- Posted on: Oct 1 2015
A common condition that is diagnosed and treated by Dr. Jeff J. Mollins (Brooklyn’s premier accident doctor) on a regular basis is sciatica. Sciatica is a condition that often arises as a result of an accident (whether it is a work accident, car accident, slip and fall, or a construction accident). Sciatica is extremely painful, often disabling, must be diagnosed immediately, and treated as expeditiously as possible. Typically, the longer you wait to treat sciatica, the longer it will take to achieve wellness. Also, the longer you wait to treat this condition conservatively the more difficult it will become to alleviate this condition and prevent the necessity for more aggressive forms of treatment.
The term sciatica describes the symptoms of leg pain, possibly tingling, numbness, or weakness that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of the leg. Sciatica is often characterized by one or a combination of the following symptoms:
- Constant pain in only one side of the buttock or leg (rarely can occur in both legs).
- Pain that is worse when sitting.
- Leg pain that is often described as burning, tingling, or searing (not a dull ache).
- Weakness, numbness or difficulty moving the leg or foot.
- A sharp pain that may make it difficult to stand up or to walk.
Sciatica symptoms occur when the large sciatic nerve is irritated or compressed in the lumbar spine. The most common cause of sciatica is a lumbar herniated disc. A lumbar herniated disc can occur as a result of a traumatic accident (such as a car accident or slip and fall), lifting, bending and/or twisting (very common in work accidents), or possibly due to long term excessive sitting (this might be due to a repetitive stress injury at work). In any of these cases a herniated disc occurs when the soft inner core of the disc leaks out, or herniates through the fibrous outer core and irritates the contiguous nerve root. A herniated disc is sometimes referred to as a slipped disc, ruptured disc, bulging disc, protruding disc, or a pinched nerve.
Diagnosing sciatica is the first step towards wellness. As always, Dr. Mollins will initially take a clear, concise history. Dr. Mollins is fully aware that understanding the precise mechanism of the injury (exactly how the accident happened) can lead to an accurate diagnosis. Dr. Mollins is very specific when performing the history and always asks about pre-existing conditions (to determine the exact cause of the injury).
The next step is to perform a comprehensive physical examination. This examination will include orthopedic and neurological tests which are specific for sciatica. Dr. Mollins will always measure the ranges of motion of the lumbar region to determine if there are any active or passive losses in those ranges of motion. Measurement of ranges of motion is also extremely important for purposes of documentation as well as to access improvement of the condition. Often Dr. Mollins will rely on diagnostic testing. With sciatica, standard x-rays and/or mri scan of the lumbar spine are commonly required. Dr. Mollins will often work with referred specialists. If he suspects sciatica, Dr. Mollins will typically refer his patients to a Board Certified neurologist to help confirm the diagnosis. EMG testing (performed by neurologists) is extremely helpful in confirming and documenting the diagnosis of sciatica.
Most cases of sciatica will respond well to conservative treatment. Sometimes a more aggressive approach is needed. Remember, the key to treatment is to remove the nerve compression which will ultimately alleviate the painful symptoms. Some of the treatments are as follows:
- Cold compression (ice) is a good idea for the first 24 hours. This will help reduce any inflammation.
- Application of heat will relax muscle spasm and promote healing.
- Start a comprehensive regimen of chiropractic spinal manipulation augmented by physiotherapy.
- A well planned out physical therapy program is recommended. Proper exercises will strengthen core muscles and stretch strained muscles. This will help remove compression.
- Non-steroidal anti-inflammatory drugs will also help reduce disc compression.
- If none of these conservative methods are successful, then the patient may have to be referred out for pain management (which may include epidural injections), or possibly surgical intervention.
So please remember if you are involved in an accident and suffering any of the symptoms of sciatica, call Dr. Jeff Mollins. Dr. Mollins believes it is always better to be safe than sorry!
Posted in: Back Pain Treatment