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Posted on 02-24-2014

What is Sciatica?

As many of my blog followers can attest, I spend a fair amount of time talking about injuries sustained in Baltimore auto accidents. Today I will talk about a different condition that is generally not traumatically induced, although it can be.  Many people have heard of the term sciatica, but what exactly is it?

Sciatica refers to a set of symptoms associated with compression of one of the five spinal nerves that combine to form the sciatic nerve.

Symptoms of sciatica include lower back pain along with radiation of the back pain typically down a leg or into the buttock. Sciatica may cause numbness and/or tingling and/or weakness down an extremity. Or, it may just be back pain with some dull pain down a leg.

Technically speaking, true sciatica is compression of the sciatic nerve. In clinical practice most presentations of sciatica are not sciatica, but instead are a combination of other causes of back pain that cause radiating leg pain. In fact, sciatica is NOT a diagnosis, but rather a series of symptoms that describe back pain with radiating leg pain. If a patient tells me they have sciatica what it really means is "I have leg pain associated with back pain and I'm not sure why."

The typical causes of sciatica include: disc herniation, spinal stenosis, facet joint irritation, piriformis syndrome and in some extremely rare cases other space occupying lesions such as cancer that can mimick the condition. Patients that carry extra abdominal weight such as obese and/or pregnant patients can get sciatica as well.

Most patients that present with sciatica will have an x-ray to rule out nefarious causes of the sciatica. Once cleared for therapy they undergo a series of physical therapy modalities along with chiropractic spinal manipulation to help alleviate the symptoms causing the nerve compression. Most patients respond fairly quickly to therapy and their peripheral (leg) symptoms resolve.

Patients that have no response or negative response to care are often referred for MRIs and/or to a specialist to consider pain management/injections. These approaches, although more invasive, are often effective in alleviating symptoms where chiropractic care has not been able to help.

If you, or anyone you know suffers from sciatica in Baltimore please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

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