The sciatic nerve is the largest single nerve in the body and is made up of individual nerve roots that start by branching out from the spine in the lower back and then combine to form the “sciatic nerve.”
- Lower back pain
- Pain in the rear or leg that is worse when sitting
- Hip pain
- Burning or tingling down the leg
- Weakness, numbness, or difficulty moving the leg or foot
- A constant pain on one side of the rear
- A shooting pain that makes it difficult to stand up
- Disc bulges/herniation
- Tight muscles in the gluteus
- Piriformis syndrome
- Nerve irritation or impingement
- Spinal stenosis
A 48 year old male presented to our office with complaints of lower back and right leg pain with associated right leg numbness and tingling. He stated that he recently started a new job, which required him to lift objects repetitively. The pain was mild upon waking but progressively worsened throughout the day, at times forcing him to stop and ice his back. He had no history of a similar condition with the exception of mild occasional backache and stiffness.
Examination revealed significant tightening of the muscles of the lower back. His lower back ranges of motion were only mildly restricted. However, he stated that with repetition, the pain would increase. His muscles were strong and his reflexes were normal indicating no significant nerve damage had yet been done. Spinal motion dysfunction was noted with joint assessment and orthopedic testing indicated that a disc was pressing on his spinal nerve. X-rays revealed a loss of the normal curvature in the lower back and moderate disc deterioration at the L4 disc level.
Our findings indicated that this gentleman’s condition did not truly begin within the past 2 months, but had been present for much longer. His body had found ways to compensate for the problem leaving him unaware of its existence. However, the increased physical demands of the new job pushed his body past its ability to compensate, revealing the underlying issue. As more stresses and strains were placed on the already weakened disc, it began to break down in a predictable pattern. This cased it to bulge in the direction of the spinal nerve.
Our team quickly designed a plan for the gentleman to get back to health. The first issue was to reduce the bulging disc and keep it reduced until healing could take place. This was accomplished with spinal adjustments, muscle release techniques, instructions involving his normal daily activities, work modifications, and specific and controlled therapeutic exercise. Symptoms diminished over the period of a couple of weeks and the patient progressed to more active care involving comprehensive spinal rehabilitation. Recovery was full within 2 months. Although he was able to return to full activity, it was recommended that permanent modification be made to his job duties to prevent reinjury.