Chiropractic Questions

Navigating Sciatica with Chiropractic Care

Brant Hulsebus DC LCP CCWP FICA Season 10 Episode 5

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Did you know chiropractors can effectively treat sciatica? Learn about the process and benefits of chiropractic care for sciatica in our newest episode of Ask the Chiropractor. Your path to relief starts here! #healthy815 #icachiropractor #palmerprou

www.rockforddc.com

Hello, Dr. Brant Hulsebus here and welcome to another edition of Ask the Chiropractor. Ask the Chiropractor is my little podcast that I do when someone has a question about chiropractic or chiropractic care, I try to answer. I'm a chiropractor here in Rockford, Illinois. I'm a proud graduate of Palmer College of Chiropractic and I'm happy to be the team chiropractor of the Rockford Icehogs. Let's dive into it. Hello and welcome to another edition of Ask the Chiropractor. Thanks for joining us. Today's episode is one that's pretty much universally accepted that chiropractic care can help. But I want to talk to you a little bit about sciatica. Now some of you probably know chiropractors help people with sciatica. And if you were to go to a primary doctor and say I'm going to go see a chiropractor because I deal with sciatica, most of them wouldn't object to this because this is one of the few areas where most health care agrees. Yeah, chiropractic takes care of people with sciatica. But I want to tell you a little bit about what sciatica is. what we look for, the different areas we check in your spine, and how we go about taking care of sciatica if you were to go with a chiropractor, what to expect. So my friend has sciatica. He's got pain going down his leg, or burning going down his leg, irritation down his leg, and a little bit of lower back discomfort. This is classic sciatica. Now what the sciatica is, it's a nerve. It's a nerve about as big as your thumb, and it's composed of your lower lumbar nerves. Coming from L3, L4, L5, some people S1, and all those nerves come together and they form a big nerve, like I said, the size of your thumb. It travels through behind the gluteus maximus muscle, most of us know what that is, right by the piriformis muscle, and it innervates the back of your leg, not your thigh, but the back of your leg, to your knee and everything kneed out. So if you're having discomfort going on your, in your quote unquote rear end, or the back of your leg, or your knee down, that's usually involving the sciatic nerve. Now a classic sciatica happens is you have a misalignment, or what we call subluxation, between L3, L4, L5, or your sacrum. Misaligned, and that creates a subluxation, and that hits one of the nerves coming out in a fixed part of the sciatic nerve. And so if you were to go to the chiropractor would take x rays of your lower back and they would determine what's going on. Now, I often get patients that have medical x rays, they go to the medical doctor and the medical doctor says there's no reason why your lower back will be causing your sciatica. Your x rays are normal. I'll look at those x rays and I won't see any tumors, I won't see any fractures, maybe I won't see any degenerative changes or arthritis, but I will see the spines misaligned. And that's what we call subluxation. Now chiropractors and radiologists that are medical doctors look at x rays the same when we look for fractures and tumors and arthritis and degeneration. We all do that the same. But what chiropractors are uniquely trained to do, where most radiologists are not, is actually look at your alignment. They do not train to look at your alignment, so they will not see that misalignment in there. So if you go to a medical doctor and they tell you, Hey, I had x rays taken of my back and they say my back is normal, let your chiropractor see the films, not the report. They give you a report that tells you what's going on. We don't really care about that report. We actually want to see the films. Because we'll look at that like a radiologist would. We'll do the same thing. We take lots and lots of radiology classes at chiropractic school. We are our own radiologists. So we'll look at our own x rays and we'll do our own analysis for those bad things. But we are also trained uniquely to look at the alignment of the spine and how it works with different parts of your back. So keep talking about classic sciatica would be the L3, L4, L5. But there's other ways you can have sciatic nerve irritation. And those are the things that we get a lot that goes missed a lot in the medical community. Now another way people get sciatica is when they have torta pelvis. Torta pelvis is when the upper lower back rotates one direction and then your hip gets pulled or twisted the opposite direction. And usually on these ones your L3, L4 and L5 actually might be very normal. But your L1 and L2 are having issues and then we see a pelvic misalignment. Now, more recently than not, we see more and more people, maybe they watch too many TikTok videos or too many YouTube shorts or something, and they're seeing that these hips, they're having SI pain. Now, your SI pain is where your sacrum and your hip, everything comes together, and people are pointing right above their belt line, either on the left side or the right side, saying, I'm having pain right here. And maybe somebody will grab that and try to make it pop or make a noise out of it, thinking they're doing what we're doing. And they'll get in and they'll make that pop, they'll make that little noise, and you'll feel a little bit of relief, very temporarily. Then you'll start to notice it's getting worse and worse. The reason this happens is because your L1 and L2 are out, and there's a hip flexor muscle that attaches to your hips, right? And when your L1 that hip flexor gets tight, it pulls and rotates your pelvis. Now your pelvis really isn't the issue. The issue is your L1, L2, but if you only take care of the symptom and not the cause, the L1, L2, this is only going to come back worse and worse and worse. So as a chiropractor is uniquely trained, I keep saying uniquely don't I, chiropractor is uniquely trained to look above where the person says it hurts. A lot of times I will fix an SI joint, I don't even want to touch the SI joint. I'll just adjust the upper lower back and the SI joint to clear itself out all by itself. And that's why if you have somebody who's not trained like a chiropractor trying to go in there and do what we do in their eyes trying to make that joint move, they'll actually continue to make it worse and worse because they avoid, they don't, they avoid, they're unaware, they're uneducated about making sure you look at what's happening above that spot too. So in this classic case of sciatica, that chiropractor will x ray you And they'll see an L1, L2, the upper lumbar spine misaligned. We'll see a pelvic rotated. And what happens then is that the sacrum, your tailbone, will stay still, but your hip will move. There's a muscle that goes from your sacrum to your hip called the piriformis muscle. When your piriformis muscle is tight and angry, the sciatic nerve usually sits above, below, And if you're really unlucky, through the piriformis muscle. And this muscle will get inflamed and spasmed and irritated on one side. And when this muscle is spasmed and irritated, those muscles get sticky like molasses. And the sciatic nerve will hit that and it will irritate part of the sciatic nerve. Now this type of sciatic nerve is really indicated by a couple of things. One, it usually gets worse with activity because it's not pinching when the nerve comes out, it's getting irritated to the muscle later on. So the more you walk, the more that nerve hits, and that's like talk more and more. These are also the people that say, boy, when I get up, it's really painful, but after a couple of steps, I feel better. But sciatica starts coming down my leg. These are classic signs that we call torta pelvis. When you go to the chiropractor, we're going to look to see if it's your upper or lower back causing the sciatica, or your lower back causing the sciatica, the traditional sciatica. I will tell you, the reason I brought up both is nowadays, more and more, we don't see the lower lumbars causing the issues like we used to. We see more of the upper back causing the issue. Now, maybe it's because chairs have gotten better for the lower back. I don't really know. I can tell you, because our practice has been open for, you see the sign behind me here, for over 75 years. My grandfather, it was really common to have those lower lumbars be a problem. Even my father, when he practiced. But I'll tell you today, there's been a change, where it's more your upper lower back. Now, sometimes when it's your upper lower back, people also complain about groin pain. That's your hip flexor muscle. That's the hip flexor I talked about. That'll show up on the front side. And so you might say, boy, it hurts on my right side, rear end and my left groin. That's classic signs of tortal pelvis. And again, we adjust this, we clear this up. Now, How does your chiropractor know to do this? Again, your medical doctor has no idea. They don't have the training we have, I should say, to look at your lumbar spine x rays and determine if it's this one or if it's either of them. They don't really know. If they don't have what they call the gene of this disease at one of those areas, they're pretty much saying it's probably not the back. But as chiropractors, we look at the alignment again. When you go to the chiropractor, they'll look at your x rays, they'll do an exam, you'll probably lay face down, have your knees bent a bunch of different ways, and try to see what's going on with your pelvis rotation. Then the chiropractor will make an adjustment. Now in our office, we'll make that adjustment and we'll have you come back. Now when you return to the office, then we'll see how you responded to the care, because everyone's going to be different. Then based on how you respond, we'll give you a care plan. We're going to say, this many adjustments for this long. We might introduce a massage along the way. We might introduce stretching, exercise along the way. or all of the above or none of the above. It all depends on your case. But we'll give you a realistic outcome, what it takes. Now to make this area stronger and make it better, eventually we want to strengthen the stabilization muscles. Those are the muscles around your spine. In today's literature, there's coming up with a fourth type of muscle group. We always had skeletal muscle, we've always had cardiac muscle, smooth muscle, but nowadays they're saying they're stabilization muscles. Those are the ones around your spine. So we'll have to come up with a way to make your stabilization muscles stronger so it's harder and harder for you to knock your lower back out. So that's what you'd expect to see at a chiropractor. The chiropractor should be able to point at the L1, L2 and show you the pelvic rotation that goes with it. Or point at the L3, L4, L5 that's causing the rotation, causing the classic sciatica. From there, you would be able to start your care plan. Again, if your medical doctor takes x rays of you, take those films with you to the chiropractor. Let the chiropractor have an opinion on them too. Don't let the medical doctor tell you that you are not a chiropractic patient, because again, they're just not, it's not part of their curriculum to look at the alignment issues. It's a big, big, big part of our curriculum of what we do. So there you have it. What to expect if you go with a chiropractor if you're dealing with sciatica and how the chiropractor differates rates between the different kinds of sciatica and how your care plan will change and adapt to the two different ones. All right everybody, I hope I answered your questions about chiropractic care for sciatica. Not, most again, most of us know you can go in the chiropractor with sciatica, but what to expect when you go. Thanks everybody for tuning in.

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