Back pain is frequently accompanied by pain radiating in to the buttock and above the knee. In severe cases it can extend below the knee into the foot. Precise diagnosis, of the cause of leg pain is difficult due to a multiplicity of, causes. First. it can be due to referral from structures of the spine and pelvis, such as facet, sacroiliac joints, spinal ligaments, and muscles. This type of pain is characterized by a diffuse ache. Second, impingement of the nerve roots which join to form the sciatic nerve. by mechanical means is possible (e.g.. disc bulge, muscular tension, bony architecture. etc.) or by swelling secondary to inflammation. If the nerve roots are affected the pattern of pain usually follows specific derma tomes, and may be accompanied by one or more neurologic symptom’s. These two causes may occur concomitantly, creating a confusing clinical picture. While special examinations such as electro diagnostic tests and imaging studies may be helpful in making a diagnosis, they are not always definitive and require close correlation with clinical findings.
Despite reports of effectiveness for treatments such as bed rest, surgery, exercises, injections, physical therapy modalities and chiropractic manipulation, no standard approach is recognized in the profession. This is not surprising since it has been estimated that 80% of patients with painful sciatic radiation are said to recover in within 3 months. (1) Few reports are available documenting cases and long term follow-up with standard outcome measures (e.g., Oswestry disability questionnaire[OLBQ], visual analog scale, or orthopedic tests). (2) This study presents a case of chronic sciatica treated by mechanical force, manually assisted short lever adjusting, high voltage electrotherapy and a video assisted, home stretching program documented with common, easy to use, outcome assessment tools over a period of two years.
Reference: Paul J. Osterbauer. D.C., Arlan w. Fuhr. D.C. Activator Methods Inc. Phoenix, Arizona; Proceedings of the California Chiropractic Foundation’s 293 7th Annual Conference on Research and Education , Palm Springs , CA , June 19-21, 1992, pp. 293-5.