Through the last 15 plus years, many patients have come through my program for the treatment of sciatica or “leg pain”. Sciatica is the most common form of “radiculopathy” (nerve pain) in the legs.
Still yet, many people don’t know what causes this life altering painful condition. In this article, I’m going to discuss different symptoms and causes of sciatic pain and also possible treatment options.
What are Symptoms of Sciatica?
Sciatic pain can be excruciating. Often people will feel a tightness into their buttocks or into the back of their legs. The difficult part of sciatica is that it can be one buttock and leg or both. It depends on where the pressure is applied to the nerve.
Some sciatica sufferers will have pain in their calves and others will have severe muscle cramps in their legs. Often, patients will complain of a particular pattern of pain that can involve the big toe or their pinky toe. Others will have numbness on the top or bottom of their feet.
By now it should be easy to determine that “sciatica” can show up in many different ways and patterns of pain. No one person is the same as the ones who came before them or those that will come after.
Every person is unique and will have different pain symptoms. The problem with sciatica or leg pain and radiculopathy is that it is a sign that there is most likely pressure on a nerve causing the nerve to malfunction.
Can Sciatica cause Nerve Damage?
In the earlier stages of nerve pressure, the nerve can send rogue pain signals in various forms and ruin someone’s life for a period of time. Where it becomes more serious is when the nerve starts to experience nerve damage from prolonged pressure and begin to malfunction.
When a nerve starts to die and become permanently damaged, it can start going “numb” or people can experience muscle atrophy. Muscle atrophy is when the muscles shrink up and get smaller because the nerve died that went to the muscle.
A common sign of permanent nerve damage caused by a pinched nerve in the low back is a condition called “foot drop”. I always explain to foot drop patients who have had foot drop for more than 6 months that the nerve is most likely completely dead.
Our treatment goals change when there is permanent nerve damage. At that point, the function of the leg and foot is gone forever. However, my treatments can still usually help relieve the intense pain, tingling, burning, or numbness that the foot drop patient will feel.
The warning signs are usually there before someone experiences nerve death and atrophy but are often ignored. People may think that the pain will just go away on its own and that they will get better someday.
What Causes Sciatica?
The reality of life is that we are all aging. The older you get, the more your joints will dry up. The joints actually dehydrate. The cushion in the joints lose water and so the bones get closer together and can grind.
Some people will have more than others but we all get joint dehydration and tissue breakdown in some form or another if we live long enough.
In the body in general, when joints break down, they get inflamed. When the joints get inflamed, calcium deposits form as a response to the chronic inflammation. It is part of the natural healing process but leaves behind arthritis.
Arthritis associated with aging is called “osteoarthritis”. Osteoarthritis in the spine is called “Degenerative Disc Disease”. It’s the same thing by a different name. Both names though refer to arthritis left behind by chronic inflammation, trauma, and wear and tear.
Can a Herniated or Bulging Disc cause Sciatica?
In the spine, the cushion between the bones are called the discs. The discs have a jelly filled center called the nucleus pulposus. Circling around the nucleus pulposus are rings called the “annular fibers”. The annular fibers look like the age rings on a tree stump.
With time, age, and trauma, the disc can dry up. The rings can become brittle and tear. When the rings tear, the disc can develop a “bulge”, “herniation”, or “a slipped disc”. A disc bulge can cause just as much pain as a herniated disc.
The basic differences between a bulging disc and a herniated disc is that with a herniated disc, all of the rings have torn. With a bulge, some of the inner rings usually tear but the disc doesn’t completely rupture.
The spinal nerves travel through a canal as they leave the spine. When a disc is bulging or herniated, it can put tremendous pressure on the nerve and cause severe leg pain and sciatica.
Often, people with sciatica will resort to physical therapy, spinal injections, yoga, burning of the nerves, stretching, chiropractic spinal manipulation, massage, fish oil and other forms of natural healthcare. While all of these methods can help some people, they are often a temporary reliever.
Can Stretching Help Relieve Sciatica or Piriformis Syndrome?
Gentle stretching can give some people relief but no amount of stretching is going to put fluid back into a worn out joint or disc space and free up a choked or pinched nerve. The muscles get their nerve supply from the nerves that come out of the spine.
If you have a pinched sciatic nerve caused by decreased disc space, stretching may help the muscles relax but only on a temporary basis. An example would be the “piriformis muscle”.
The piriformis muscle is in the buttock area. The sciatic nerve runs right under the piriformis muscle and it is common for people to have “piriformis syndrome” when they have sciatica.
Stretching the piriformis muscle can often give temporary pain relief. However, when the nerve is pinched, it is inflamed and oxygen deprived. Therefore, it is an unhappy nerve.
In working with thousands of disc pain and sciatica patients, I recognize that even though many patients will have pain in the piriformis muscle area, the piriformis itself isn’t the problem. The real problem is the pinched nerve coming out of the low back that is inflamed and ready to strike like a snake in the grass.
Can Massage Therapy Help Relieve Sciatica?
Massage has many health benefits. It’s good for promoting healthy lymphatic flow and sure feels good. However, if you have a pinched or choked nerve that is going to your muscles, you can get all of the massages you want but your nerve is still choked and pinched.
Don’t get me wrong. I’m pro massage therapy. It helps relax the body and can cause a release of endorphins and help the body heal faster. It can break up adhesions and scar tissue. The benefits are too many to mention here but for most people who have sciatica, it isn’t a long-term fix.
Can Spinal Steroid Injections Help Sciatica?
One of the common side effects of spinal injections is that they are damaging to soft tissues in the body. Let me repeat: Corticosteroid injections used to relieve nerve pain can cause damage to soft tissues.
The disc material is soft tissue. So are the bones. That is why the annual dosage is 3 injections per year. The limitation placed on the number of injections someone can have in a calendar year is done in attempt to limit soft tissue damage.
Through the years, I have had multiple patients begin my program because their doctors told them they couldn’t have any more injections due to the damage that it was causing to the skeleton and bones. One of the possible side effects of injections is osteoporosis.
Can Having My Nerves Burned Relieve Sciatica?
What patients report to me is that RadioFrequency Nerve Root Ablation gives temporary relief. The real issue is that the pain usually returns within a year and then they have to go back and repeat the procedure.
I have worked with many patients who have had radiofrequency ablation (had their nerves burned) and they have all told me that the pain would come back after 6 months to a year. Additionally, burning leaves behind scar tissue.
I have read MRI reports that showed encapsulation granulation tissue surrounding the nerve root after ablation procedures. Basically, encapsulation granulation tissue is scar tissue. Several reports actually said that “a sleeve of encapsulation granulation tissue surrounded the nerve root”.
Scar tissue hardens over time. So, if someone has a sleeve of scar tissue surrounding their nerve, it can get hard and then the scar tissue becomes part of the overall problem. It can be a domino effect.
What about a Laminectomy for Sciatica Relief?
A laminectomy is a surgical procedure where part of the bone gets removed from the vertebrae. Theoretically, by removing the bone, there is more space for the spinal cord and nerves.
The issue with a laminectomy is that the spinal cord doesn’t have elastic properties, so the space creation is minimal. Additionally, the laminectomy procedure doesn’t do anything to restore disc space height or hydrate worn out disc material.
So, after someone has a laminectomy, they still have the same degenerative disc disease with a compressed or herniated or bulged disc. The root cause of the problem is still there even after the surgery to remove the lamina.
Does a Discectomy Relieve Sciatica?
A discectomy or partial discectomy is a common back surgery performed around the world every day. Once again, by removing part of the disc, a void is created. Disc space is important! You need the space to separate the vertebra so that the nerves have space and room.
When part of the disc is removed, it is permanently gone. The disc has less annular rings and can become weaker over time. In the last decade, I have had more discectomy and laminectomy patients go through my treatment programs than probably any other group.
In my experience outcomes of laminectomy and discectomy procedures are usually temporary if people get any relief at all. It is because these surgical procedures remove anatomical structures that belong in the body.
Getting to the root cause of the problem and working to improve health is what my goals are with every single patient. Address the cause of the problem and work to help it through natural methods.
Does a Spinal Fusion Surgery Relieve Sciatica?
A spinal fusion surgery takes 2 (or more) segments (vertebra) in the spine and fuses them together. Before spinal fusion surgery, the individual vertebra and discs act as shock absorbers. There is a little motion at each segment and that is how we get our range of motion (bending, twisting, etc…).
A fusion turns 2 short segments into 1 long segment. Or, a multilevel fusion can turn 3 or 4 segments into 1 long segment. When levels are fused, it creates more torque in the spine and the disc spaces above and below the fusion can become the new problem.
It is very common for me to work with someone that had a spinal fusion and 2-4 years later had to go back in to the surgeon with new symptoms of pain and had another level or 2 fused. In my opinion, spinal fusion surgery is not a winning strategy.
It’s just plain physics. A longer lever creates more torque. More torque puts more pressure and when we are talking about the spine, causes breakdown of adjacent disc spaces, ect…
Does Laser Surgery Relieve Sciatica?
Of all forms of back surgery, laser surgeries are the most advanced. A small incision is performed and the laser device is guided to the area where it cuts, burns and removes tissue. Even though it removes tissues and it is minimally invasive, there are still risks.
Risks of laser surgery are the same as regular surgeries: nerve damage, paralysis, infection, reaction to anesthesia, and death. No surgery is a simple surgery unless it’s being done on someone else other than you. People die every day from “simple” surgeries.
I have had patients come see me after having laser surgery and tell me what their experiences were. Some say it was no big deal, it just didn’t work. Others tell me of all of the pain and anguish that they went through after the procedure or show me an area where they got a staph infection and have hard scar tissue, etc…
Do you see a pattern here? Nerve pressure is nerve pressure. The only way to get relief from nerve pressure is to free up the nerves so that they can send the proper electrical signals instead of rogue pain signals and muscle tightness or cramping.
Doing stretching, yoga, massage, physical therapy, may get some relaxation of the muscles for an hour or two, or a day or two, or a week or two, but the muscle spasms, pain or tightness will come right back when you have a pinched nerve caused by a dehydrated and inflamed disc.
Will an X-Ray or MRI Show the Cause of Sciatica?
After many people have tried all of the natural methods for help, they often go get X-rays or an MRI which shows that they have a bulging, herniated, or desiccated disc, have spinal stenosis, arthritis, bone spurs, facet joint hypertrophy, etc…
Often they are told that they have bone spurs or arthritis in their back that is causing the problem. Many of them will take pain pills or muscle relaxers in their desperate attempts to get pain relief. Only to find out that they don’t work.
To be honest, most of my patients have already had failed surgery before they come to me. Conway, Arkansas is located in central Arkansas. It’s easy for someone from Little Rock to go through one of my treatment programs but more difficult for people who have to travel.
So many people make the decision to go under the knife and most of them live to regret it. Even in the modern era, back surgery failure rates are sky high. There are also risks associated with back surgery. Not to mention that most of my patients tell me that after the surgery (or surgeries), they still have the same pain (or worse pain) than before the surgery.
What are the Risks of Back Surgery?
Back and neck surgery aren’t as simple as some would think. Even the new hi-tech laser surgeries have risks. The following table illustrates some of the risks of neck and back surgery.
Risks of Surgery
- Reaction to anesthesia
- Scar tissue
- Acquiring a life threatening infection
- Permanent nerve damage
- Tissue damage
- More pain
- Less Range of Motion
I have 15 years of experience helping patients get to the root cause of their low back pain, leg pain, neuropathy, fibromyalgia, neck pain and sciatica. I believe my unique approach is what gives my treatment protocols their high success rate and high patient satisfaction levels.
My protocols focus on disc hydration. By hydrating disc material, the space between the bones can be enlarged and the nerves can get some pressure release or “Relief”.
Also, another major focus of my treatments are my LiteForce Class 4 deep tissue laser treatments. The LiteForce Expert lasers work to reduce inflammation of tissues and also increase ATP production so tissues can heal faster.
Can Functional Medicine Help Me?
I also do functional medicine with many of my patients to help them improve their overall health. Just as people travel from all over the country to get my help with their painful conditions, people seek out my care from all around the globe for my functional medicine skills.
Functional Medicine consists of performing advanced diagnostic laboratory testing to identify health problems and nutritional deficiencies. Once deficiencies are detected, my patients and I work together to get their inflammation levels down and improve the overall function of the organ systems and body in general.
My treatment methods are non-invasive and have no harmful side effects. I jokingly like to tell people that for many of my patients, the most common side effects of treatments are more smiles, happiness, quality time with friends and family, and a dramatic improvement in quality of life.
Health is Happiness,
Dr. Keith Currie