What is Sciatica?

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Sciatica is a pain in the ass

Do you have “true” or “false” sciatica?

Sciatica is the most common problem I treat but it’s cause is commonly misunderstood by patients. First sciatica is a general term that doctors use to name pain in the low back, buttocks, into the legs, or some combination of those three places. Based on the underlying cause of the symptoms, some practitioners will call sciatica either “true” or “false.” But regardless of whether your sciatica is “true” or “false” it is painful as heck and often debilitating. Treatment can range from the simple to the surgical. Here are the 3 most common causes of sciatic symptoms.

To schedule an appointment click here or call (530) 403-6386

First lets talk about the 2 “false” forms of sciatica;

Sciatica trigger points

Trigger points in the muscles of the buttocks can cause terrible pain in the buttocks and/or down the leg. A trigger point is a knot in the muscle (the ancient Chinese called them “ashi” points-literally “that’s it!”). These knots can radiate pain some distance from their actual location and this radiating pain mimics “true” sciatica. In the image above, white X’s mark the trigger point location and the red areas show where the pain generated by them typically goes. Acupuncture is the #1 choice for this problem because it is the fastest way to get those knots to “let go.”

To schedule an appointment click here or call (530) 403-6386

Piriformis syndrome illustration

Piriformis syndrome-in a percentage of the population the sciatic nerve actually passes through a muscle in the buttocks (the piriformis) and if that muscle spasms, the nerve is painfully pinched. The sciatic nerve is the largest nerve in the entire body. It arises from nerves in the lower back and, in the majority of people, passes uneventfully underneath the muscles of the buttocks. In an unfortunate group of people, the nerve formed in such a way that it actually passes through the middle of the piriformis muscle. If the piriformis spasms in those people, the sciatic nerve is put in a “choke-hold” that will cause an intense deep achy pain in the buttocks and often an intense pain, tingling, or numbness down the leg. Acupuncture is the #1 choice for this problem too.

To schedule an appointment click here or call (530) 403-6386

So far… Acupuncture 2/ Surgery 0!!

Lastly let’s discuss “true” sciatica. This is when a herniated disc presses on a nerve in the low back and causes symptoms to appear somewhere “downstream” in an area that is fed by that nerve, most commonly the buttock but often the leg or even as far as the toes. This “pinching” can cause pain, tingling, numbness, or any number of weird feelings. While this is the most common diagnosis patients get from their doctor, THIS IS THE LEAST COMMON CAUSE that I’ve seen in my 20 years in practice.

You may have had an MRI that showed a disc problem. But bear in mind that, depending on age, 37-96% of healthy, pain-free people show disc problems. The MRI needs to be scrutinized carefully to see if the disc is actually contacting the exiting nerve.

What are your treatment options? Before you even consider surgery it is prudent to try more conservative methods

  • Traction or decompression is the treatment of choice for this in my opinion
  • Acupuncture can play an important supporting role by loosening the muscles around the spine so the traction can be more effective.
  • Chiropractic care can help to make sure everything is in position.
  • Diet can often be very helpful too. By following a “low-inflammation” diet, the swelling around the disc and nerve can sometimes be reduced enough to take the pressure off the affected nerve and stop the pain.

To schedule an appointment click here or call (530) 403-6386

When is Surgery Necessary?

Unfortunately in a minority of cases surgery is necessary. Especially if these red flag symptoms appear. They mean the nerve is actually being damaged and the damage could become permanent!

  • Weakness of the leg – doctors often check for this by having you walk on your tiptoes and then on your heels. If the leg has weakened, you won’t be able to do this and you need to consult with an orthopedic surgeon or neurologist asap.
  • Loss of bladder or bowel control – Another serious symptom that means you need to consult with a specialist asap.

If you see an M.D. for your sciatica, typically they will just try to mask the problem with addictive pain killers or consider something drastic like surgery. But most of the time the problem is much simpler to fix, and much less stressful. So before you let a doctor talk you into invasive treatments you might not need, take the time to look into the alternatives.

If you or someone you knows suffers from sciatica, tell them to call my office ASAP. (530)403-6386

To schedule an appointment click here or call (530) 403-6386

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