Soft Tissue Phenomenon versus Frank Nerve Root Irritation of Pathology
When a patient presents to a chiropractor’s office with a full blown case of acute lower back pain and associated sciatica, a very delicate onion must be unraveled. One clue to an early and successful resolution of sciatica is knowing what to work on first, soft tissue complications or vertebral associations of the nerve roots involved [L3, L4, L5, S1 and S2 primarily].
As often as not, everything has to be taken into consideration from a 360 degree perspective and this is where a particular methodology called Sacro-Occipital technique application may make the greater difference in successful resolution of the dreaded condition of sciatica.
The earliest stage of sciatica starts when the sacrum subluxates or becomes fixated between the two iliac bones, with the iliac bones themselves remaining positionally normal in their reciprocal movement and support functions. The attempt to anchor the sacrum and minimize irritation to anterior sacro-iliac ligaments as well as the dural covering of the entire spinal cord initiated soft tissue related sciatica.
Normal or abnormal tone of the extensor chain of either lower extremity can be evaluated through a chiropractic SOT procedure called Heel Tension testing.
Abnormal tonicity and shortness of the kinetic chain of extensor anti-gravity stability, which starts with the piriformis is then compromised. The piriformis muscle comes off the anterior surface of the sacrum and inserts out into the greater trochanter of the femur head.
The extensor chain of leg muscles, extending down through the hamstring muscle and subsequently through the Achille’s tendon of to the gastrocnemius/soleus muscle into the back part of the heel, may subsequently shut down. This is all due to sacral base related distortion of the dural ports that the sciatic nerve fibers pass through as they go down to all the extensor muscles of the leg.
With persistent piriformis spasm, and a secondary cascade of inter-related abnormal neurologic associations throughout the extensor muscle chain of the involved lower extremity secondarily, the problems of sciatic nerve irritation can become acutely disabling.
To make a sensible start in resolving sciatica means to simply but definitively correct the sacral fixation between the iliac support buttresses and reduce hypertonicity of the piriformis muscle. Thusly is corrected the first stage of sciatica related to the impingement of its nerve fibers, even though there may be other degenerative discal issues [usually there are] to subsequently attend to.
Dr Slater