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Let's Talk... Low Back Pain and Sciatica

Every low back pain is NOT Sciatica!!! 

Why is it that every time someone has pain in the low back or down the leg is it immediately assumed “It’s Sciatica”?  Let me dispel the myth right now.  There are LOTS of reasons why you can have pain in the Low Back and down the leg that are not sciatica. 

So, what is TRUE Sciatica? 

True Sciatica is a compression of one of the nerves that comes from the lower back that is part of the nerve bundle called the sciatic nerve.  This compression of the nerve can happen with disc herniation, disc bulging, excessive inflammation, or narrowing of the space where the nerve exits the spine. 

True Sciatica is recognized by symptoms of severe low back pain with very sharp shooting pain that travels down the leg.  This shooting pain can:

1. Wrap around the hip and go into the groin 

2. Travel down the back side of the leg or

3. Travel down the outside of the leg and into the foot. 

This pain is usually so severe that you can barely walk or not walk at all. 

Pseudo Sciatica is a compression or irritation of the Sciatic nerve bundle as it travels through the pelvis.  It can be compressed or irritated by the structures in the pelvis.  Often the piriformis muscle is involved in Pseudo Sciatica.  There is argument as to whether the piriformis muscle is too tight or too weak.  I personally believe it is a little bit of both. I find that if you stretch the piriformis too much without strengthening your efforts are in vain.  I have also found that most cases of Pseudo Sciatica involve high levels of inflammation in the SI (sacroiliac joint) and in the muscles of the pelvis, including hip rotators. 

Pseudo Sciatica has similar symptoms as true sciatica but tends to be less severe and debilitating. 

Treatment for both True and Pseudo Sciatica are similar but with some major differences.  Here at Live Well we focus on reducing the inflammation in the lumbar spine and the pelvis with laser therapy first.  Laser Therapy, also called photo-biomodulation, works to decrease the inflammation and repair the tissue via tissue regeneration.  Laser therapy is a stimulatory technique that is curative and thus long lasting.  However, laser therapy is only part of the equation.  Next, we need to focus on releasing the muscles and improving their function.  That usually means manual therapy with either me or Meagan Wall our new Athletic Therapist.  Once the muscles are released and function is improved, we work on strengthening to prevent recurrence. 

If you believe you have some form of sciatica, give us a call at 613-308-9450 and we will take care of the rest.  

As always have a great week and Live Well. 


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