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A description of the causes of sciatic nerve pain and subsequent treatment protocols using chiropractic care and acupuncture. Provided by Dr. Kirk Johnson of Johnson Chiropractic & Acupuncture P.A.

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  1. 1. Chiropractic Care Diagnosis and Treatment of Sciatic Nerve Pain Dr. Kirk Johnson B.S., D.C., F.A.S.A.
  2. 2. Sciatic pain, what is it? <ul><li>Sciatic nerve pain, also commonly called “Sciatica” </li></ul><ul><li>The sciatic nerve carries sensory and motor function to the lower extremities. </li></ul><ul><li>This very large nerve can be the source of many symptoms of pain in the lower extremities </li></ul>
  3. 3. Symptoms of Sciatica <ul><li>Cramping sensation in the thigh </li></ul><ul><li>Radiating pain from the buttock down the back of the leg </li></ul><ul><li>Tingling in the legs </li></ul><ul><li>Numbness in the legs </li></ul><ul><li>Burning sensation in legs or thigh area </li></ul><ul><li>Severe cases present with muscle weakness </li></ul>
  4. 4. Symptoms of Sciatica <ul><li>Most often the symptoms are seen only on one side </li></ul><ul><li>If the symptoms are present on both sides the disc bulge is usually more severe </li></ul><ul><li>Most often the symptoms are continuous </li></ul><ul><li>Literally a pain in the butt! </li></ul>
  5. 5. Anatomy of the Sciatic Nerve
  6. 6. Causes of Sciatica <ul><li>Lumbar spine disc bulge </li></ul><ul><ul><li>Most common cause of sciatica </li></ul></ul><ul><ul><li>This can occur from simple bending and twisting movements </li></ul></ul><ul><ul><li>When this happens, the patient reports stabbing and shooting pain that travels down the leg </li></ul></ul><ul><ul><li>This radiating pain is very indicative of a disc lesion </li></ul></ul>
  7. 7. Causes of Sciatica <ul><li>Piriformis Syndrome </li></ul><ul><ul><li>The piriformis muscle goes from the sacrum to the hip </li></ul></ul><ul><ul><li>In most of the population the sciatic nerve actually pierces through the belly of the piriformis muscle </li></ul></ul><ul><ul><li>An over contraction of the piriformis will lead to sciatic like symptoms. </li></ul></ul><ul><ul><li>Pain is usually located more in the buttock area with slight radiation </li></ul></ul>
  8. 8. Causes of Sciatica <ul><li>Sacroiliac joint dysfunction </li></ul><ul><ul><li>The sacroiliac joint affects the biomechanics in the pelvis </li></ul></ul><ul><ul><li>When a fixation occurs at this joint the patient will experience muscle tightness </li></ul></ul><ul><ul><li>The muscle tightness will then lead to sciatic like symptoms </li></ul></ul><ul><ul><li>Pain is usually more localized to the hip and buttock area, rarely below the knee </li></ul></ul>
  9. 9. Treatment for Sciatica <ul><li>Lumbar disc bulge </li></ul><ul><ul><li>A complete orthopedic and neurological examination to determine level of disc bulge </li></ul></ul><ul><ul><li>MRI may be necessary to determine extent of damage </li></ul></ul><ul><ul><li>Chiropractic manipulation with acupuncture yields excellent results </li></ul></ul><ul><ul><li>Interferential therapy and cold laser may be used to reduce inflammation and pain </li></ul></ul><ul><ul><li>Enzyme therapy will help recovery time </li></ul></ul>
  10. 10. Treatment for Sciatica <ul><li>Piriformis syndrome </li></ul><ul><ul><li>Examination to rule out disc bulge </li></ul></ul><ul><ul><li>Determine piriformis function, i.e. muscle is too tight or too weak. </li></ul></ul><ul><ul><li>Treat the piriformis with cold laser and manual muscle techniques </li></ul></ul><ul><ul><li>Chiropractic manipulation to restore proper pelvic biomechanics </li></ul></ul><ul><ul><li>Acupuncture to relieve pain </li></ul></ul>
  11. 11. Treatment for Sciatica <ul><li>Sacroiliac Joint Dysfunction (SIJ) </li></ul><ul><ul><li>Exam to rule out disc bulge </li></ul></ul><ul><ul><li>Chiropractic manipulation to reduce the fixated joint </li></ul></ul><ul><ul><li>Cold laser therapy for inflammation and pain </li></ul></ul><ul><ul><li>Acupuncture treatment for pain </li></ul></ul>
  12. 12. Treatment Duration <ul><li>The dreaded lumbar disc bulge will take the longest to return to normal </li></ul><ul><ul><li>I have had patients respond in as little as 5 visits, and upwards of 30 visits </li></ul></ul><ul><li>Piriformis syndrome may take up to 4 weeks, usually I see a large reduction in symptoms in 2 weeks </li></ul><ul><li>SIJ dysfunction can take the least amount of time to correct </li></ul><ul><ul><li>I have seen results in 2 visits, it could take 8 visits. </li></ul></ul>
  13. 13. Enzyme Therapy <ul><li>Nutri-West’s Lyso-Lyph-Forte </li></ul><ul><ul><li>Natural and effective </li></ul></ul><ul><ul><li>No side effects (no stomach pain) </li></ul></ul><ul><ul><li>Uses natural enzymes to help decrease inflammation and regulate pain pathways </li></ul></ul><ul><ul><li>Decreases recovery time </li></ul></ul><ul><ul><li>Used by professional athletes </li></ul></ul>