Endurance.Net Ridecamp Archives

Please Reply to: Bruce Weary, D.C. bweary@xxxxxxxxxxxx or ridecamp@xxxxxxxxxxxxx
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Hi Mary--
Allow me to comment on your dilemma about your sciatica. First of all, true 
sciatica is actually quite rare, although pain in the leg is very common. True 
sciatica has certain characteristics that must be present for it to be 
diagnosed. You would likely have symptoms that accompany your leg pain, such as 
markedly increased pain during a cough or sneeze, and the inability to lie on 
your back and  have someone lift the painful leg (while straight) beyond 75 
degrees. You might also have a feeling of weakness in the affected leg, and 
possibly even some tingling or numbness in the toes.
 Be wary of anyone predicting at the outset how much treatment you will need. 
I'm guessing this doctor recommended a lengthy treatment program with a 
significant discount if you pay up front? Be careful.
 A couple of things you should be aware of. All the textbooks agree that xray 
findings do not correlate with pain findings. There are people who have nasty, 
curved, arthritic-looking spines who are pain free, and those with nice clean 
straight spines who are in agony. The old model of vertebrae being displaced 
(and subsequently re-placed with manipulation) has been discarded, largely due 
to the evidence provided by MRI and other imaging methods. Manipulation is 
still an extremely effective tool when practiced by a skilled person. It just 
works differently than we once thought.
 I'm going to go out on a limb here and guess that you are suffering from one 
of two common patterns of back pain. The first, and most common, is called a 
sacroiliac syndrome, named after the two large joints of the pelvis, the 
sacroiliac joints. They are located at the base of the spine, directly 
underneath the "dimples" you see when people are wearing a bathing suit. Or 
thong, or whatever. With this problem, the pain is usually over the sacroiliac 
joint, hurts to sit down and rise from a chair,is worse on rising in the 
morning but improves a bit with activity, doesn't hurt much with cough/sneeze, 
and if it goes down the leg,                            it won't usually pass 
the knee.
 The other most common back pain is the disc syndrome. This situation is 
different in that you usually feel better in the morning and worsen with 
activity, you have more pain on cough/sneeze, and your leg pain may go all the 
way to the foot.
 There are some variations on these, but they are still usually pretty 
distinct. The good news is both situations usually resolve, and much more 
quickly with proper treatment. Exercise alone will not "fix" a back problem, 
for various reasons I won't go into here. They do help, however, after you have 
recovered.
 In short, I would use ice, and if there is not 75% or more relief within 48 
hours, get another opinion from a reputable chiropractor. A really good 
chiropractor is still your best bet for recovery. It's finding him that's the 
hard part. I tell people to ask their medical doctor for a referral, as they 
will usually know the good ones, or at least who the bad ones are. Hope this 
helps,  Bruce Weary, D.C.


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