion range of motion.

To perform the exercise:

1. Lie on the back with the knees bent.
2. Slowly lift the bent knees towards the chest and grasp the knees with both hands.
3. Gently pull the knees toward the chest.
4. Hold the position for 1 or 2 seconds.
5. Slowly lower the knees back to the starting position.
6. Perform for 10 repetitions.
7. Stop the exercise if experiencing an increase in pain in the lower back, buttocks, or legs.

Hip and Core Strengthening

Once cleared, individuals can progress to an abdominal and core strengthening program. This involves performing specific motions for the hips and legs while maintaining a pelvic neutral position. Advanced hip strengthening exercises help generate strength and stability in the muscles that surround the pelvic area and lower back. A physical therapist can help decide which exercises are recommended for the specific condition.

Return-to-Work and Physical Activities

Once individuals have gained an improved lumbar range of motion, hip, and core strength, their doctor and therapist may recommend working on specific activities to help them return to their previous level of work and recreation. Depending on job occupation, individuals may need to:

• Work on proper lifting techniques.
• Require an ergonomic evaluation if they spend time sitting at a desk or workstation.
• Some surgeons may have restrictions on how much an individual can bend, lift, and twist from two to six weeks after surgery.

Low-back surgery can be difficult to rehab properly. Working with a healthcare provider and physical therapist, individuals can be sure to improve their range of motion, strength, and functional mobility to return to their previous level of function quickly and safely.

Sciatica, Causes, Symptoms and Tips

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Johns Hopkins Medicine. (2008). The road to recovery after lumbar spine surgery.

Johns Hopkins Medicine. (2023). Minimally Invasive Lumbar Discectomy.

Ellis, R. F., Hing, W. A., & McNair, P. J. (2012). Comparison of longitudinal sciatic nerve movement with different mobilization exercises: an in vivo study utilizing ultrasound imaging. The Journal of orthopaedic and sports physical therapy, 42(8), 667–675. https://doi.org/10.2519/jospt.2012.3854

It's not unusual for runners to experience tingling, pins and needles, and numbness in their feet while running. Running foot numbness is a relatively common problem for runners and can be easily remedied. Numbness will present in one part of the foot or just the toes. Sometimes it can spread throughout the whole foot. Different causes, most of which are not serious, can be easily dealt with. Serious causes can be treated with chiropractic, massage, decompression therapy, and functional medicine.

Running Foot Numbness

Reasons why the feet experience numbing sensations when running, include:

• Improper footwear.
• Laces that are tied too tightly.
• Foot strike pattern.
• Foot structure.
• Training schedule.
• Muscle tightness.
• Compressed nerve.
• Medical conditions like neuromas or peripheral neuropathy.

Footwear

• A common cause of running foot numbness is having overly tight shoes that place added pressure on nerves.
• If this could be the reason, the remedy is to get new shoes.
• Try to find a store that specializes in running shoes and ask for help.
• Footwear professionals look at the size of the foot, the shape, and running gait.
• For example, individuals with a wide foot may need a style with a wider/larger toebox or the front of the shoe that houses the forefoot.
• Get a pair that's one-half to a full size larger than a regular everyday shoe size.
• This is because when running, the feet swell, especially in hot and humid weather.
• Going up a half or whole size will also accommodate thicker socks for individuals that run in cold weather.
• Sometimes numbness can result from biomechanical issues that can be corrected with the proper shoe.

Tight Laces

• Sometimes it's not the shoes but the laces that are too tight.
• Pulling a little tighter to get a firm fit around the ankle is common, but this can entrap nerves on top of the foot at the ankle/anterior tarsal tunnel, similar to the carpal tunnel in the wrist.
• This can be problematic for individuals with high arches.
• Loosening the laces are recommended.
• However, runners may feel insecure with looser laces.
• Experimenting with different lacing techniques is recommended to find one that keeps the shoes comfortable without creating undue pressure over the top of the foot.
• Using padding under the tongue of the shoe can help.

Foot Fall Pattern

• Sometimes running form can put pressure on nerves that, lead to numbness.
• Overstriding - Landing heel first with the foot ahead of the body's center of gravity places the feet on the ground for too long.
• Correcting this issue can be achieved by shortening the stride and focusing on landing on the midsole.
• This way, the feet will land directly under the body.
• Running like stepping on hot coals is recommended, keeping the movements light and quick.
• Correcting overstriding saves energy and lowers the risk of shin splints.
• A sports chiropractor, physical therapist, or running coach can help fine-tune form for specific guidance.

Foot Structure

• The anatomy of the feet, specifically the arches, can contribute to running foot numbness.
• Flat feet mean the entire bottom of each foot is in contact with the floor when barefoot.
• Overly flexible feet are more likely to experience nerve compression.
• This can be corrected with shoe orthotic inserts.
• Over-the-counter orthotics may work, but custom orthotics are another option if they don't.

Muscle Tightness

• Stiff, inflexible muscles can lead to anatomical conditions that generate nerve pressure.
• Warm-up exercises before running will get the muscles loose and ready.
• Stretching is very important before and after running.
• Individuals prone to muscle tightness should include flexibility exercises.
• Yoga can improve flexibility and body alignment.
• Foam rollers and other massage tools will work out kinks in areas where tightness forms and affects nerves, like the quadriceps, calves, hamstrings, and I.T. band.
• Regular sports massage and chiropractic can help keep the body pliable.

Sciatic Nerve Issues

• A compressed nerve causes a decrease in the sensation to the areas the nerve supplies.
• Foot numbness, especially around the heel or the sole, can be caused by sciatic nerve compression.
• The pain from sciatica might originate in the back but can end up causing numbness in the feet and/or toes.
• Poor posture, tight piriformis muscles, or other back injuries can also cause sciatica.
• A chiropractor or physical therapist can prescribe decompression therapy, MET stretches, and rehabilitative exercises.

Prevention

Most of the time, running foot numbness can be treated by adjusting footwear or technique. Here are a few tips for injury prevention:

Evaluate Shoes

• First, make sure the shoelaces are not overly tight.
• If the shoes are uncomfortable when running, look for another set and get a custom fitting.

Running Form

• Avoid overstriding by focusing on landing on the midsole instead of the heel.
• This will take the pressure off of the feet.

Foot Orthotics

• Individuals with flat feet, high arches, or overly flexible feet should consider orthotics.

Avoid Overtraining

• Work rest days into the training schedule and gradually build up to avoid overuse injuries.
  Stretch to prevent muscle imbalances, keep muscles loose, and improve the range of motion.

Chiropractic and Physical Therapy

• If symptoms don't improve, see a doctor, podiatrist, or chiropractor so they can rule out conditions and develop a personalized treatment plan.

Benefits of Custom Foot Orthotics

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Aldridge, Tracy. “Diagnosing heel pain in adults.” American family physician vol. 70,2 (2004): 332-8.

Atik, Aziz, and Selahattin Ozyurek. “Flexible flatfoot.” Northern Clinics of Istanbul vol. 1,1 57-64. 3 Aug. 2014, doi:10.14744/nci.2014.29292

Jackson, D L, and B L Haglund. “Tarsal tunnel syndrome in runners.” Sports medicine (Auckland, N.Z.) vol. 13,2 (1992): 146-9. doi:10.2165/00007256-199213020-00010

Souza, Richard B. “An Evidence-Based Videotaped Running Biomechanics Analysis.” Physical Medicine and rehabilitation clinics of North America vol. 27,1 (2016): 217-36. doi:10.1016/j.pmr.2015.08.006

Sridhara, C R, and K L Izzo. “Terminal sensory branches of the superficial peroneal nerve: an entrapment syndrome.” Archives of physical medicine and Rehabilitation vol. 66,11 (1985): 789-91.

Sciatica From Working Out: There are benefits from strenuous exercise and a level of acceptance of the discomfort that goes with exertion. While this is true to a certain degree, when individuals feel the pump and are in the workout zone, it can be very easy to take off and overdo it. This is when the body and the back become susceptible to injuries. Sciatica from working out occurs when added pressure on the sciatic nerve results in a compressed/pinched nerve. Left untreated can lead to further back problems and other health issues. The Injury Medical Chiropractic and Functional Medicine Team can relieve the compression, release the nerve, relax the muscles, and restore function.

Sciatica From Working Out

Microtrauma

Building muscle and increasing strength require a certain amount of physical damage to the muscles for successful progress. Intense and heavy exercise tear the muscle tissues causing microtrauma that triggers a healing response that creates muscle mass. These micro-injuries can cause the back muscles to tighten up, shifting the spine out of alignment, causing the discs to slip and compress nerves, or by tight leg muscles like the piriformis swelling and squeezing the sciatic nerve.

Causes

Rest and Recovery

• It’s important to understand that proper recovery is essential to an exercise program.
• It can take up to 72 hours to recover from the microtears.
• Individuals that go right back for a similar workout can aggravate existing micro tears while creating more, resulting in a downward cycle of symptoms that can lead to other problems or become a chronic condition.
• Rotating to exercises that go easy on the back and leg muscles assists in the normal healing and development of muscle tissue.

Not Warming up Before Workout

• Not warming up before exercising can cause injuries.
• When muscles are cold and not warmed up properly, they can become stiff and inflexible, causing them to strain and tear when exposed to sudden, intense exertion.
• Before performing any exercise, always start with a low-impact, gentle warm-up.

Not Stretching Properly or at All

• Full-body stretching is necessary as the torn, tight muscles need to be relaxed and kept loose.
• Make sure to stretch the hamstrings and hips thoroughly.
• After each workout, take 10 minutes and stretch.

Not Stretching After

• Always do some stretching after a workout.
• Stretching after can help prevent muscle fatigue and soreness from a lactic acid buildup.

Starting With Heavy Weights

• Many injuries happen because individuals start too heavy.
• Challenging the body’s performance is part of the process but should be done in small steps.
• Start with lighter weights and add more gradually.

Improper Posture and Form

• A leading cause of back problems is poor posture and form.
• Curving the back while lifting weights is the most error.
• Overarching can also cause injury.
• When performing push-ups or planks, avoid sinking the hips.

Hard Surfaces

• For runners, hard surfaces like concrete or asphalt force the body and back to absorb most of the impact.
• This compresses the vertebrae, which can irritate the sciatic nerve.
• Rotate by using running trails or a treadmill.
• Work on running with a shorter stride to reduce bounce and impact.
• Incorporate cross-training.
• Rotate upper body strength training to give the legs, gluteals, and back muscles a rest.

Chiropractic Rehabilitation

Chiropractic care, massage, and decompression therapy can relieve sciatica pain. Using spinal manipulation techniques and other therapies, chiropractors can alleviate the pressure on the nerve. Treatment involves:

• X-rays are taken so that the chiropractor can understand the cause.
• Massaging the muscles to relax and release them and increase circulation.
• Stretching and applying controlled pressure to the joints.
• Specific exercises and stretches will be recommended to do at home.
• Health coaching and nutrition and wellness recommendations.

Personalized Sciatica Treatment

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bonasia DE, Rosso F, Cottino U, Rossi R. Exercise-induced leg pain. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(3):73-84. doi:10.1016/j.asmart.2015.03.003

Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, Whitford M. Risk factors for first-time incidence sciatica: a systematic review. Physiother Res Int. 2014 Jun;18:65-78. doi:doi:10.1002/pri.1572

Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313‐1317. doi:10.1136/bmj.39223.428495.BE

Lewis RA, Williams NH, Sutton AJ, et al. Comparative clinical effectiveness of management strategies for sciatica: a systematic review and network meta-analyses. (PDF). Spine J. 2015;15(6):1461-77. doi:10.1016/j.spinee.2013.08.049

Ropper AH, Zafonte RD. Sciatica. N Engl J Med. 2015;372(13):1240–8. doi:10.1056/NEJMra1410151

Salehi, Alireza, et al. “Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.” International Journal of community-based nursing and midwifery vol. 3,4 (2015): 244-54.

A certified/licensed massage therapist performs chiropractic therapeutic massage under the direction of a chiropractor to soothe tense muscles, release pressure on the nerve/s, break up scar tissue and stimulate the release of endorphins. Studies have shown that a therapeutic chiropractic massage is as effective as nonsteroidal anti-inflammatory medications for pain relief caused by various musculoskeletal conditions, including sciatica. Although medications can work for a time, they do not deal with the underlying cause of sciatica.

Sciatica Massage

A sciatica massage offers several benefits that include the following:

• Improved and increased blood circulation.
• Lowered blood pressure.
• Release of hormones that help reduce anxiety, depression, and pain.
• Relieves body discomfort and soreness by decreasing the activation of pain receptors in the spine and muscles.
• Inflammation alleviation.
• Muscle stress relief.
• Muscle relaxation.
• Flare-up relief and prevention.
• Improves sleep.

Massage Types

Each type of massage is designed for a different purpose.

Manual Manipulation

• Improves mobility and reduces pain.
• Stretches tendons, ligaments, and muscles.

Mobilization

• Focuses on the musculoskeletal system to improve mobility.

Connective Tissue

• A deeper massage that targets connective tissues like ligaments and tendons.

Deep Tissue Massage

• Designed to reach the deep layers to realign the muscles and fascia.

Myofascial Massage

• Releases trigger points, adhesions, and nerve endings.

Healing Phases

Most cases of sciatica resolve in less than 4 to 6 weeks with conservative treatment. More severe cases with neurologic symptoms can have a longer recovery period.

Phase One

• Alleviates discomfort, numbness, tingling, pain, and other symptoms.
• The pain is reduced so the chiropractor and therapists can begin to address the cause, although the other symptoms and sensations could still be experienced.
• If muscle spasms are present, they will be less frequent and with less intensity.

Phase Two

• The individual can focus on functioning within their normal environment.
• The chiropractor and therapists examine if they can get up and stand from a chair without problems, get in and out of a car, sit for longer periods, and walk with less discomfort.
• A reflex test will be performed to analyze how the healing process is coming along.
• If there is significant nerve damage, reflexes could be lessened.
• For example, if sciatic inflammation is present, and the Achilles tendon is tapped with a reflex hammer, there could be little or no movement of the calf muscles.
• If there is an improvement, there will be a healthy reflex.
• The straight leg test will show if the individual can lift their leg with little or no pain.

Phase Three

• The final healing phase provides the ability of normal movements and full strength.
• This is when the individual can resume normal activities, specifically those stopped because of the pain.
• This can include walking, driving, house chores, sports, or working out.

Contact our office for treatment options customized to the individual and their injury.

Sciatica?

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Camino Willhuber GO, Piuzzi NS. Straight Leg Raise Test. [Updated 2022 June 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539717/

Chang C, Jeno SH, Varacallo M. Anatomy, Bony Pelvis, and Lower Limb, Piriformis Muscle. [Updated 2022 October 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519497/

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

Marian Majchrzycki, Piotr Kocur, Tomasz Kotwicki, "Deep Tissue Massage and Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain: A Prospective Randomized Trial," The Scientific World Journal, vol. 2014, Article ID 287597, 7 pages, 2014. https://doi.org/10.1155/2014/287597

Miller, Kenneth Jeffrey. "Physical assessment of lower extremity radiculopathy and sciatica." Journal of chiropractic medicine vol. 6,2 (2007): 75-82. doi:10.1016/j.jcme.2007.04.001

The Centralization Phenomenon in Chiropractic Spinal Manipulation of Discogenic Low Back Pain and Sciatica. https://chiro.org/Low_Back_Pain/The_Centralization_Phenomenon.shtml. Accessed October 22, 2022.

Sciatica is common and affects up to 40% of the general population. Different types include acute, chronic, alternating, and bilateral sciatica. The sciatic nerve comprises three specific nerve roots in the lower back. The three nerves originate in the L4 and L5 vertebrae and the sacrum, just below the vertebrae. The nerve then branches off and runs through the back of each thigh. Injury, compression, or irritation of these nerves can cause various symptoms, including numbness, tingling, electrical shooting pain, and muscle spasms in the low back, the leg, and the foot. Chiropractic care can realign the spine, relax the muscles, release compression and relieve sciatica.

Acute, Chronic, Alternating, and Bilateral Sciatica

Acute

• Acute pain can be brought on by sudden irritation to the nerves that have become pinched, compressed, or a combination.
• Causes a constant burning or shooting sensation through the low back, buttocks, down the leg, and possible hip discomfort.
• It becomes worse when sitting.
• It can cause immediate and short-term pain lasting for 1-2 weeks.

Chronic

• Chronic sciatica can last for months or years on and off or continuously.
• It can be caused or worsened by inflammatory conditions like rheumatoid arthritis, injuries, infections, and spinal misalignment issues.
• It can resolve but will come back without treatment or lifestyle and activity adjustments.

Bilateral

• Sciatica typically takes place in one leg; it has been known to be bilateral and experienced in both legs.
• This type of sciatica is rare but can occur from degenerative changes in the vertebrae and/or the discs at several spinal levels.
• If there is pain in both legs, it is likely not a herniation but degenerative changes like spinal stenosis.
• The symptoms can range from infrequent to irritating to severe and debilitating.
• It could be a red flag symptom of cauda equina syndrome.
• Weakness may be felt in the leg and foot, or a feeling of heaviness, making it difficult to lift the foot off the floor.

Alternating

• Alternating sciatica affects both legs alternately. It is usually connected to bilateral sciatica that switches sides.
• This type is rare and can result from degenerative problems in the sacroiliac joint, the joint connecting the spine to the hips, or sacroiliac arthritis.

Spinal Sources

Sciatica occurs when L4, L5, and/or S1 nerve roots are affected.

L4 Nerve Root

• Pain in the hip, thigh, inner medial areas or the knee, and the calf.
• Weakness in the thigh and hip muscles.
• Reduced knee-jerk reflex.
• Loss of sensation around the calf.

L5 Nerve Root

• Pain in the buttock and the outer area of the thigh.
• Weakness in the buttock and leg muscles.
• Difficulty moving the ankle and lifting the big toe upward.
• Loss of sensation between the big toe and the second toe.

S1 Nerve Root

• Known as classic sciatica.
• Pain in the buttock, back of the calf, and side of the foot.
• Fatigue in the buttock and foot muscles.
• Difficulty and discomfort raising the heel off the ground or walking on tiptoes.
• Loss of sensation in the foot's outer side, including the third, fourth, and fifth toes.
• Reduced ankle-jerk reflex.

Chiropractic Care

Chiropractic care can directly address the root cause of the problem, treat the cause, and alleviate the symptoms. Chiropractic manipulation is recommended by the American College of Physicians as a first line of treatment for back pain before medication, muscle relaxants, injections, and surgery. Treatments to address sciatic nerve impingement:

Ice/Cold Therapy

• Reduces inflammation and swelling.
• Prepares the patient for massage and adjustments.

Therapeutic Tissue Massage

• This therapy promotes muscle relaxation and lessens the muscle spasm/recoil response.

Ultrasound

• Soothing heat created by sound waves penetrates the muscles, increases circulation, and relaxes the muscles to alleviate spasms, stiffness, and pain.

Transcutaneous Electrical Nerve Stimulation/Tens Unit

• A muscle stimulation machine that applies electrical impulses to relax the muscles and untangle muscle knots.

Spinal Manipulation

• This process realigns the spine to move properly and restores vertebral health.

Stretches and Exercises

• This ensures treatment will last once treatment has or is coming to an end.

Spinal Decompression

• Pulls and stretches the body to release any compression on the nerve roots and infuse circulation back into the discs.

The pressure is taken off the sciatic nerve, and routine adjustments will retrain the muscles to maintain their re-alignment. The duration of treatment will vary based on the root cause of sciatica. Each treatment plan is tailored to the individual patient's situation.

Severe and Complex Sciatica Syndromes

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

Hernández C.P., Sanchez N., Navarro-Siguero A., Saldaña M.T. (2013) What is Sciatica and Radicular Pain?. In: Laroche F., Perrot S. (eds) Managing Sciatica and Radicular Pain in Primary Care Practice. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-907673-56-6_1

Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Ngnitewe Massa R, Mesfin FB. Herniation, Disc. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

Ombregt L. The dural concept. In: A System of Orthopaedic Medicine. Elsevier; 2013:447-472.e4. doi:10.1016/b978-0-7020-3145-8.00033-8

Witenko, Corey, et al. “Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low-back pain.” P & T : a peer-reviewed journal for formulary management vol. 39,6 (2014): 427-35.

Wright R, Inbody SB. Radiculopathy and Degenerative Spine Disease. In: Neurology Secrets. Elsevier; 2010:121-130. doi:10.1016/b978-0-323-05712-7.00007-6

Many individuals deal with sciatic nerve discomfort and pain that radiates from the lower back down through the glutes, legs, and feet. It can affect anyone and be challenging to deal with because it can be sudden and unpredictable. A professional hands-on therapeutic massage can play a vital role in alleviating back and sciatic pain but is not always available. This is when a quality massage chair can provide pain relief and relaxation at home.

Sciatica

Not everyone who has sciatica will have the same symptoms. But common symptoms include:

• Tingling, numbing sensations in the lower back and down the leg.
• Electrical sensations running down the leg.
• Lower back pain that spreads into the buttocks, thighs, calves, and feet.
• Pain may be described as mild, dull, achy, and sharp.
• Sneezing or coughing can increase the pain.
• Weakness in the leg.

Massage Chair

A massage chair can assist with sciatic pain by soothing tense muscles and relieving the pressure on the surrounding tissues. When the back muscles are tense, they contract and compress down on the nerves, including the sciatic nerve. Massaging the tight muscles minimizes the pressure on the sciatic nerve and helps alleviate pain. Research has shown the main reasons why massage is beneficial:

Improves Circulation

• Massaging the muscles increases blood flow.
• Increasing blood circulation facilitates the absorption of nutrients into the muscles and tissues.
• Increasing lymphatic circulation clears toxins out of the painful areas.
• Revitalizes the area.

Decreases Tension and Improves Flexibility

• Massaging helps loosen tight and strained muscles.
• Percussive kneading and rolling allow muscles to relax and increase endorphin levels.
• Endorphins are the body's natural pain killer chemicals.
• Increased endorphin levels expedite recovery and decrease anxiety.

Features and Functions

Massage chairs have come a long way and vary in their capabilities, features, and functions.

Body Scanning

• High-end massage chairs often include a body scan mode.
• The chair has a built-in computer that scans the individual's body shape to deliver a customized massage to the different body areas.

Multiple Massage

• Most massage chairs come with rollers and nodes to access the sore muscles.
• Many chairs offer a variety of pre-programmed massages.
• Higher-end programmable chairs provide kneading, reflexology, and Shiatsu, to name a few.
• The massaging action is designed to help alleviate muscle discomfort.

Heated Massage

• Many high-end chairs offer an optional heated seat and/or back.
• Some chairs provide full-body infrared heat to relax the muscles.

Reclining Function

• Most chairs feature multiple recline functions.
• Zero-gravity recline is a popular option.
• However, all recline options enhance relaxation.

Options

Choosing one will be based on specific needs and budget. Some tips to help figure out which is the most beneficial massage chair include:

Consult A Doctor

• A doctor, spine specialist, or chiropractor can recommend the best type of massage chair for the individual's specific injury, condition, and/or disorder.
• A doctor will inform the individual if a massage chair is a safe option for their sciatica pain if they have health conditions like high blood pressure or neuropathy.

Chair Objectives

• Figure out what the chair will help with short and long-term before shopping.
• For example, if the goal is to relieve sciatica and lower back tension, an L-Track massage chair can go further down the spine to the glutes and hamstrings.

Injury Medical DOC Spinal Decompression Table

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cyganska, Anna, et al." Impact of Exercises and Chair Massage on Musculoskeletal Pain of Young Musicians" International journal of environmental research and public health vol. 17,14 5128. 16 Jul. 2020, doi:10.3390/ijerph17145128

de Souza, Talita Pavarini Borges et al."“The effectiveness of Chair Massage on Stress and Pain in Oncology" International journal of therapeutic massage & bodywork vol. 14,3 27-38. 2 Sep. 2021, doi:10.3822/ijtmb.v14i3.619

Hand, Mary et al." "Massage Chair Sessions: Favorable Effects on Ambulatory Cancer Center Nurse" Perceived Level of Stress, Blood Pressure, and Heart Rate" Clinical journal of oncology nursing vol. 23,4 (2019): 375-381. doi:10.1188/19.CJON.375-381

Kim, Seung-Kook, et al." "Clinical outcomes and cost-effectiveness of massage chair therapy versus basic physiotherapy in lower back pain patients: A randomized controlled trial." Medicine vol. 99,12 (2020): e19514. doi:10.1097/MD.0000000000019514

Kumar, Saravana, et al. "The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews." International journal of general medicine vol. 6 733-41. 4 Sep. 2013, doi:10.2147/IJGM.S50243

The lower back core muscles initiate and control movement and posture. Total body movements start at the pelvis and are carried out by the low back and abdominal muscles. These core muscles provide control and stability when moving. When the body is not moving, standing and sitting posture habits (healthy and unhealthy) develop based on how an individual controls/holds their pelvis posture. The lower back muscles are in constant demand for performing repetitive motions or forceful actions. The muscles become chronically tight and sore,  joints and nerves get compressed, and bones and connective tissue stay in a stressed state, causing intense pain and damage to the body's structure. These problems can result from muscle memory, the nervous system's operating procedure to make movements automatic.

Muscle Memory

The nervous system controls the movement and contraction in the muscles and constantly reinforces and learns new movement patterns to become more efficient through muscle memory. However, this learning process allows for the development of healthy muscle habits and unhealthy muscular habits. An example is sitting using a slouching posture. The nervous system will store that posture data and subconsciously contract the abdominal and pectoral muscles, so the slouched posture takes over. Because of the continual usage and compromised postures, various muscles start to tighten up. Individuals are typically not aware of the gradual tightening until stiffness, soreness, and pain sets in. Tight muscles pull the skeleton in awkward ways that cause body misalignments, causing:

• Posture problems
• Limited movement
• Functional leg length discrepancy
• Idiopathic scoliosis
• Repetitive strain injuries
• Joint degeneration
• Nerve impingement - sciatica

Individuals develop unique muscle patterns and tension levels throughout the body due to repetitive daily activities, stress responses, injuries sustained, and physical activities. Muscle memory issues can contribute to chronic back pain and sciatica. Unhealthy muscle memory causes the muscles not to return to their natural state but to the awkward position and makes that the natural state. Healthy muscle memory leads to instant reflexes that make movements smooth and effortless.

Chiropractic will relieve back and sciatica pain by inducing deep muscle relaxation that releases endorphins. The soreness and tension will be massaged, and mechanical decompression if necessary. Massage and stretching will help retrain muscle and movement memory, along with exercises to reinforce the retraining.

Spinal Decompression Therapy

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Campbell, James N, and Richard A Meyer. "Mechanisms of neuropathic pain." Neuron vol. 52,1 (2006): 77-92. doi:10.1016/j.neuron.2006.09.021

Wilder, David G et al. "Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomized controlled trial." Trials vol. 12 161. 28 Jun. 2011, doi:10.1186/1745-6215-12-161

Living with sciatica can be debilitating and exhausting. Find out how different individuals reduced their pain from this condition. Sciatica has different treatment options. It is often a matter of trial and error to find a treatment/therapy that works for the individual. These include:

• Physical therapy
• Medication
• Chiropractic
• Injections
• Acupuncture
• Surgery

Different individuals with sciatica share what works for them. Here are their stories.

Rudy Found Relief With Self Care

A bad fall left Rudy, a graphic designer, with a broken pelvis and broken foot. I was in the hospital for a few days, and when I came home, I noticed I was hobbling. I had developed sciatica. I was in a lot of pain but decided to try the treatment that had helped me manage chronic migraines. This was yoga. Specifically, it was hot yoga sessions that, despite the pain, worked. However, for others, he recommends not staying still. The body can't stay stagnant with no movement.

Rudy follows a plant-based diet. Eating right has helped significantly. He starts the day with a green smoothie and sips one throughout the day. This reduces inflammation and pain. His stress would also contribute to the pain. Anything felt from a pain perspective becomes amplified when in a sad, frustrated, confused mood. Rudy's advice is to get the body moving. And follow a plant-based anti-inflammation diet.

Medication and a Topical Pain Balm Work For Jose

Jose, 66, figured how his sciatica developed was when he decided to insulate the garage. I was bending, twisting, turning, and contouring my body every which way. A week after the job, I developed excruciating pain that got worse over the following weeks. I would jolt out of bed at 2-3 in the morning with severe pain. My doctor gave me steroids that didn’t do anything. I could barely sit down and had to go through a careful method of getting into a chair. 

I was prescribed Vicodin - hydrocodone/acetaminophen. I took them for a week and a half.

The pain went away, but it came right back as soon as I stopped taking the meds. The meds were only masking the pain. I decided only to use it when the pain was excruciating. This was because I was worried about addiction. I tried chiropractic, massage, acupuncture, cupping, and physical therapy. Unfortunately, I was not feeling any real relief. Then I went to a pain management doctor, who ordered an X-ray and an MRI.

The doctor informed me that my spine was in great shape. The pain management doctor gave me a piriformis injection and, later, an epidural steroid injection. There were still no positive results. My primary care doctor prescribed gabapentin. This is an anti-epilepsy medication that has been shown to help some cases of back pain. Most of the major pain is gone, and I'm pretty sure it’s from the gabapentin along with weekly deep massage sessions. I also use CBD cream with arnica. Movement is important; during the day, I make sure to stand up and walk around.

Epidural Injections Work For Isabel

Isabel has chronic pain. This comes from arthritis, migraines, and fibromyalgia. Sciatica developed as a result of these conditions. Soon she couldn't get into the car or even empty the dishwasher without going through excruciating pain. Nerve ablation or physical therapy was ineffective at relieving the pain. Then my doctor suggested getting an epidural injection. This is not the same type of injection as when having a baby.

It is not the same at all. The injection includes a steroid medication called a corticosteroid that is an anti-inflammatory, along with an anesthetic. I tried it and got some relief, but the pain came back. However, after a month and a half, I began to feel more relief. The pain is not completely gone. I do feel better, but there is still some pain. My doctor told me that patients are all different and require different amounts of medication and time to work.

Surgery Gave Pablo His Life Back

Pablo, 50, is no stranger to back pain or back surgery. After living with chronic back pain from a roll-over auto accident, Pablo underwent a laminectomy. A doctor removed a portion of the vertebra in 1998 and spinal fusion in 2004 that fused the discs from L5 to S1. Life was going well until I was laid off from my desk job. I started working at a warehouse doing light work, but I would still help lift moderate/heavy bags, boxes, etc. I just pushed through the pain, thinking it was a strain that would go away.

However, during the last six months, the pain was so bad I had to stop working. I needed a cane to get out of a chair. Friends and family told me I was walking like a 90-year-old. I also lost feeling in a couple of my toes. In 2021 I had another fusion and had a broken screw from my earlier fusion repaired. The surgery went well, and they said as long as I don't do any heavy lifting, I should be alright. Although there is still pain, it is much less than it was before the surgery. My doctor recommended a new desk job and a physical therapy rehabilitation, stretching, and strengthening program.

Body Composition

Calories burned from 10,000 steps

Estimations of how many calories are burned from exercises like walking or running depends on how heavy an individual is. Heavier people use more energy to move than lighter people. Estimates revolve around 100 calories burned per mile for a 180-pound person. 10,000 steps comes to around roughly 5 miles. 

Assuming an individual weighs 180 pounds means 100 calories x 5 miles equals 500 calories. Over a week, it becomes 3,500 calories. However, lighter or heavier individuals will burn less or more calories while walking the same number of steps or distance.

Inversion tables and inversion treatment/therapy could help with low back/leg pain and sciatica. It’s non-surgical and an option your doctor, or chiropractor could recommend to you before looking into more invasive options. Individuals with low back pain, sciatica or both found inversion therapy with an inversion table provided relief from symptoms, and continued use has kept them and their spines healthy.

With an inversion table, you don’t have to use gravity boots or completely hanging upside down. There are inversion boots and hanging racks that also offer inversion therapy, this type is not for beginners. With experience, you can move on to this type but for now, leave it to individuals in top health and athletic condition. This type of inversion table therapy is an alternative that doesn't require being completely upside down.

An Ancient Therapy Brought Back

Inversion therapy is nothing new. Hippocrates, the father of medicine, saw what inversion therapy could do and the benefits around 400 BC. The goal is to use gravity to release compression in the spine. The downward force pulls everything toward the earth's center. 

How It Works

Inversion therapy works in a way like spinal traction.For example, when we stand and sit gravity pulls the spine downward and this is what compresses the discs, vertebral bodies, nerves, and other spinal structures. The physical dynamics along with gravity helps relieve spinal compression. As the spine is stretched out the pressure on your back is reduced.

The theory behind inversion therapy sounds like a fantastic non-surgical option to back pain. However, the research going into inversion therapy is a bit more mixed. One study found that almost 77% of patients that were candidates for surgery no longer needed the surgery after using inversion therapy. For patients that didn’t use inversion therapy, only 23% avoided surgery.

But like all back pain/sciatica treatment plans, it's what works for you. Ask your doctor/chiropractor about the pros and cons of this type of treatment as it relates to your condition to make an informed decision.

Other Benefits

Many patients report that inversion therapy is a great way to:

• Stretch the muscles and ligaments
• Reduce muscle spasms
• Improve circulation

Stretching stimulates the lymph glands which increases the flow of lymphatic fluids, that are part of the body's waste disposal. Cellular health depends on healthy blood circulation to be delivered, to nourish and remove waste.

The therapy also helped to relieve motion sickness and stress. This is because the body is more aware of its spatial orientation along with balance as the inner ear gets stimulated while inverted. As stated earlier it is not necessary to be positioned completely upside down to benefit from this therapy. Inversion tables are adjustable and offer the flexibility to find the best angle.

Discuss Inversion Therapy with A Doctor

Before you start using an inversion table talk to your doctor. Certain medications and health conditions could make using an inversion table unsafe.

It could be recommended against inversion table therapy if you have:

• Detached retina
• Eye infection
• Glaucoma
• Fracture
• Heart condition
• Hernia
• Implanted device
• Middle ear infection
• Obese
• Osteoporosis
• Pregnant
• Spine injury

There could be other medical conditions that are not listed but could interfere with inversion therapy, so make sure your doctor knows all your medical history/conditions and current health state before beginning.

Starting Inversion Therapy

How to start an inversion therapy program? Take it very slow, easy, taking your time and have someone there to help and assist until you are comfortable doing it on your own. The tables can be set at different angles and it is recommended you start at the first and work your way to the last. At the 15-degree angle, your body will feel a stretch along with the benefits of increased blood circulation.

Most people don't have to go beyond 60-degrees, as the spine decompresses at this angle. But you might want to completely invert yourself as you work through the different degrees and go for the full inversion. But don't overdo it and listen to what your body tells you.

The tables come in a variety of styles, so be sure to research the different brands. Some tables can include a sliding backrest and foot lock that lets you work in gentle stretching exercises during inversion. This could include head movements from side-to-side, stretching the arms overhead, and doing abdominal sit-ups or crunches.

But first, find out from your doctor how often you should invert and the kinds of movements that will help with your condition and enhance your inversion program. Inversion therapy is another option for a back, sciatic pain treatment plan. For the different forms of spine pain, a doctor will try several non-surgical treatment options before discussing surgery. Inversion therapy could be part of a conservative treatment plan and could help prevent the need for spine surgery.

Get Rid of Sciatica Pain! El Paso, Texas

NCBI Resources

The spine is the primary support for the body. When it breaks down, the body suffers. Regular chiropractic treatment ensures that the spinal column remains in proper alignment which, in turn, keeps the body in proper alignment. It helps with joint health as well as the health of the related muscles and ligaments.

Your chiropractor can also recommend stretching and strength-building exercises to help keep your spine healthy and supple. Chiropractic helps to keep the back flexible which aids in preventing injury. A healthy spine is also less likely to become misaligned or experience pain. It can significantly improve your quality of life as you are more flexible and mobile.

The discs that cushion the vertebrae are made up of a tough outer layer and a softer inner layer. When the outer layer is damaged and the inner layer comes out into the spine, it is referred to as disc herniation.

Often the symptoms of a herniated disc include back pain, as the inner layer of the disc puts pressure on nerves in the spine. A herniated disc can impact the sciatic nerve, leading to sciatica.

If you know that your sciatica was caused by a herniated disc then try these exercises and stretches to help reduce back and leg pain.

Exercises that help relieve sciatica from a herniated disc

If your spine specialist or chiropractor informed you that a herniated disc is what caused the pain also known as lumbar radiculopathy they may recommend  three sciatica exercises:

• Prone on elbows into Press-up
• Upper back extension
• Opposite arm and leg extension

These stretches can help provide relief when the root cause of sciatica from herniated or bulging disc.

Prone Elbows/Press-Up

This exercise is to ease sciatica from herniated disc pain and pressure in the lumbar spine/low back.

How to:

• Lay on stomach
• Slowly push up until rested on forearms
• Beginners hold for 30 seconds
• Once strength is gained and you feel comfortable then hold for 3 to 5 minutes
• Gently lower to the floor
• Repeat 10 times
• Once comfortable holding for 5 minutes then perform an extended arms version, which is like push-ups raising your arms to the point where your elbows lock

Upper Back Extension

This exercise is to strengthen and stabilize the low back muscles.

How to:

• Lay on your stomach with a small pillow or rolled towel under your hips
• Rest your arms at your sides
• Slowly lift your upper body up off the floor, contracting your low back muscles as you rise
• Hold the lifted position for 3 seconds
• Slowly lower your body to the ground
• Repeat 10 times

Throughout this exercise, keep movements fluid and controlled.

Opposite Arm and Leg Extension

This exercise is to stabilize your spine and strengthen your low back, hamstring and gluteus muscles.

How to:

• Lay on your stomach with a small pillow or rolled towel under your abdomen
• Extend both arms in front of you
• Contract your abdominal muscles as you slowly lift both your right arm and left leg
• Hold for 3 seconds. Lower your leg and arm down
• Repeat with your left arm and right leg
• Hold for 3 seconds
• Repeat the exercise 5 to 10 times on each side

As you alternate the lifts, make sure to keep abdominal muscles contracted to get the full benefit.

How do these exercises relieve sciatica from a herniated disc

These exercises and stretches are designed to move the pain from the leg and into the low back.

This is centralization/localization.

This is a good thing, as the goal is to get the pain centralized and back at the source.

When the leg pain goes away, it means the pressure on the sciatic nerve and related nerves has been removed.

If sciatic pain stretches down to the foot, you will feel these exercises, meaning that the pain and electrical sensations will move through the ankle and knee. Which means you're doing it correctly.

This does not mean that the pain is immediately going to centralize to the low back, it does take time because you are trying to stretch and straighten out this long nerve.

But you will notice sciatica pain does not go as far down the leg.

Therefore these exercises need to be done consistently and be made a part of your routine. 

What to know before exercising

Before starting these stretches, consider three recommendations:

Get a doctor’s approval

A spine specialist should clear you to perform these stretches and exercises before you start.

While these exercises are safe, get a doctor’s permission before starting physical activity.

Know the cause so your exercise program helps and not makes the condition worse

Sciatica from herniated disc means a different type of exercise than sciatica caused by piriformis syndrome.

Knowing this information will help you choose an exercise plan that provides maximum relief.

Don’t push too hard

Don't aggravate sciatica, listen to your body and go slow.

Experience any pain or symptoms:

• Weakness
• Tingling
• Numbness

Contact a spine specialist immediately!

Sciatic nerve pain caused by a herniated or bulging disc is a common problem.

But incorporating these exercises and stretches can provide sustained relief.

The sciatic nerve is a large nerve that travels from the lower back down both of the legs and into the feet. When pressure is placed on the nerve, such as from a herniated disc, it can lead to the symptoms commonly referred to as sciatica.

The sciatic nerve can be impacted by a number of different things, including injury and degenerative diseases.

Difference Custom *FOOT ORTHOTICS* Make to Control Posture & Mobility | El Paso, TX (2019)

Custom foot orthotics can help control foot motion and posture. Healthcare professionals prescribe custom foot orthotics to help patients focus on the control of their foot posture and mobility. Research studies have determined that utilizing custom foot orthotics for posture and mobility control can help correct excessive foot pronation and supination to prevent a variety of foot health issues. The following video describes how custom foot orthotics can help control foot posture and mobility to improve health and wellness.

Active release therapy, more specifically referred to as the active release technique, is a patented system designed by Dr. P. Michael Leahy which focuses on the treatment of developed scar tissue in damaged muscles all across the human body. When Dr. Leahy first developed the technique about two decades ago, he realized that the damage in the complex soft tissues of the muscles might perhaps be able to be sensed as well as addressed directly through movement in the form of specialized techniques. With its proven ability to cure pain, its own acronym, ART, provides the active release therapy with some ironical link to being a true art form in chiropractic care.

When athletes overwork their muscles from playing sports or even through just everyday activities, many individuals don’t understand how scar tissue can develop on our muscles in the first place. The scar issue forms in order to help heal damaged muscles, however, it can ultimately create painful symptoms which may last long after these have healed. Scar tissue most commonly develops as a result of pulled muscles or muscle tears, or even from a lack of oxygen, called hypoxia.

As the scar tissue builds in the damaged or injured muscles, if the individual does not maintain a proper level of mobility in the affected area, it can progressively cause muscles to become stiff or tight and weak, eventually leading to health issues such as tendonitis or nerve problems. This explains why some people with pain or limited range of motion, often will need to visit a healthcare professional immediately. Fortunately, many doctors are certified to treat these type of problems using active release therapy.