Leg pain can be an incapacitating condition. There are a number of conditions originating in the lower back that can cause leg pain.
The most commonly thought of cause for low back pain into the leg is a disc injury. A herniated disc - also called a slipped disc or a ruptured disc - is when the semigelatinous center of the disc, called the nucleus pulposus, extrudes through a crack in the tough outer portion of the disc called the annulus fibrosis. When this occurs the herniated nucleus can put pressure directly on a nerve root, or the spinal cord, and this in turn can refer pain into the lower leg as far as the toes or anywhere between the back and the toes. When the nerve root is compressed it is called a radiculopathy. This pain tends to be very sharp and makes movement very difficult. It also usually increases significantly with coughing, sneezing, and bowel movements. If the nucleus doesn't herniate and just pushes against the back of the disc against the outer layes of the annulus you have a disc bulge. This too can irritate the nerve roots and give you a similar pain into the leg. Both disc bulges and herniations will respond to chiropractic treatment. The degree of improvement is determined by the location and severity of the bulge or herniation. Many times patients with these injuries can successfully avoid surgery through proper chiropractic care. When necessary, we refer patients who are not good candidates for our care to the appropriate neurosurgical specialists for treatment.
Sciatica is the common name for leg pain originating from the back. However, this is a very imprecisely used term. True sciatica is pain that follows the distribution of the sciatic nerve. This very large nerve originates in the pelvis and low back, passes through the deep muscles of the buttocks into the back of the thigh. When it reaches the knee the sciatic nerve divides into the common peroneal and tibial nerves which continue to supply sensation from the calf and the foot. Sciatica is an appropriate term for much of the leg pain patients have. It can originate, as mentioned already, from a disc bulge or herniation. It can also be due to compression of the sciatic nerve under the piriformis muscle in the buttock. But not all leg pain is due to sciatica.
Another souce of pain in the legs is referred pain from the ligaments of the low back and sacroiliac joints. This type of pain is dull and diffuse and does not follow the same pattern as sciatica or pain from a pinched nerve root. It does commonly go into the buttocks and thigh, and even the calf. Chiropractors are highly trained musculoskeletal specialists who can accurately differentiate between these pain types and institute the appropriate treatment. This is important because a diagnosis of sciatica can often lead to expensive or uncomfortable tests that can be avoided if accurately diagnosed.
If you experience leg pain, numbness in the groin and inner thighs (called saddle anesthesia), incontinence of bowel or bladder function, you should immediately report to the nearest emergency room. This may be a condition called a cauda equina syndrome and unless treated surgically very soon may be permanent. Again, while not common, this condition is a surgical emergency.
While not all leg pain will respond completely to chiropractic care, many conditions do very well with our conservative care and do not need more aggressive therapies. If you have leg pain and are looking for help in Conway, North Conway, or the Mount Washington Valley, let us evaluate your complaint and see if chiropractic care may be of benefit to you.