Leg pain may not just be pain in the leg. Its source of pain may be the spine.
The clinical term for leg pain is "sciatica." Sciatica is leg pain that originates from the spine and extends down the leg and sometimes into to the foot and toes. Sciatica is the result of slipping of the nucleus pulposus in a contained disc or non-contained disc that results in back pain, and, depending on the severity of the slippage, pain down the leg.
- If the slippage is minimal, your pain may only extend into your buttock.
- If the slippage is a little more severe, the pain may extend into your calf.
- If the slippage is really severe, the pain may extend into your foot and toes.
A thorough, clinical examination that may include imaging is important to your recovery.
The clinical examination of sciatica is vital to the diagnosis of sciatica's source which may be revealed with just a few questions about its symptoms.
Lumbar Spine Exam Description
The location of the pain in the leg may indicate which sciatic nerve root is compressed, making its diagnosis relatively clear. If the little toe hurts, the S1 nerve is inflamed which lies between the L5 and S1 vertebrae.
The pain distribution is usually into just one leg though both legs may be affected in some cases. Severe cases of sciatica may even result in the inability to move the leg.
Sciatic pain may range from a dull ache to a sharp, stabbing pain. It may be described as burning, numb, pins and needles, tingling, or "worms crawling in the skin." Even the term you choose to describe your pain gives a clinical clue to your doctor of your diagnosis, so explain fully what you feel.
You may find that leaning to one side can alleviate your pain. Leaning into the side of pain, away from the side of pain or just standing "frozen" may reveal where the disc bulge is in relation to the spinal nerve root.
, Vancouver Spine Care Centre uses Cox Technic Flexion Distraction and Decompression to lower the pressure in the disc so the nucleus pulposus returns to the center of the disc, aid in the healing of the torn anular fibers, and drive out chemicals that irritate and inflame the spinal nerves.
Graphic Animation of Cox Technic - Lumbar Spine
The disc is pressing on the nerve. Note that as the disc herniation reduces, the pinched nerve is relieved.
This is an animation of the goal of Cox Technic
Flexion-Distraction and Decompression: reduced irritation of spinal elements
enough to relieve pain and help you regain your quality of life. The amount of
decrease in size of the herniated disc necessary for pain relief varies from 0%
to 100% for each individual patient.
Cox Technic Protocol I - for severe pain or pain that extends below the knee
Cox Technic Protocol II - for pain that is in the low back and stays above the knee
You must understand that it takes three months for a torn disc to heal well enough to allow you to return to daily activities like prolonged sitting, bending, lifting, twisting, etc. The first three to four weeks of concentrated treatment, therapies, and at-home care are designed to allow the best opportunity for the disc to heal quickly. This three month window does not mean that you must be treated continually throughout this time period, but rather it means that you must be cautious and aware of your spine's healing. Recognize that even though the pain is gone, healing is still taking place and could be hindered if you do something to aggravate the process.
In the 1000 cases study of patients undergoing care for their back pain, 91% reported maximum improvement in 90 days of care and 70% of patients in less than 30 visits.
The Healing Pattern of Sciatica
The pain of sciatica is quite disturbing to the daily activities of life. The day that it seems to be gone is a day to celebrate. However, know that sciatica is serious. It will be discouraging when you find you are having periods of time then days without pain and then the old pain may start back again. Know that this is to be expected. It is common to have recurrences of sciatic pain during healing.
The sciatic pain's going away more than it comes is a true sign of healing.
At Home Care
At home you will want to avoid sitting for long periods of time, wear a support brace if recommended, take nutritional supplements that help rebuild disc cartilage, sleep on a supportive mattress, sit in an ergonomically designed chair, avoid constipation which just forces you to use pressure that your spine doesn't need, and modify your daily activities as needed.
Exercise is important to your recovery and prevention of future pain.
It is important to start exercises as soon as possible, not vigorously, but gently.
Do only exercises recommended.
Do exercises only to your tolerance.
Clinical Case Reports