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#94 True Sciatica 

4/15/2014

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            If you have true sciatica, you know it!  You will have shooting pains down your leg or from your butt to your foot.  You may have pins and needles sensations in your foot or leg.  You may also have weakness of some of the muscles in your legs.  The pains are often constant and debilitating, but can be more intermittent.  Regardless, they are real and severe and need to be taken seriously.  There is also a condition called false sciatica that feels nearly as bad but typically does not travel further down the leg than the knee.  There is usually a lot of buttock pain and sometimes a vague ache in the calf or foot along with very tight muscles.  False sciatica can be nearly as debilitation as the true sciatica, but is typically less serious and easier to treat.  To find out which one you have requires a good history, the right clinical exam, an experienced clinician to discern the nuances, and finally a competent chiropractic technician to get you through this tough time.  This article will be devoted to true sciatica. 

            As with so many health conditions, true sciatica begins with the vertebral subluxation complex, the chiropractic $20 word for spinal damage.  Time, life, and gravity have acted on your spine either severely enough or long enough that inflammation generates scar tissue.  This leads to loss of spinal joint motion.  This causes less nutrients and water to get to the vertebral discs which lack a blood supply.  They then dehydrate, degenerate, tear, bulge, and finally herniate.  So true sciatica takes a long time to develop even though the symptoms may have appeared out of nowhere for no reason over night.  It is years or decades in the making.  And the thing that differentiates it from false sciatica is the disc.  With false sciatica, the disc is not involved as a source of pain.  With true sciatica, the disc is involved, making it much more complicated.  So what do we do about it?

            As always there are only 3 tools we use to correct subluxation; the adjustment, stretching exercises, and deep tissue massage.  The purpose of these tools is to improve motion of the damaged joint, to reduce nerve stress, to reduce muscle tightness, to reduce inflammation, and to break down scar tissue.  In a case where there is no disc damage, these tools work fantastic nearly every time.  They work quickly and with few if any side-effects.  However, when there is disc herniation, as in sciatica, this complicates things.  Disc herniation is when the jelly middle of the disc (the nucleus) oozes out through the degenerated rings of the cartilage outer portion of the disc (the annulus).  The bigger the herniation, the longer treatment will take, the less success they may be in pain reduction, and the worse the long term prognosis.  But, with time, the adjustments can still work fantastically.  But remember, it took a long time to get here.  It may take a long time to get under control.  But nothing can ever truly fix it!

            Adult humans don’t make cartilage, so once the disc is damaged it cannot be undamaged.  The herniation can be made smaller.  The pain can be reduced or eliminated. The inflammation can be lessened.  The rate of degeneration can be slowed.  Episodes of pain can be made less frequent.  But the disc will never be whole again.  Impossible.  This is all about spinal subluxation management.   

            So what happens when chiropractic cannot help the victim of true sciatica?  If you are not getting better we order an MRI to assess the disc damage.  And if you still don’t get better with that information we combine decompression with the adjustments.  And if you still don’t get better, which is a rare few, then and only then do we consider the injections of pain management and the costs, pain, and failure rate of back surgery.  Only then.

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    Dr. Rick

    After writing an article per week for a year, I just kept going.  These are most of my collection.  They are written with my existing patients in mind, so some stuff may seem odd or unusual, but would make perfect sense to those who know chiropractic and who know me.  Enjoy and share!  For my personal blog visit: 

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Yolanda wrote:
     
     I used to suffer severe headaches and migraines on a daily basis, usually all day.  I managed to work in an office because I had to.  When I went home at the end of the day I would often close the shades and go to bed.  I could not plan weekend events because I simply never knew how I was going to feel tomorrow.  If there were a special event such as a birthday or wedding, I would begin to medicate myself two weeks in advance to give myself the best chance of making the event.
     Friends and fellow church-goers had been trying to get me to see Dr. Rick for some time before I finally gave in.  Looking back, I don’t know why I waited.  Within a month, I was headache free.  I couldn’t remember what it was like to not feel pain.  I could do whatever I wanted and not live in fear of the headache.  This was a miracle for me, but the story does not end here.
     An opportunity came up for us to adopt a newborn baby girl not long after I began chiropractic care.  This baby was particularly important to me and my husband because her mother is a relative.  Tragically, her mother was also a drug user and did drugs during her pregnancy.  If we could not adopt the baby she would have been put into the foster system since the biological mother was incapable of raising her.
     To keep a long story short, we did adopt her and she is doing fantastically.  There is no sign of any effect of the drugs on her as of yet, and with God’s help, there never will be.  We think that is because of the vast amounts of love and attention she gets from us, her real mommy and daddy.
     What does this have to do with chiropractic?  The reality is that without chiropractic, I would still be nearly an invalid with headaches.  I COULD NOT HAVE TAKEN CARE OF AN INFANT OR RAISED A YOUNG CHILD.  THEREFORE, SHE WOULD NOT HAVE ANY OF THE OPPORTUNITIES IN LIFE THAT MY HUSBAND AND I WILL BE ABLE TO PROVIDE FOR HER.  MY DAUGHTER’S LIFE IS POSSIBLE BECAUSE SOMEBODY MADE ME GO TO A CHIROPRACTOR. 
     You need to tell everyone you know what you know about chiropractic.  Who knows who’s life you will change too.
Andrew's mother, Barbara, wrote:

     Hello, My name is Andrew and I am a happy, healthy one year old.  But I wasn’t so happy or healthy when I first met Dr. Rick a few months ago.  I had been having problems with my ears for four months, I couldn’t sleep at night and I was miserable.  We’d been to the doctor lots of times but nothing was helping.  In fact, all the medicines the doctor had tried seemed to make me worse instead of better!  Both the regular doctor and the Ear-Nose and Throat doctor said that if the antibiotics didn’t work, then they’d just have to put tubes in.  Now my Mom and dad weren’t about to let them do surgery on me, especially since they had been reading and learned that tubes can cause more problems than they solve.  My mom and dad did a lot of praying.  Then my mom heard that sometimes babies who have a traumatic birth like mine have ear trouble.  You see when I was born they used a vacuum extractor and forceps to pull me out.  I guess all that yanking on my head, hurt my neck.  She also heard that chiropractic care can be the answer.  Now she was skeptical because she couldn’t imagine a chiropractor helping ear infections!?!  But at that point she was willing to try anything!!  Happily, a few weeks of adjustments and my ears were all cleared up.  In addition, I no longer had a stiff neck or shoulders and my whole personality was happier.  I have to tell all babies who have ear troubles, don’t let them give you tubes until you at least try chiropractic care first.  After all, it can’t hurt and if you’re like me, you could be perfectly well with no drugs and no surgery.  In my family, we thank God for Dr. Rick, because I feel better, my mom and dad are happier and sometimes, I even sleep through the night.