Sciatic and cervico-brachial neuralgia: what is it?

Sciatica and cervico-brachial neuralgia are nerve compressions:

•    An impingement of the sciatic nerve in the case of sciatica
•    An impingement  of the crural nerve in the case of cruralgia
•    An impingement of one of arm nerves in the case of cervico-brachial neuralgia (usually the median nerve, ulnar nerve or radial nerve).

These nerve impingements can produce a loss of sensitivity in the skin, tingling, burning, pins and needles sensations, and pain that can be very intense.

Nerve interferences may also originate from a worn intervertebral disc (disc herniation, protrusion), an over-contracted muscle that touches the nerve (piriformis, scalene), arthrosis or some other rare cause.

Sciatica is very well-known because of the frequency and severity of the pain.

The most common cause of sciatica is the impingement of the sciatic nerve, often through a disc herniation. It triggers a pain that runs through the back of the thigh, calf, and foot.

Misdiagnosis:

There is a muscle called the piriformis that runs from the sacrum to the femur, which touches the sciatic nerve. In a third of the cases, the sciatic nerve even passes through this muscle.

Therefore, if the piriformis is over contracted, it can put pressure on the sciatic nerve, causing a sciatica-like syndrome called the piriformis syndrome. This often leads to the misdiagnosis of the patient’s condition.

Consequently, your chiropractor should always check for piriformis tension if you present sciatica symptoms, as the piriformis syndrome can mimic or aggravate back-related sciatica.

The loss of muscle strength, muscle atrophy (abnormal loss of volume in the muscle) loss of sensation in the perineum or the butt area (saddle anesthesia) or sphincter disorders (such as urinary and fecal leakage) are severe alert signals. You should inform your medical doctor and/ or chiropractor of these symptoms so that your health practitioner can recommend the best course of action for you.

Cruralgia (thigh pain) is often misdiagnosed as sciatica because both conditions often have the same causes and similar symptoms.

However, the location of the pain is very different, usually localized on the anterior face of the thigh although it can also range to the foot.

The loss of muscle strength, muscle atrophy (abnormal loss of volume in the muscle) is severe alert signs. You should inform your medical doctor and/or your chiropractor when getting checked so that your health practitioner can provide the best care for you.

When the median nerve is compressed, the symptoms and pain will appear on the palmar side of the first three fingers and run up to the anterior part of the forearm, the internal face of the arm and up to the cervical spine.

When the ulnar nerve is compressed the symptoms and pain start from the last two fingers and run-up to the internal side of the forearm, the internal face of the arm and up to the cervical spine.

When the radial nerve is compressed the symptoms and pain start from the back of the hand and fingers (tips usually not included) and run up to the back of the forearm, the posterior face of the arm (in a spiral path) and up to the cervical spine.

In all these cases, loss of muscular strength and muscle atrophy (abnormal loss of volume in the muscle) are severe alert signals.  You should inform your medical doctor and/or your chiropractor when getting checked so that your health practitioner can provide the best care for you.

Cervicobrachial pain syndrome is usually diagnosed when the impingement comes from the cervical spine, and the thoracic outlet syndrome is diagnosed when the impingement comes after the cervical spine.

By adjusting the vertebrae responsible for putting pressure on these nerves (and other joints if needed), chiropractic frees the nerves up so that they can get back to their normal function.

The symptoms can diminish as early as the first session or in as little as a few sessions. However, healing takes time and even if the symptoms disappear, you should be careful about your posture and the movements that you perform up to a few months following the initial treatment phase. Continue to get checked regularly, to ensure that the problem gets cured for real, and that the symptoms haven’t just been relieved for a while. Your chiropractor will often recommend rehabilitation exercises or lifestyle advice that can help you heal better or faster.  Sticking to these recommendations will ensure faster and more efficient treatment, allowing you to enjoy the full benefits of your chiropractic sessions.