Sciatica "The Scourge & The Treatments"

Constipation is a leading cause of low back pain in America and can cause a chain reaction in the rest of the body. When the digestional tract swells, it generates added stress on the back and surrounding nerves. Prolonged constipation and pressure can cause sciatica symptoms. Constipation sciatica can be relieved through chiropractic treatment, therapeutic massage, non-surgical spinal decompression, and functional medicine to alleviate symptoms and restore optimal body function.

Constipation Sciatica

Sciatica is irritation, compression, and inflammation of the sciatic nerve, which supplies the thighs, lower legs, and feet. It is usually caused by a pinched/compressed of one or more spinal nerve roots between the vertebrae of the lower back. The buildup of stool in the intestines can cause a dull aching sensation in the low back that can radiate to surrounding areas. Common causes of constipation include:

• Insufficient water/hydration levels.
• An unhealthy diet.
• Vitamin deficiency.
• Stress.
• Little to no physical activity.
• Sporadic and unhealthy bowel movements.
• Overuse of laxatives or enemas.

Other causes of constipation include:

• Medication reactions.
• Antacids that contain aluminum or calcium.
• Calcium channel blockers.
• Iron supplements.
• Pain medications, especially narcotics.
• Sedatives.
• Antispasmodics.
• Antidepressants.
• Anticonvulsants.

Symptoms

Bowel movements vary for everyone, and not having a movement daily does not mean constipation is occurring. Some individuals have only three movements a week, while others have multiple movements daily. A recommended indicator of constipation is if there has been a sudden decrease in typical bowel movements. The digestive tract occupies a significant region of the lower torso. Back pain symptoms can present after the rectum becomes obstructed or stools have solidified in the colon. Once constipation has developed, the blockage presses against the nerves and muscles of the back. This causes a range of discomfort signaling by the brain, which worsens as the backup grows. Symptoms of general constipation include:

• Feeling full despite not eating anything.
• Bloating.
• Swelling.
• Abdominal cramping.
• Infrequent bowel movements.
• Discomfort or aching when trying to pass a stool.
• Hard and/or lumpy stool.

Constipation is considered chronic when two or more of the following symptoms occur for at least three months:

• Further decreased bowel movements.
• Straining to defecate.
• Stools do not loosen without the use of laxatives.
• Passage of hard pebble/pellet stools.
• Consistent abdominal pain that is relieved by even slight movement.
• Feeling as if the bowels are not fully emptied or a blockage in the rectum.
• Feeling the need to assist the release by pressing on the abdomen.

Chiropractic Treatment

Chiropractic treatment can realign the spine, release compressed nerves, increase the frequency of bowel movements, and through the massage and relaxation of the muscles, help to soften stools. Intestinal muscles push the stool to the anus, where it leaves/evacuates the body. Special nerve cells in the intestine, known as ganglion cells, innervate the muscles to push. These nerves connect to the celiac ganglion, which connects to the spinal cord through nerve roots that exit the spine in the lower thoracic and upper lumbar region. The celiac ganglion innervates the liver, stomach, gallbladder, spleen, kidneys, small intestine, and the ascending and transverse colon. Treatment for constipation and back pain depends on the cause of the symptoms. For example, if the constipation is caused by dehydration, a chiropractor will instruct the patient on water intake as part of the personalized treatment plan.

Diagnosis to Recovery

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Fernandes, Walkyria Vilas Boas, et al. “The effect of a six-week osteopathic visceral manipulation in patients with non-specific chronic low back pain and functional constipation: study protocol for a randomized controlled trial.” Trials vol. 19,1 151. 2 Mar. 2018, doi:10.1186/s13063-018-2532-8

Panarese, Alba, et al. “Chronic functional constipation is strongly linked to vitamin D deficiency.” World journal of gastroenterology vol. 25,14 (2019): 1729-1740. doi:10.3748/wjg.v25.i14.1729

Rédly, Monika. “The effects of chiropractic care on a patient with chronic constipation.” The Journal of the Canadian Chiropractic Association vol. 45,3 (2001): 185–191.

Trager, Robert James, et al. “Association between radicular low back pain and constipation: a retrospective cohort study using a real-world national database.” Pain reports vol. 6,3 e954. 26 Aug. 2021, doi:10.1097/PR9.0000000000000954

Sciatica is experienced as lower back pain and pain that radiates down the back of the legs. It is pain caused by compression, irritation, or inflammation of the sciatic nerve. It is generally experienced on one side of the body. Body movements like twisting, bending, sitting, or responses like coughing and sneezing can worsen the pain. Individuals with sciatica also experience muscle weakness, numbness, tingling, or electrical shock-like sensations. Injury Medical Chiropractic and Functional Medicine Clinic offer manual and motorized sciatic nerve decompression to stretch/realign the spine, release the compressed nerves, and relieve pain.

Sciatic Nerve Decompression

The spine consists of 23 spinal discs that are shock absorbers for the body during movement. Each disc consists of a soft inner core of a gel substance and a thick outer layer. Wear and tear of the spinal discs from aging, degenerative disc disease, repetitive physical activities like lifting and bending, obesity, and poor posture are some of the factors that can stress the spine, causing the thick outer layer of the spinal disc to crack/breakdown causing the soft inner core to leak out forming a bulging or herniated disc. This type of injury compresses, pinches, or irritates one or more nerve roots that form the sciatic nerve, triggering sciatica.

• Spinal bone spurs.
• Spinal stenosis or the narrowing of the spinal canal.
• Spondylolisthesis, or the slipping or dislocation of the spinal vertebrae in the lower part of the spine.
• Are also known sciatica causes.

Symptoms

Common compressed nerve symptoms include:

• Pain or burning sensations radiating down the leg.
• Because branches of the sciatic nerve extend from the lumbar spine through the buttocks and down the leg, pain, burning sensations or dull aching can present along the nerve's pathway if the nerve gets compressed or irritated.
• Weakness in the affected leg.
• When walking or moving the legs, the nerves transmit information to the brain, stimulating the muscles to react in specific ways.
• A pinched sciatic nerve can cause interference with relaying signals, resulting in weakness.
• Numbness.
• The compression impedes blood circulation and nerve energy transmission.
• Pins and needles sensations - paresthesia.
• Like numbness, paresthesia sensations happen when a nerve is compressed or irritated.

Non-Surgical Sciatic Nerve Decompression

Spinal decompression therapy relieves pressure on the spine by pulling/stretching it in small increments. Non-surgical spinal decompression creates negative pressure within the discs. The negative pressure pulls or vacuums back the disc material that has protruded or herniated and an abundance of nutrients to activate the healing response. The chiropractor, physical therapist, or nurse uses motorized medical equipment with sensors linked to a computer-aided system to perform the procedure. The equipment is designed to adjust the pull force accordingly to prevent muscle resistance. The adjustable table also allows the spine to be stretched at different angles to target the upper or lower back.

The objective of spinal decompression treatment is to relieve the symptoms of sciatica or disc disorders and heal the injured disc. We utilize spinal decompression as an effective tool in treating a vast array of spinal conditions.

DRX9000 Non-Surgical Spinal Decompression

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Berry, James A et al. “A Review of Lumbar Radiculopathy, Diagnosis, and Treatment.” Cureus vol. 11,10 e5934. 17 Oct. 2019, doi:10.7759/cureus.5934

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 Feb 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/

National Institutes of Health. (2019.) “Sciatica.” https://medlineplus.gov/sciatica.html

Rain generally comes with a drop in barometric pressure. A low-pressure system you may have heard from the local weather forecast. Lower pressure outside can cause tissues inside the body to swell and irritate sensitive nerves. For those who have sciatic nerve pain, rainy, hot, humid weather can cause the nerve tissues to expand causing increased compression, inflammation, and pain.

Rainy Weather 

For anyone who is prone to inflammation, there are ways to cope with rainy weather-related symptoms, including:

• Stay inside air-conditioned areas where the humidity level is lower.
• Use a dehumidifier to keep the indoor air at 40-60% relative humidity for comfort.
• Utilize vent fans in the kitchen and in laundry areas and after baths/showers in bathrooms.

Easy Physical Activity

Easing the pain can also be done through:

• At work, school, home adjust the seat to work for you. Individuals with sciatic nerve pain already know how to make adjustments to chairs and other places for sitting.
• If you’re heading out to a baseball or soccer game, you may want to use a comfortable sideline seat that provides cushion and support. If attending a pro game, check online or call to see if you can bring a therapeutic seat cushion.
• Stretch throughout the day and evening
• Try not a hunch over or crouch
• Whether job occupation, house, or yard work use a stool or a pair of kneepads
• Take a regular stand up, move around, and stretch breaks
• Walking will keep the muscles, tendons, and nerves stretched and loose
• Light exercise will help bring down swelling

Traveling

Going on a trip whether road or flight, seats might not be comfortable or supportive. Tips that can help maintain comfort to mitigate the pain, include:

• Adjust the seat for proper posture to maintain spinal curvature
• Use lumbar support
• Maintaining a workout routine is key leading up to your trip. If the body is inactive for a period of time, the back muscles are more likely to spasm when having to sit in tight quarters.
• Don’t overpack. Carrying around heavy luggage increases the risk of straining the muscles.
• Pack pain medication or anti-inflammatories on hand in case of a flare-up.

Inflammation

• Target inflammation with ice therapy
• Using topical heat or a heating pad can get the blood circulation flowing through the area
• Wear compression garments over the affected areas to bring down swelling and promote blood and nerve circulation.

Chiropractic Rainy Day Relief

Chiropractors know the whole musculoskeletal system. Chiropractic massage therapy induces deep muscles relaxation and the release of endorphins/natural painkillers. A regular spa massage can release sore muscles and tension, chiropractic massage focuses on soothing and healing sciatica. Adjustments or spinal manipulations allow the disc/s rest back into position and relieve the pressure on the sciatic nerve. This will lessen the pain and generate nerve signal flow and mobility.

• Spinal decompression relieves the compression of the nerves that are causing sciatica pain. This includes techniques to lengthen the spine and enhance the space between the vertebrae.
• A chiropractor will recommend exercises to prevent nerve aggravation and help release the pressure that comes from the inflamed and tight muscles.
• Exercises include stretching programs that can be done at home to release pressure on the nerve and ease irritations.

Body Composition

About Fat

Fat, also known as adipose tissue, contributes to overall body weight. This is also the type that individuals want to get rid of when talking about weight loss. Two different kinds of fat:

• Subcutaneous fat is the fat that is beneath the skin.
• Visceral fat lies deep in the abdominal cavity and surrounds the organs.
• Having a certain amount of fat tissue is necessary for a healthy body.
• The body stores unused energy from food as fat. This is to provide a reliable source of fuel when the body needs it.
• Fat tissue acts as insulation to keep the body warm and as a cushion to protect the vital organs.
• Fat is an endocrine organ. This means that it releases hormones and regulates blood sugar.
• The problem/issue is excess body fat. This is what leads to higher body weight and altered hormone release that can make the excess weight condition worse.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.

StatPearls [Internet]. (2020) “Anatomy, Sciatic Nerve.” www.ncbi.nlm.nih.gov/books/NBK482431/

Zwart, J A et al. “Warm and cold sensory thresholds in patients with unilateral sciatica: C fibers are more severely affected than A-delta fibers.” Acta neurologica Scandinavica vol. 97,1 (1998): 41-5. doi:10.1111/j.1600-0404.1998.tb00607.x

Zwart, John-Anker, and Trond Sand. “Repeatability of dermatomal warm and cold sensory thresholds in patients with sciatica.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 11,5 (2002): 441-6. doi:10.1007/s005860100333

Pregnancy sciatica is a common condition that is brought on by the added weight that irritates, compresses, and inflames the surrounding nerves of the spine. It can cause pain during walking, sitting, sleeping, etc. Keeping the body and baby healthy is the top priority. There are natural remedies to safely relieve pregnancy sciatica.

True Sciatica

True sciatica is when either the roots of the sciatica nerve or the nerve becomes compressed. This compression is commonly known as a pinched nerve. This can be caused by disc herniation, spinal stenosis, or bone spurs. Sciatica is characterized by pain, tingling, and numbness usually on one side.

• The pain, tingling, numbness runs down the buttock, back of the thigh, and at times down to the foot
• Pain can be constant or it comes and goes depending on the type of movements being performed
• There could be a pulling sensation of the nerve and muscles down the lower back and leg
• There could also be radiating/spreading pain that is felt around the hips

Pregnancy Sciatica Stretches

A highly recommended remedy for the body during pregnancy is to stretch regularly. The stretches listed are for relieving and preventing sciatica and for overall health and wellness. Maintaining a healthy mind and body maintains the baby's health.

Seated Piriformis Stretch

The piriformis muscle can be a significant contributor to the development of pregnancy sciatica. This stretch can help reduce the irritation of the nerve.

Pigeon Pose

This is a yoga pose that is great for stretching the hip flexors and buttocks. This is a stretch that should be eased into when the hips are tight. Do not push/stretch any further than feels comfortable.

Ice/Heat Treatment

The body does become swollen during pregnancy. This can irritate the sciatic nerve in different ways. Heat and ice therapy can reduce the pain/swelling and help the body relax. Whenever the pain presents, use an ice pack, frozen water bottle, or a bag of frozen vegetables. If the pain is in the buttock or leg, apply the ice pack to the low back. The nerve tends to become irritated where it exits the spine in the low back. Hold in place for 15-20 minutes at a time. Although ice usually does the trick, using a heated pad after the ice enables more blood flow to help soothe, relax, and heal the area. It is recommended to wait an hour between ice and heat sessions. Avoid doing either if there is nerve damage or pre-existing conditions that could be affected by the extreme temperatures.

Pregnancy Massage

A professional massage during pregnancy is safe and can bring significant relief. Prenatal massage is different than a regular massage, but the objective and benefits are the same. This includes:

• Pain relief
• Stress relief
• Tension release
• Improved circulation
• Relaxation
• Expedites Healing/Recovery

Inform the massage therapist of the sciatica symptoms and they will target the areas to relieve the pressure on the nerve. Look for a massage therapist that specializes in prenatal massage.

Chiropractor

For an effective, safe, and natural way to relieve pregnancy sciatica chiropractic care is a recommended treatment option. Gentle adjustments of the spine along with hip, pelvis, leg, and feet are done to realign the body, release tight muscles/tendons/nerves and increase blood and nerve circulation. In addition to pain relief, chiropractic can:

• Help with stretches and physical therapy
• Educate on maintaining proper posture during pregnancy
• Educate on maintaining a healthy diet
• Provide postpartum back pain relief

Added Tips

Some small things to add that can help with sciatica pain.

• Sleep on the opposite side when the pain presents
• Use a full-body pillow for support
• Avoid sitting for extended periods. Allowing the body and feet to rest is fine. It is too much sitting that can exacerbate the problem
• Try swimming if possible. This is a good way to exercise while pregnant as it takes the pressure off of the body

Sciatica During the First Trimester

Many women do not experience sciatica symptoms until the third trimester. But it can happen in the first or second trimester. If the pain is severe or is causing sleep problems, it could be time to consult a chiropractor.

Body Composition

Benefits of Strength Training for Women

Healthier bones and joints

Women that do not exercise can lose three to eight percent of their muscle mass as a result of inactivity. Studies show that strength training:

• Increases bone development
• Reduces low back pain
• Reverses skeletal muscle aging factors

Strength training is beneficial for the muscles by helping to reduce joint pain and preventing bone loss.

Reduced anxiety

Lifting weights helps to relieve stress and anxiety. The link between resistance training and stress/anxiety reduction has been shown to be significant. Research shows that resistance training at low-to-moderate intensity is beneficial for reducing anxiety.

Healthy body

Overall resistance training can help individuals feel better about themselves. According to a study, strength/weight training has been associated with significant improvements in body image, positive physical activity behavior, self-satisfaction, and improved quality of life.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

American Academy of Family Physicians. (2018.) “Piriformis syndrome.” familydoctor.org/condition/piriformis-syndrome/

National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.

Westcott, Wayne L. “Resistance training is medicine: effects of strength training on health.” Current sports medicine reports vol. 11,4 (2012): 209-16. doi:10.1249/JSR.0b013e31825dabb8

Trying to get a proper night's rest and healthy sleep with sciatica can be difficult. Here we discuss how to combat sciatica discomfort for a better night’s rest. The sciatic nerves are the two largest nerves in the body. They run from the low back through the:

• Hips
• Buttocks
• Down each leg into the feet

When the nerve gets:

• Irritated
• Inflamed
• Pinched
• Compressed

Sciatica can cause pain, tingling, numbness in the butt, lower back, leg, calf, and foot. It is a common condition that affects many individuals.

Is It Sciatica

Sciatica happens when the nerve becomes pinched from a bulging or herniated disc. In rare cases, the pain can result from a tumor putting pressure on the nerve or damage to the nerve caused by disease. The location and intensity of the pain depend on where the injury or damage occurred and how bad it is. Sciatica pain can be described as:

• Dull
• Sore
• Numbing
• Jolting
• Throbbing
• Hot
• Stabbing
• Radiating

For many sciatica usually resolves within a matter of weeks. However, once sciatica has presented future episodes are almost guaranteed to resurface and if not treated properly can lead to more serious problems.

Symptoms

The sciatic nerve/s can affect several areas of the body, making symptoms vary. The most common include:

• Lower back pain starts at the low back, runs along the hips and buttocks down each leg.
• Pain radiates/spreads down the butt/leg area sometimes described as a shooting pain and usually occurs on just one side.
• Pain while sitting for long periods of time places pressure on the gluteal muscles, lower back, and nerves. This can cause or worsen the condition. When having to sit for a while, it is recommended to get up every hour or so and walk/move around. This gets the blood flowing and stretches out the tightened muscles.
• Hip pain, as the sciatic nerves run through the hip joint and in some cases can cause pain to settle in the hip. Injuries in the hip can mimic the symptoms of sciatica. If there is hip pain that does not improve with time get checked by a doctor to rule out other causes like osteoarthritis, bursitis.
• Numbness, some experience weakness in the legs and an altered sensation of numbness. This is caused by a herniated disc in the lower lumbar region.
• Burning/tingling like a pins and needles sensation, especially in the feet and toes.

Conditions/Causes

There are several conditions that can cause sciatica:

• Degenerative Disc Disease is where the discs of the spine deteriorate and become susceptible to painful herniation.
• Spondylolisthesis is a painful condition where the lower vertebrae slip forward onto the bone directly below impinging the sciatic nerve.
• Muscle Spasms and involuntary contractions of the muscles can cause sciatica if they compress the nerve.
• Pregnancy sciatica is not uncommon. As the baby grows it places pressure on the nerve causing aches and pains.
• Lumbar spinal stenosis is when the spaces in the low back begin to narrow compressing and irritating the nerve.

Risk factors include:

• Age, as the spine gets older it becomes more susceptible to herniated discs and bone spurs, which are leading causes of sciatica.
• Obesity and excess weight create added stress on the spine, which can inflame the nerves.
• Occupation/work that requires standing/sitting for long periods or if a lot of heavy lifting is involved there is added pressure on the back increasing the risk for back problems.
• Individuals with diabetes have an increased risk for nerve damage. When nerves are damaged, they can cause radiating pain.

Night Time

Sleeping at night can be a challenge, especially not being able to get into a comfortable position. Sleep deficits and insufficient sleep can reduce the body’s tolerance to pain and worsen inflammation. Many wake up with increased symptoms.

This is likely due to the fact that when the body is laying down the discs draw in and absorb fluid, which results in increased pressure within the disc, creating more pressure on the nerve. But there are some things to do to lessen pain and get a good night’s sleep. This includes changing sleep position, stretching, and practicing healthy sleep hygiene.

Sleeping Positions

• Sleeping on the back is considered the best sleeping position for sciatica because it eases pressure on the low back and discs where the nerves are located.
• Sleeping on the side can be more comfortable and is a good position because it doesn’t place direct pressure on the muscles, discs, or sciatic nerve. But, it is important that the mattress is supportive enough to keep the spine aligned. If more support is needed place a pillow between the legs.
• Sleeping with the knees elevated can help take the pressure off the low back. To achieve this place a pillow under the knees or, with an adjustable bed, use it to elevate the foot of the bed.
• Sleeping with a body pillow provides extra comfort and helps the body remain in a certain position throughout the night. These pillows come in a variety of shapes, sizes.

Stretches

Stretching can provide relief. It’s important to stretch to keep the body flexible and to prevent pain. Gentle stretches before bed, and after waking up will loosen the muscles and ligaments surrounding the spine and joints.

• Reclining pigeon pose is a yoga pose that opens the hips and eases lower back pain.
• Lying on the back with both knees bent.
• Lift the right leg and place the ankle on the top of the left knee. Hold the stretch for 15 to 30 seconds.
• Repeat with the other leg.

• Sitting pigeon pose stretch is similar to the reclining pigeon but is done while sitting.
• Sitting on the floor with knees bent. Keep balance by placing the hands on the floor.
• While seated, place the right ankle on the top of the left knee.
• Lean forward and move the upper body forward. Hold for 15 to 30 seconds.
• Repeat with the other leg.

• Forward pigeon pose is a more advanced version of the pigeon stretch.
• Start in a plank or push-up position.
• Move the right leg in front so that the right knee is toward the right wrist and the right foot toward the left wrist.
• Stretch the left leg out behind. The top of the foot should be on the ground and toes flat against the floor.
• Shift the weight forward onto the hands or elbows. Feel the stretch in the right glute.
• Repeat steps with other leg.

• The knee to the opposite shoulder is a simple stretch that is easy and pain-relieving.
• Lie on back with legs extended.
• Bend the right leg, grasp the knee and pull it toward the abdomen.
• Straighten the leg and then repeat these steps with the left leg.
• Do three times on each side.

• Sitting spinal stretch can help open the vertebrae to relieve sciatica pain.
• Sit on the floor with the legs extended.
• Bend the right knee so that the foot is next to the inside of the left knee. Keep the right foot flat on the ground.
• Move the left arm around so that the elbow is on the outside of the right knee. Place right hand behind for balance.
• Gently turn toward the right, looking behind. Hold the position for 15 to 30 seconds.
• Repeat with the other leg.

• Standing hamstring stretch can ease pain in the hamstrings.
• Stand and place one heel on an elevated surface, like a chair.
• Fully extend the knee and flex the ankle by pointing the toes toward the ceiling.
• Bend forward at the hips keeping the spine in a neutral position. Hold for 15 to 30 seconds.
• Repeat with the other leg.

Sleep Hygiene

Proper sleep hygiene helps prepare for a good night’s sleep. Here are some tips to help improve sleep hygiene.

• A nighttime routine will help unwind the body before bedtime. Start the routine 30 minutes before planning to go to sleep. Some things to do to help unwind:
• Take a warm bath
• Listen to relaxing/soothing music
• Meditation
• Reading

• Get a new mattress. An old, sagging mattress can worsen sciatica and strain the back. The best mattresses for sciatica pain combines contour comfort to ease pressure points at the hips and shoulders with the proper support to keep the spine aligned.

• Eye masks can help with artificial light which can fool the mind along with the circadian clock into thinking it’s daylight. Keeping out unwanted light all night can help.

• Avoid blue light too close to bedtime, like lamps and device screens. These are great for the day, as they help boost attention, reaction time, and mood. But at night it can be disruptive. Turn off electronics at least 30 minutes before bed to help the body adjust.

• Room temperature control has found that most sleep better in a cool room. The optimal temperature is between 60 and 67 degrees.

• Avoid exercise close to bedtime. Working out before bed can interfere with sleep. This is because exercise releases adrenaline keeping the mind and body alert.

• Avoid stimulants before bedtime like caffeine, sugar, etc. which will keep the body up.

Medical Intervention

Sciatica pain can be mild or severe. Stretching or changing up sleeping position can help ease discomfort. But if the pain is severe or chronic, and if it prevents getting a good night’s sleep, consult chiropractic professional.

InBody Spotlight

Sleep And Body Composition

A lack of sleep makes it harder to gain muscle and harder to lose fat.

• Sleeping less means fewer opportunities to secrete growth hormone and develop muscle
• Testosterone is negatively affected by lack of sleep
• Sleeping less can increase cortisol levels, impairing muscle development

• Irregular sleep throws off the body's cycles, making the body feel hungrier
• Sleeping less is linked to eating more snacks, increasing energy levels
• Lack of sleep can cause reductions in Basal Metabolic Rate by 20%, reducing total energy output
• Being tired reduces spontaneous movements, reducing total energy output

If trying to get into shape and change body composition, sufficient sleep is vital. Any positive changes to get more sleep is going to have positive changes in efforts to change body composition.

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References 

Siengsukon, Catherine F et al. “Sleep Health Promotion: Practical Information for Physical Therapists.” Physical therapy vol. 97,8 (2017): 826-836. doi:10.1093/ptj/pzx057

Weakness, pain, and numbness can find their root in the spine. It is known as radiculopathy. If left untreated, health problems will only continue to get worse, with the potential to become a chronic condition. When it comes to degenerative pain conditions they usually start small. There is occasional discomfort that gradually develops into pain, then weakness and numbness.

Usually, by the time an individual seeks help, the original condition has devolved into radiating pain. This is why it is important to address the issue right away. Chiropractic works with individuals to help them understand the degenerative nature of pain and how to address and prevent it. Early intervention will prevent minor discomfort from turning into debilitating, chronic pain.

Radiculopathy

Radiating pain root cause is a compressed or inflamed nerve. It happens at the site of compression and spreads outward growing larger with time. It can be a catalyst for different pain conditions and syndromes like sciatica or complex regional pain syndrome. There are a variety of terms for nerve pain, they are typically a form of radiculopathy.

Stages

The pain can spiral as fast as the underlying condition/s that is causing it. A compressed nerve that generates pain but does not become worse in severity is usually because the compression stays the same. Conversely, minimal discomfort brought on from shifted vertebrae can rapidly progress into weakness, numbness, and reduced mobility as a nerve is continually and severely getting compressed. Radiculopathy pain usually follows a pattern. Understanding the signs and symptoms will help determine to what extent the condition has progressed, and how it can develop into a worsening nerve injury:

• Discomfort is the first stage. Subluxation, rotation, or a spinal shift is what is occurring, with the nerve not yet affected.
• The pain signals that come from nerve compression along with the severity can help determine the cause of the condition.
• Weakness usually follows pain. The nerve that is affected begins to take on permanent damage and cannot function properly.
• Numbness follows the weakness reaching the most severe level. Mobility is limited along with a high increase for permanent nerve pain.

Being aware of these radiculopathy symptoms will help an individual stay ahead of nerve injury. Acting on discomfort can prevent progression into pain, addressing pain can stave off weakness, and acting upon weakness may prevent permanent nerve damage. The sooner an individual seeks help for any type of pain, the better chance they have to prevent degeneration.

Long-Term Prevention

It is crucial to consult with a chiropractor at the first sign of discomfort in the spine or if there is radiating/spreading back pain. A chiropractor will be able to provide decisive treatment that will bring relief and prevent the pain from worsening. The pain, weakness, and numbness can be avoided, along with long-term damage to the nerves.

Advanced Chiropractic Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Stochkendahl, Mette Jensen et al. “National Clinical Guidelines for non-surgical treatment of patients with recent-onset low back pain or lumbar radiculopathy.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 27,1 (2018): 60-75. doi:10.1007/s00586-017-5099-2

Low back and mid-back pain could be caused by abdominal or pelvic organ distress/irritation or infection that an individual doesn't know about. This could be a viscerosomatic reflex. This can be the case when there is no back injury, muscle strain, or sprain that would coincide with back aching and soreness. Identifying the symptoms and diagnosing the underlying cause is the first step in getting ultimate pain relief.

The Organs

Inflammation and other issues with any internal organs in the central, abdominal, or pelvic region can produce low back pain. These include the following:

• Heart
• Lungs
• Stomach
• Intestines
• Liver
• Gallbladder

Viscerosomatic reflex pain can also be felt in a completely different body part than where the organ is located. This can cause an individual to think something is wrong in that body region when there is not.

Kidneys

• The kidneys help remove liquid waste from the body.
• Urine that contains more chemical substances than what can be diluted can cause kidney stones to form and sharp pain in the side and the lower back.
• Kidney stones can also cause difficulty urinating and blood to show up in the urine.
• A kidney infection can result in mid-low back pain and fever.

Pancreas

• The pancreas plays a vital role in digestion and blood sugar regulation.
• Pancreatitis is inflammation that can cause severe and disabling pain that starts in the upper abdomen and radiates to the low back.

Appendix

• The appendix is located in the lower-right abdomen.
• Its function is to store healthy, beneficial bacteria.
• It can become inflamed, causing severe pain in the lower abdomen and spreading to the lower back.
• If it bursts, the leak can cause toxic effects on the body, which is why an inflamed appendix needs to be surgically removed.

Large Intestine

• Inflammation of the large intestine/colon and/or ulcerative colitis can also cause:
• Low back pain.
• Abdominal cramps
• Rectal pain.

Visceral Pain

Visceral pain is different as it can be harder to pinpoint a source and feels like a dull aching or tightening pressure.‌ The pain originates in the organs of the respiratory system, stomach, or pelvis that is often described as a dull ache but is also described as:

• Colic
• Gnawing
• Twisting

Visceral pain has distinguishing characteristics:

• The pain originates in the middle of the body but can be felt in other areas.
• The pain can be scattered, and difficult to locate a definitive source.
• The affected area or other body regions can become sensitive.
• It can accompany other symptoms like nausea, vomiting, sweating, or heart palpitations.
• Psychological symptoms like depression can begin to present.

Chiropractic Care

Chiropractic focuses on healing the musculoskeletal system of aches and pain, muscle stiffness, and/or chronic conditions that complement traditional medical care. Adjustments can correct the body's alignment and how the body physically functions. A chiropractor will use manual or mechanical decompression techniques to realign the spine. This will release the muscle, tendon, ligament, and nerve tension, bringing pain relief, and improving nervous system function, and viscerosomatic reflex. Treatments include:

Adjustments

• Will gently realign the joints to decrease pain and increase range of motion.

Soft-tissue therapy

• Will relax tight muscles, relieve spasms, and release tension in the surrounding connective tissues.

Exercises and stretches

• Will restore and maintain joint stability and mobility.

Joint bracing and Kinesio taping

• Will support sprained joints or muscles as the healing process continues.

Integrative medicine expert referrals

• Experts will guide individuals on diet and nutrition to reduce inflammation and promote healthy eating for overall health.

DRX9000 Low Back Pain, Sciatica, Herniated Disc

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bath M, Owens J. Physiology, Viscerosomatic Reflexes. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559218/

Beal, M C. "Viscerosomatic reflexes: a review." The Journal of the American Osteopathic Association vol. 85,12 (1985): 786-801.

Lefebvre R, Peterson D, Haas M. Evidence-Based Practice and Chiropractic Care. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/) J Evid Based Complementary Altern Med. 2012;18(1):75-79. Accessed 4/25/2022.

Sikandar, Shafaq, and Anthony H Dickenson. "Visceral pain: the ins and outs, the ups and downs." Current opinion in supportive and palliative care vol. 6,1 (2012): 17-26. doi:10.1097/SPC.0b013e32834f6ec9

Zhou, QiQi, and G Nicholas Verne. "New insights into visceral hypersensitivity--clinical implications in IBS." Nature reviews. Gastroenterology & hepatology vol. 8,6 (2011): 349-55. doi:10.1038/nrgastro.2011.83

 Dr. Alex Jimenez and Dr. Mario Ruja discuss what sciatica does to the body and how it affects a person’s overall health and wellness.

Chiropractors and Sciatica Syndrome Expose

The sciatic nerve is the largest in the body and is created by five nerve roots that come together and exit the lower spine. It goes through the buttocks on either side and down the thighs all the way to the heels and soles of the feet. The sciatic nerve connects the spinal cord to the muscles of the thigh, leg, and foot. Any type of pain and/or neurological symptom/s that comes from the sciatic nerve is known as sciatica. The symptoms can be felt along the nerve's path. This could be the:

• Low back
• Buttocks
• Thighs
• Calves
• Feet
• Or it could be a combination of all the areas

Neurological Symptoms

When the nerve is compressed,  neurological symptoms can accompany the pain. These include:

Thigh muscle weakness

If the thigh muscles are affected, weakness can be felt when bending or flexing the knee.

Leg and foot muscle weakness

Weakness can be felt while attempting to bend the knee or pointing the foot/toes upward/downward. This can lead to foot drop, which makes lifting the front part of the foot when walking difficult. Difficulty can also present when getting up from a sitting position or walking on the tiptoes.

Numbness

Loss of sensation can happen when the nerve impulses/transmissions cannot pass all the way through. Common areas affected by numbness are the:

• Side of the calf
• Side of the heel
• Bottom of the foot
• Top of the foot

Paresthesia

This is an abnormal sensation felt on the skin. It is brought on by improper nerve transmission. This sensation can include:

• Tingling
• Tightness
• Pins-and-needles
• Crawling feeling along the back of the thigh and/or leg

The Sciatic Nerve Gets Affected

The sciatic nerve can become:

• Irritated
• Compressed
• Inflamed
• This lumbar/low back radiculopathy means that the pain originates in and around the lumbar and/or sacral/sacrum nerve roots.

Compression

Physical forces could affect the nerve following common conditions:

Disc Herniation

A disc in the lower back can bulge or herniate. This causes irritation that can lead to compression of a nerve root.

Stenosis

Stenosis means the opening where the sciatic nerve exit into the buttocks begins to get narrow in size. This creates a clog with the other nerve roots that compresses or irritates the sciatic nerve. Degenerative changes in the spine like the thickening of the facet joint capsules and/or ligaments can also compress the sciatic nerve.

Instability

Instability of a vertebral segment happens when one vertebra slips over the one below it, known as spondylolisthesis. There are also vertebral defects like spondylolysis which is a complete dislocation of one or more vertebrae. This can directly compress the sciatic nerve roots.

Inflammatory Response

The body's own chemicals can irritate the nerve causing inflammation. These chemical irritants include:

• Hyaluronic acid
• Fibronectin protein fragments leak out of degenerated or herniated discs onto and around the sciatic nerve roots.
• There are times when degenerated discs can cause nerve tissues to grow into a disc. The tissue penetrates the outer and inner layers of the disc, causing inflammation and pain.
• Some studies have shown how an immune system response can contribute to sciatic pain when there is exposure to the disc material from herniated disc/s.

Glycosphingolipids which are fats, and neurofilaments which are protein polymers. They are secreted by the immune system and have been found to have high levels in individuals with sciatica. It is believed they are released in reaction to the nerve roots and exposed disc material. This can lead to inflammation of the sciatic nerve.

Body Composition

The physical characteristics of an individual can also affect the sciatic nerve. Research has shown an increased risk of sciatica in:

• Overweight individuals
• Obese individuals
• Older individuals
• Tall individuals 

Work Injuries

Individuals with certain jobs can have an increased risk of developing sciatica. Examples include:

• Semi-Truck operators
• Machine operators
• Construction workers
• Hairstylists
• Office workers
• Athletes that lift weights

This comes from:

• Sitting for long amounts of time
• Poor posture
• Constant bending forward or sideways
• Regularly lifting the arms above shoulder level
• All are risk factors.

Vitamin B12 deficiency

Adequate levels of vitamin B12 are important for nerve health. Vitamin B12 supports the myelin sheath that covers and protects the nerves. It is important in nerve function and in transmitting impulses. Sciatica can present from vitamin B12 deficiency. However, this is more common in individuals 60+.

Body Analysis

Alleviating Nerve Pain Through Clinical Nutrition

Clinical nutrition is a powerful tool to help alleviate sciatica. Many individuals can relieve their pain through diet adjustments. Here are a few diet tips to alleviate sciatic nerve pain through clinical nutrition:

• Sometimes, sciatica can be triggered by constipation from an unhealthy diet
• Incorporate fiber-rich foods
• Fruits and vegetables will prevent constipation
• Oily fish like salmon and halibut are rich in omega 3 fatty acids
• Fresh pineapples and berries are anti-inflammatories that support healing and boost the immune system
• 2-3 cups of green tea
• Add turmeric, ginger, and garlic to meals
• B-Vitamins are important to take in when going through sciatica and are found in green peas, spinach, navy beans, nuts, bananas
• Foods that are rich in A-Vitamins like dairy products, dark leafy vegetables, orange-colored fruits, eggs, and oily fish
• Foods rich in C-Vitamins, like citrus and tomatoes
• K-Vitamins like  broccoli and spinach
• Drink plenty of water, between 6 to 8 glasses a day

Foods to Avoid

• Nutritionists recommend cutting out meat products except for oily fish for the first two weeks.
• Foods that contain sunflower oil, corn oil, sesame oil, margarine, and partially hydrogenated oil.
• Stressor foods like caffeine, processed food, soda, refined sugars, and chocolate.
• Alcohol

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/.

Heuch I, Heuch I, Hagen K, Zwart JA. Association between body height and chronic low back pain: a follow-up in the Nord-Trøndelag Health Study [published correction appears in BMJ Open. 2015;5(10):e006983]. BMJ Open. 2015;5(6):e006983. Published 2015 Jun 15. doi:10.1136/bmjopen-2014-006983.

Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Quero L, Klawitter M, Schmaus A, et al. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signaling pathways. Arthritis Res Ther. 2013;15(4): R94. Published 2013 Aug 22. doi:10.1186/ar4274.

Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a Risk Factor for Sciatica: A Meta-Analysis. American Journal of Epidemiology. 2014;179(8):929-937. doi:10.1093/aje/kwu007.

Determining if sciatica pain and symptoms are showing improvement can be as simple as the pain significantly reducing or it could be a bit more complex, depending on the severity of the condition. Chiropractic treatment keeps track of the location and movement of the pain as a reliable indicator that complete relief is getting closer. When the pain retreats up the leg, it is a sign of improvement even with back and buttock aches/pain that feel like it's worsening.

Various Symptoms

The most common symptoms include:

• Tingling
• Numbness
• Sharp pain
• Dull pain
• Radiating/spreading pain
• A feeling like insects crawling or water trickling down the leg
• Changing sensations in the buttock, back, leg, or foot

Does It Get Worse Before Getting Better?

Sciatica can get worse before it gets better. This is known as centralization where the pain moves or retreats back towards the midline of the spine after repeated movements or guided/chiropractic positioning and adjusting. It can be misleading, making the individual think the sciatica is worsening, or that something has caused a sciatica flare-up. However, healing is taking place. The furthest location away from the low back is the area to pay attention to. It's different for individuals. It could be the:

• Foot
• Calf
• Back of the thigh

No matter where the pain is pay attention to that particular area. If it feels like the sciatica is getting worse, take a moment to determine where the pain is presenting. If the pain has retreated and there is no pain in the foot, calf, or leg, the sciatica is getting better. What happens is the retreating pain going up the spine increases the pain in the back and buttocks. This means there is an improvement.

Sciatica Getting Worse

How to tell if it’s getting worse? An increase in pain could indicate that it is getting worse. But, the key is to pay attention to the location and movement of the pain. When it gets worse the pain is advancing, for example, if there was pain only in the back and buttock yesterday, and today the pain is radiating down the back of the leg into the calf, then the sciatica is getting worse.

Length of Time Sciatic Nerve Pain Lasts

For most individuals, sciatic nerve pain lasts from two to six weeks.

• The acute pain lasts around 1 to 2 weeks, with lingering discomfort as the condition heals
• There are factors that can cause sciatica to remain longer, or increase the chances of returning This includes:
• Tight hamstrings
• Weight gain
• Pregnancy
• Poor posture
• Improper lifting

Sciatica that lasts more than six weeks is considered chronic. Medical intervention should be sought out if it lasts this long. Non-invasive treatment like chiropractic or physical therapy is recommended to help speed the healing process and reduce pain.

Permanent Cure

Most sciatica cases are caused by a spinal disc disorder in the lower back. Around 85% of sciatica cases are disc-related. There is a chance that sciatica can return. For most individuals, it only takes a small amount of work to keep sciatica at bay. Staying healthy and flexible are two ways to prevent sciatica from returning. This can be done through:

• Healthy diet
• Maintain a healthy weight
• Staying active with 2 ½ hours of physical activity/exercise a week
• Maintain proper posture
• Regular stretching
• Quitting smoking

If overweight it is highly recommended to lose weight. One study showed that obesity increased the risk of hospitalization by 36%. Other factors that increase the potential for sciatica are frequent intense physical activity levels in sports, exercise, DIY projects, etc.

Chiropractic

Whether dealing with sciatica during pregnancy, from tight hamstrings, or piriformis syndrome, chiropractic can help. A chiropractor can bring relief through:

• Ice therapy to reduce swelling
• Heat therapy to increase blood circulation
• Ultrasound
• Transcutaneous electrical nerve stimulation
• Massage

Once the pain is manageable, the chiropractor will get to the root cause. They will utilize:

• Spinal manipulation to relieve pressure
• Soft tissue therapy
• Stretches to release tight muscles
• Strengthening exercises
• Physical therapy
• Nutrition/health coaching
• Lifestyle adjustments

Surgery is rarely needed and only as a last resort. Chiropractic is well-suited to educate the individual on what to do to prevent sciatica from flaring up.

Body Composition

Essential Fat vs Storage Fat

There is essential fat in the body. It has a significant role in overall health and is essential for survival. Essential fat is present in the:

• Organs
• Bone marrow
• Nerve cells
• Brain

Essential fat helps with:

• Maintaining sufficient energy reserves that function as a metabolic fuel
• Conserves body heat and functions as an insulator
• Protects the internal organs and joints acting as a soft cushion
• Reproduction as adipose tissue/fat cells and fertility are linked

Non-essential/storage fat is adipose tissue that accumulates as an energy reserve. Storage fat affects body shape and appearance.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.

North American Spine Society. (2012.) “Clinical Guidelines for Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy.” www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LumbarDiscHerniation.pdf

StatPearls [Internet]. (2020) “Anatomy, Sciatic Nerve.” www.ncbi.nlm.nih.gov/books/NBK482431/

StatPearls [Internet]. (2020) “Sciatica.” www.ncbi.nlm.nih.gov/books/NBK507908/

Chronic inflammation is quite common and can cause a variety of painful back conditions. Fortunately, chiropractic treatment can extinguish the inflammation at its core/root cause and bring long-lasting relief. Inflammation can be a significant factor in causing body and back pain. The proper and lasting treatment goes beyond anti-inflammatory medications. The objective is to extinguish the inflammation completely.

Inflammation

The number of diseases associated with chronic inflammation is increasing exponentially. An estimated 60% of Americans deal with at least one chronic condition caused completely or in part by inflammation. Inflammation is the body's immune response to something that is not right in the body. Typically, there is:

• Swelling
• Redness
• Warmth/heat signaling an inflammatory response from injury or infection

Chronic inflammation can present through a series of symptoms, including:

• General fatigue
• Pain throughout the body
• Off feeling/not focused

Inflammatory conditions can include:

• Skin changes like a rash
• Joint swelling
• Lymph node swelling
• Endocrine, heart, lung, and neurological complications

Inflammation can generate inflammatory back pain as well when this happens. This is because the immune system is trying to protect the body from whatever is trying to infiltrate. The cells and chemicals fight the attack and try to heal whatever is going on. Sometimes, there is nothing going on but the immune system becomes hyper-reactive and attacks itself. This is the case of autoimmune disease, or what becomes chronic inflammation. Chronic inflammation lasts longer than 3 months and can lead to diseases like:

• Diabetes
• Heart disease
• Autoimmune inflammation can manifest in rheumatological disorders like rheumatoid arthritis

Inflammation and Inflammatory Conditions

Autoimmune inflammation that presents as ankylosing spondylitis and rheumatoid arthritis is in a different category. This is when the body begins attacking itself. This can be triggered by a viral infection, which stimulates the immune system. This can cause:

• Joint destruction
• Ligament pain
• Soft tissue swelling
• Some conditions are hereditary

Inflammatory Spinal Conditions

Inflammation can travel into the body’s spinal and neurological systems. This results in painful conditions that can affect an individual's quality of life.

Ankylosing Spondylitis

Ankylosing spondylitis usually starts in the lower back and can spread up. It is a form of arthritis that causes the vertebrae to fuse together. It can also cause inflammation in the urological and ophthalmological systems. It is believed to have a somewhat genetic connection. There is a marker called HLA B27 that is usually positive in patients and is more common in young males.

Rheumatoid Arthritis

Rheumatoid arthritis/RA causes inflammation in synovial joints. These produce a fluid that helps lubricate and nourish the joints. RA is found most commonly in the hands, wrists, and knees, but can also present in the spine’s facet joints that connect vertebrae. There is some genetic association but is common with smoking and obesity. It is diagnosed with lab work, like inflammation markers, rheumatoid factor, and physical examination. RA pain typically presents in the cervical spine or neck region.

Transverse Myelitis and Multiple Sclerosis

These conditions are closely tied and caused by inflammation in the central nervous system/CNS. The immune system attacks the nerve cells and removes the fatty substance that insulates the nerves and helps them transmit impulses to and from the central nervous system. This causes:

• Pain
• Weakness
• Numbness
• Bladder/bowel issues

Transverse myelitis affects the spinal cord whereas multiple sclerosis can affect the brain and the spinal cord. Transverse myelitis is typically acute, whereas multiple sclerosis is long-term and can have an increasing/decreasing course of progressive symptoms. And transverse myelitis can be a symptom of multiple sclerosis. Certain lifestyle choices/habits can cause or worsen inflammation. Obesity, smoking, and an unhealthy diet can have a significant impact on chronic inflammation.

Spinal Structures Affected

Inflammation can affect every area of the spine. From the lower back to inflammation of the vertebrae themselves. Injuries to the spine, that include the:

• Bones
• Discs
• Ligaments
• Joints

This can cause swelling and a build-up of fluid that can be found on an MRI. This is the preferred method of detecting inflammation. When the term itis is used this usually indicates a type of inflammation. For example, neuritis means inflammation of the nerve/s. This can be seen with nerve compression where the nerve is swollen on an MRI.

Extinguish Spinal Inflammation

Causes of inflammation can be traced back to lifestyle choices, but can also be alleviated through healthy lifestyle adjustments that turn into habits.

Nutritional Health Coaching

Recommended is to avoid or decrease processed foods, trans fats, and sugar. Consider supplementing vitamin D, magnesium, and omega 3s.

Quit Smoking

Quitting smoking will improve circulation and extinguish vascular inflammation.

Regular Physical Activity/Exercise

Aerobic exercises improve cardiac function and circulation as well as exercises that support the spine ergonomically. Core and pelvic stabilization are necessary for lower back pain.

Medication

For acute inflammation caused by injuries steroids and NSAIDs can help with severe pain and inflammation.

Chiropractic Extinguisher

When the spine and the body's joints are in proper alignment, and the nerves are functioning at optimal levels the body's biomechanics return to normal. This stops neuropeptides from producing and helps extinguish inflammation.

Surgery

With the spine, surgery is not recommended as a first-line treatment unless it is an emergency or there is potential for permanent neurological damage. If medication, chiropractic, physical therapy, supplements, lifestyle changes, and/or complementary treatments like acupuncture do not help and quality of life and function are significantly impacted, then elective surgery can be considered.

Body Composition Spotlight

All-around Exercise Regimen

As individuals continue to struggle with obesity and functional fitness with age, exercise becomes more important than ever. It is crucial to combine diet and regular physical activity/exercise to lose weight, have a favorable impact on body composition and lifespan. A well-rounded exercise regimen that incorporates all types of fitness. Aerobic exercise helps maintain an elevated heart rate and helps get rid of fat-free mass.

Resistance training helps to build lean muscle mass. Combining the two, with concurrent training, or utilizing a HIIT workout when there is not enough time will work wonders. Being better equipped and understanding why exercise is important for the body's health, different types of exercise, and which ones are best suited for each individual's needs will keep the body in top form for the long term.

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico 

References

What Is Inflammation?: StatPearls. (November 2020) “Chronic Inflammation” https://www.ncbi.nlm.nih.gov/books/NBK493173/

Types of Inflammatory Spinal Conditions: Current Opinion in Rheumatology. (January 2014) “When and Where Does Inflammation Begin in Rheumatoid Arthritis?” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033623/