Question
QUESTION: A year ago I went to a DC for the first time because I was experiencing some sciatica in my left calf whenever I sat for extended periods of time, he performed side posture manipulations on me and I have been in severe pain ever since, I have had an MRI showing a small bulging disk at L5/S1 but the doctors do not think this is the cause of my pain, I am experiencing pain all around my sacrum which is worse on the right side and is terribly painful when I sit at first I could not even sit for 5 mins I was in so much pain but now I can sit for up to 30 mins before I have to get up. I have tried multiple rounds of PT and even another DC who made my condition worse. What could be causing this pain? It is very frustrating that I went from a very active person to dealing the horrible pain for a year and no one can tell me what is causing it...

ANSWER: Dear Eden

I can hear your pain and frustration in your question. I am so sorry that you have had a negative experience with your chiropractors, and that you feel that you have not been getting any answers.

Lets get to the meat of this quickly...

First of all, your MRI was a snap shot in time. The pictures show your back and discs how they looked at that particular moment in time.

A relatively small disc bulge can cause the symptoms that you are describing, even though "the doctors" don't think that it is the cause. It is also possible to have a disc bulge with little or no pain. The MRI is a tool, but it doesn't tell all.

Here are some other possible causes of sciatic neuralgia or neuropathy. (since it appears to get worse with adjustments of the lumbar spine, I am going to assume that it is spinal related, for now. Please remember, this is a partial list and not a diagnosis)

1) Disc bulge, herniation, degenerative changes, etc
2) Facet joint degeneration
3) Central canal or lateral recess stenosis (narrowing of canals through which nerves pass)
4) Muscular referral pain, such as associated with gluteal or lumbar musculature.
5) Congenital or developmental defects of the spine, including but not limited to scoliosis, spina bifida, spondylolisthesis, asymetrical facts, transitional segments, etc
6) Sciatic nerve entrapment by the pyriformis muscle.
7) Sacroiliitis

Eden, the key is to not give up. Find another chiropractor, and insist that they NOT do side posture adjustments on you. If they don't agree, find another one. A good chiropractor will do a good consultation and examination BEFORE they treat you. They should be willing and able to perform all kinds of different techniques, not just side posture diversified manipulation.

I am so sorry for your pain. I hope that this gives you some ideas and hope for answers. Never give up. There is an answer, you just have to find it!

Dr. Biggs
www.eastmesachiropractor.com





---------- FOLLOW-UP ----------

QUESTION: Thank you for your response, another thing I forgot to add was after the adjustments I had really bad sciatica down both legs for a few weeks and it took quite a while for it to centralize up into my back, hips and buttocks, every dr I see gives me a different diagnosis, I know I do have some arthritis in my si joints and facet joints but would that cause sciatica?

Answer
Dear Eden,

The facet joint arthritis can definitely contribute to your sciatica. The SI joint arthritis, in my opinion, is less likely causing your sciatica, although it could be a contributor.

Eden, you are right, there are as many opinions as there are doctors. In my 20+ years of experience, when there is significant radiating pain past the knees, especially when accompanied by any weakness in the leg, ankle, or foot muscles, it is usually due to a disc/facet joint & stenosis problem.

Dr. Biggs
www.eastmesachiropractor.com