Sciatica has many different causes. A bad disc in the lumbar/lumbosacral spine is one of the culprits I see in practice. Bad disc can be described as disc bulges, disc herniations/protrusions, degenerated discs, slipped discs, or swollen discs. Sciatica is the symptom you get when there is irritation to the sciatic nerve. The sciatic nerve is made up of multiple nerves that exit to lumbar and sacral spine. It consists of nerves: L4, L5, S1, S2, S3. These nerves leave the left and right sides of the spine, join together in the buttocks region, and travel down the legs into the feet.
These nerves are responsible for the communication of health, healing, and function from the brain to the lower body and lower extremities.
They supply such organs as the large intestine, bladder, prostate, and reproductive organs. They also supply the muscles in the low back and muscles down the legs. Irritation to these nerves not only causes sciatica but disrupts the communication/supply to the structures listed above. This can or will disrupt the function of these structures creating distress that leads to disease.
There are 24 bones that make spine called vertebra. Between each vertebra is an intervertebral disc that allow for motion of the spine. The disc are also responsible for shock absorption and through a process called imbibition, provide the nutrient to the vertebra. The disc are kidney shaped and are made up of 2 layers. The hard outer layer, the annulus fibrosus, is made up of several layers of fibrocartilage which provide strength. The inner layer, the nucleus pulposus, has a gel-like consistency and is contained within the annulus fibrosus. The gel-like material contains nutrients and water to hydrated and keep the spine healthy. This material is also what herniates and pushes through the annular fibers due to a violent or abnormal force.
A herniation is defined as an abnormal protrusion of an organ or other body structure through a defect or natural opening in a covering, membrane, muscle, or bone. With spinal herniated discs the abnormal protrusion is the nucleus pulposus tearing through the annlus fibers causing the disc to bulge enough to compress the nerve.
In a previous blog I wrote titled “Tree of Life” it describes the levels of health based on the levels of a tree. Imagine the branch of a tree being being chopped or cut in half.
What then happens to the products of that branch? Does the fruit get the same nutrients from the root of the tree with half of its branch working? My answer would be no. My younger self unscientifically tested this theory by mistake when climbing a tree (or trying to climb a tree) when the branch gave way. It didn’t break completely but enough to tell me I wasn’t wanted. But most of the leaves distal to that branch died in the process. Imagine if that branch exiting the tree was a nerve exiting the spinal cord. Then comes along a bad disc bulging or protruding out and compressing that nerve, disrupting the flow of communication of function and healing. The organs and structures distally are affected by not being able to function as they would if the nerve had no abnormal pressure. This story doesn’t give you much about a herniation specifically but highlights the importance and the negative effects of compromised nerves.
How does a disc herniate?
There are a few ways a disc can herniate. Traumatic events where a very abrupt force is applied. The posterior lateral aspect of the disc is known to be the weakest area of the disc and as a result the most common area to herniate. When most think of traumatic events, examples are car accidents, falling, sports or other forms of athletics or violent actions. Some of the worst disc damage I’ve seen came from a few air borne trained Army Vets I had the privilege to treat.
Repetitive motion are also a common known to cause disc herniation. Any activity that involves lifting something while twisting the torso is, in my opinion, the position or action that leaves you most susceptible for disc herniation. The torque that is placed on the disc with the load of the object being lifted is the event or action I’ve seen most often.
The most common cause of disc herniation is from normal, aging wear and tear of the body due to everyday life. Gravity constantly applies load to the discs every second of the day, times spent sitting for long periods, falls throughout life especially as kids, the sports as kids throughout adulthood, everyday jobs that add stress physically and mentally, this list can go on and on. As you age, your spinal discs lose some of their water content. That results if more stiffness and a disc that is more susceptible to injury.
What are my treatment options.
The first thing to do is to get an evaluation by a chiropractor. The goal of a chiropractic evaluation is to check the cause of your problem. You will be likely be given thorough a functional assessment. This assessment will dictate what type of treatment is necessary. I’ve had people tell me they didn’t think chiropractic could help with disc issues but this is far from the truth. Chiropractic is likely the first place to get the correct care to help with disc problems.
Chiropractic treatment to help with disc bulges and herniation will vary based on how bad your disc is. Manual manipulations will help to correct abnormal vertebral misalignment and increase the mobility of the joints that are stuck or restricted. Some chiropractic doctors have specialized tables such as decompression tables, flexion-distraction tables, elevation tables and drop tables to help or provide the correct mobility to improve a disc problem. Chiropractic will also be the most cost effective treatment. In conjunction with chiropractic adjustments, a prescribed rehabilitation program can help improve mobility and functionality. Ice and electrical stimulation (or a TENS unit) can help decrease inflammation and pain.
Dr. Bryen Brown is married to Dawn and has one son. He grew up in Bogalusa, LA and received his Bachelor of Science Degree in Biology from Grambling State University in 2008. He then attended and graduated from Texas Chiropractic College in 2012. Click Here To Read Full Bio