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Lower Back Pain and Sciatica

Updated: Jun 21

A series of blogs by Dr Megan Wilson (Chiropractor)

SCIATICA


It isn’t actually a diagnosis, it’s a symptom. Sciatica can present as low back pain, hamstring tightness, pins and needles, shooting pains into the back of calf...just to name a few! One of the causes of Sciatica is Piriformis Syndrome.


A study conducted in 2018 found the incidence of Piriformis Syndrome was 2.4 million cases.


When the Piriformis muscle is overused and inflammed, by prolonged sitting for example, the adjacent Sciatic nerve is irritated.


The best management is short term rest, anti-inflammatories and physical therapy.


A good stretch for Piriformis Syndrome can be seen above - to increase the stretch lie on your back and in this example, hug the right knee.


Hold for 30 secs on each side and stretch daily.


Chiropractic may aid in decreasing pain associated with Piriformis Syndrome - a case study showed improvement through a combination of chiropractic adjustments, massage, Piriformis muscle stretching and exercise in a 32 year old male who had symptoms for 5 years prior.


The papers:

- https://www.ncbi.nlm.nih.gov/books/NBK448172

- https://pubmed.ncbi.nlm.nih.gov/22942838



***


LOW BACK PAIN


Australia spends $4.8b per year on the management of Low Back Pain (LBP) with 25% of Australians suffering from LBP on any given day.


Earlier this year a study was published that explored the psychological impacts of LBP. It was found over the course of a year of LBP that of the 633 patients in the study, almost half reported severe LBP at some point during the year. 24.3% reported disability due to LBP at least twice during the year. The study showed that persistent, severe LBP, and disability is associated with a variety of psychological risk factors, in particular, catastrophisation and depression.


In a study conducted in America earlier this year, it was found that Chiropractic care was shown to be a cost effective alternative compared to physical therapy for adults with at least 3 weeks of LBP over the last 6 months.


Studies like these highlight the importance of holistic care and that chiropractic care may help to alleviate low back pain.


The papers

- https://www.monash.edu/news/articles/global-burden-of-low-back-pain-a-consequence-of-medical-negligence-and-misinformation

- https://pubmed.ncbi.nlm.nih.gov/32045707/

- https://pubmed.ncbi.nlm.nih.gov/32102417/


Another natural and evidence based treatment for low back pain is muscle rehabilitation.


Chronic low back pain is associated with lumbar extensor deconditioning which can impact neuromuscular control and balance.


A 2018 study aimed to examine the relationships among balance, lumbar extension endurance and pain.


The results suggested that the lumbar extensors may be an important factor in determining the motor control dysfunctions, such as limited balance, that arise in chronic low back pain. Specific strengthening of this musculature may be an approach to aid in reversing these dysfunctions.


Specific rehabilitation exercises will be given to each patient where indicated to complement the chiropractic adjustment.


The paper - https://pubmed.ncbi.nlm.nih.gov/29407352


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