Chiropractic Treatment for Sciatica, Research Paper Example

Introduction

By definition, sciatica involves the inflammation of the sciatic nerve which originates in the sacral plexus and extends through the muscles of the thighs, legs, and feet with numerous branches. In many sufferers, sciatica may be a symptom of what some refer to as a pinched nerve that affects some the nerves that descend downwards from the based of the spinal column and into the legs and feet. Physiologically, this type of pinched nerve is either compressed inside the spinal column via a disc or externally by a muscle or tendon (Donaghy, 2001, p. 450).

There are four basic causes or conditions for sciatica–1), a herniated or slipped disc in the spinal column that creates pressure on the root of the sciatic nerve; 2), a condition known as the piriformis syndrome which is created when the piriformis muscle, a flat, pyramidal muscle lying almost parallel with the posterior margin of the gluteus medius and located partly within the pelvis and partly at the posterior of the hip joint, becomes tightened which causes spasms that place pressure on the sciatic nerve; 3), a condition known as spinal stenosis which occurs when the spinal canal becomes too narrow which places pressure on the nerves; and 4), another condition known as spondylolisthesis which occurs when a vertebrae slips out of alignment with the vertebrae either above or below it, most commonly the fifth vertebrae, thus causing pressure and narrowing that affects the sciatic nerve (What is Sciatica? 2014).

The most common approach to diagnosing sciatica includes a complete and thorough review of the patient’s medical history, a review of the various symptoms, and a thorough physical examination. A health care provider, such as a physical therapist, might begin the diagnostic process with a straight leg-raise test which involves raising the leg until a point is reached whereby pain is noticed by the patient. Very often, this type of test can help to determine if the nerve pain is located in a spinal disc or generates from the sciatic nerve itself.

There are four other types of tests that a therapist may utilize to properly diagnose sciatica–1), x-rays to check for any kind of fractures in the spine; 2), MRI and/or CAT scans which provide vivid images of the spine and related anatomical features; 3), nerve conduction velocity examinations (a.k.a. electromyography) which reveals if electrical impulses are traveling properly through the sciatic nerve; and 4), a myelogram which involves injecting a dye between the vertebrae in order to determine if the discs are misaligned or applying pressure to the spinal cord and nerve endings (Glanze, 2005, p. 657).

Chiropractic Procedures

If a person is suffering from sciatica and seeks out treatment from a traditional physician or physical therapist, treatment will most probably consists of either some type of conventional physical therapy composed mostly of exercises or some type of medication, such as anti-inflammatory drugs (ibuprofen and naproxen) which help to lower swelling and stiffness. However, chiropractic treatment for sciatica has proven to be highly effective for individuals who wish to pursue what some call alternative medicine or that which lies outside of accepted medical practices (What is Sciatica? 2014).

Trained chiropractors are able to diagnose and treat sciatica through various approaches that for the most part aim to dispense with the discomfort and pain associated with the sciatic nerve. As noted by Michael Donaghy, sciatica pain is generally due to spinal misalignment; thus, “by eliminating this type of restriction on the spinal vertebrae, a patient’s body can begin to heal itself properly without the need for medications” (2001, p. 453).

Much like a traditional physical therapist, a chiropractor will first attempt to determine the cause of the patient’s pain via X-rays, MRI imaging, and other radiological procedures. One this has been accomplished, the chiropractor will devise an appropriate plan for treatment. According to Donaghy, the foundational core of chiropractic treatment for sciatica is spinal manipulation which helps to eliminate various types of restrictions in the spinal vertebrae and aids in restoring misaligned vertebrae to their proper position in the spinal column. This type of treatment reduces stress on the sciatic nerve that often creates spasms and inflammation. Many times, a single treatment session is sufficient for the relief of pain and discomfort associated with sciatica (2001, p. 455).

As a procedure, spinal manipulation involves the forced passive flexion, extension, and rotation of the vertebral segments which carries the elements of articulation beyond the usual range of movement to the limits of anatomical range. This procedure usually involves pushing and flexing the spinal cord in order to free up the sciatic nerve if it is being pinched or restricted by the spinal column (Donaghy, 2001, p. 456-457).

Another common procedure is typical physical therapy which involves a series of specialized exercises that focus upon stretching (mostly bending and twisting) and strengthening the muscles attached to the spinal column. During these exercises, the chiropractor may opt to apply ice packs which helps to reduce swelling and inflammation. Another common procedure is the use of ultrasound which utilizes heat generated by sound waves to improve blood circulation in the deep tissues of the back. This often results in a reduction of spasms, inflammation, and of course pain associated with the sciatic nerve. A second option for the chiropractor is using an electrical nerve stimulator which sends electrical currents through the affected muscles, thus reducing swelling and pain (Donaghy, 2001, p. 458-459). Overall, chiropractic interventions related to sciatica have been shown to be quite effective in relieving the pain and discomfort associated with the disorder.

References

Donaghy, M. (2001). Brain’s Diseases of the Nervous System. UK: Oxford University Press.

Glanze, W.D. (2005). Mosby’s Medical and Nursing Dictionary. St. Louis, MO: C.V. Mosby Company.

What is sciatica? (2014). Cleveland Clinic. Retrieved from http://my.clevelandclinic.org/health/diseases_conditions/hic_What_is_Sciatica