Symptoms, Causes and Treatment
Hey guys, Dr. Todd here, I very frequently get the question, What is sciatica? Or what is sciatic pain? And what causes it? That's never a simple question, nothing in the body is ever super simple question. For example, I just had a girl come in this morning who said to me, she's had sciatic pain for the last about 10 years, she fell in... Well, 20 years ago she fell, and has had pain ever since, but she went to an orthopedist and they said, Oh well, we can't find the cause on your X-rays, so we're just gonna give you medications. So she wasn't satisfied with that. So fast forward another 10 years, I don't know why it took her so long to get here. Everybody watching this video, you gotta spread the word that we help people with this because it's serious, and if you live in Timbuktu and can't get access to our clinic here, call me, message me, contact us so we can let you know exactly who the best doctor in your town is to go to, but it really, really matters whom you go to when you have sciatic pain so this is a patient who does have sciatic pain, and so I'm gonna run through her X-rays and what we plan to do with her. She's not started to care yet.
So first of all, we're gonna do a very, very thorough analysis of the posture and the alignment, so the posture is taken with a photograph with an iPad where we digitize if someone shifted like this or tilted like that or from the side, if they look like that, then we take a photograph and we map that out, and then we're also gonna take X-rays, believe in it or not, the posture picture can look very, very different from the X-rays, and we have to very carefully compare the two and figure out what that three-dimensional structure looks like by comparing the two, so we're gonna just go over the x-rays of this gal today, so when we look at this, this is the side of her neck, so there's an absolute normal when it comes to the neck, and if you can see that there's a green line right there, well, her... She's where the red line has her red line curves backwards, that means that she was injured, and as I look at her x-rays, it's about 25 years ago, and I know that because their spine is degenerated because of that injury 25 years ago, the curve has been backwards ever since.
And so those joints have been being injured and degenerating, decaying every single day for the last 25 years. So why does that have to do with low back pain and sciatic pain, because when there's a reverse curve in the neck that we have recent studies to show this, but it just makes sense mechanically, that creates nerve stress all the way down, if there is a nerve stress here, it's nerve stress all the way down the spine, so one of the things we need to do is to correct her neck curve. Okay, so the next thing is we're gonna look at her... These are motion studies, so these are the studies that we take where we tip the head forward and we tip the head back, or we need to see how every single vertebra is moving compared to the one above and the one below, so we need to figure out if she just needs some simple strengthening and exercises, or does she need actual structural rehabilitation because those ligaments and the muscles are stuck and holding it in place turns out because these are not moving, we can't see super well in this tiny view, but they're not moving super well, so we need actual structural rehabilitation for her.
So the next thing we're gonna look at is the side of the thoracic spine or the middle back, as you see, we're in thoracic parks, so we're honoring the thoracic spine, so we look at this and her thoracic spine, her side view, and it turns out her red line is pretty darn close to her, green line which is pretty cool at the top there, there's a little bit of what we call a dish, it's curving the wrong direction, so we need to correct that, but the overall shape is pretty darn close.
So that's pretty cool, that means two-thirds of our spine is in pretty good shape, but it turns out as we go to the next, view the side of her low back, we take these in sections because you can't accurately take the whole spine in one picture. So we look at this green line, and her red line is way behind the normal green line, especially at the very bottom there, that's called a retro list, this is to wanna geek out too much, but it means that that vertebra slid behind the normal compressing those nerves. So this is putting a lot of strain on her nervous system, we also see here all that, those black splotches, those are all fecal matter, she's backed up, 'cause their nervous system is under stress, not just her sciatic nerve, that's just where she feels the pain, but her nerves to her female organs, her colon, her bladder are all greatly affected by this, it's not just about pain, that's why we can't just medicate it, there's no medication you can take to correct this alignment, that's where we need to actually correct it. So now we're gonna look at her low back from the back, in other words.
So the right side is here, and the left side is there, so it turns out she actually has a short leg, and this is not something that's caused by her pelvis being twisted, her pelvis is not twisted, it's all lined up perfectly and we measure for that, but her leg is actually short, so as a result, her body has shifted over to the right, her red line and the low back is to the right of her, of her middle line, so we need to actually... She needs to wear a foot lift, unfortunately for the rest of her life. Now, if we catch this when she is before about 13 years old, we can often encourage that leg to grow out, it's like it's so so important to have your kids checked, but so right here, we see that that leg is actually shorter, so we need to shim that up or put a foot lift under there, there are a variety of ways that we do that, but we also need some specific exercises for this, so how are we gonna handle this case, so she's a fairly complex case, actually, I'm gonna show you this view from the full view of the side, so we see the green line is the normal line, and then her red line is where she is, so she's really far from normal, it's no wonder she has sciatic pain, headaches and other problems like this.
So we need to correct the whole thing, so people say, gosh, does everyone need three months of rehabilitative care? Not everyone does, but most people do we find because of text neck and car crashes and all these other problems that we have most people need some type of rehabilitation in order to permanently correct it, now people often get relief from one or two adjustments, which is awesome and very, very rewarding to deliver, but what we really need to do is to actually correct the structure in order to do this, so how are we gonna do this? We are going to eat.
Now, what does that mean? Mean that we're gonna go to cheeseburgers next door from the Hearth. No, it means we are going to exercise, adjust and traction. So what's gonna happen is she's gonna have some home, unless we've had people come here from across the country and even outside of the country for two weeks at a time where they're here four hours a day and they do work all day here, and we correct some amazingly abnormal structures during that time, but that means you gotta spend four hours here. So short of that people come in and they do things here, but they're gonna do things at home while they can 'cause that saves you a bunch of time and money. Not having to do everything here in the office.
So the first thing when people come in, after we do this very, very thorough analysis is they're gonna do specific exercises, so as you may remember, her neck curves backwards in the bottom there, so she's gonna have a rubber band strengthening exercise called a pro lordi, she's gonna strengthen by stretching her neck back and helping to bend her spine, we have to strengthen the muscles that create that curve. The second thing that happened, as you remember, is that her low back shifts or mid-back backwards, so she's gonna do exercises or she's gonna have her back on the wall. Excuse me, she's gonna... She's gonna face the wall and have a block down low at her pelvis, she's gonna shift her mid-back forward, if she's athletic enough, she's gonna do them both at the same time, but most people aren't, so they have to do those exercises separately, she's also... Because her low back, because of that short right leg, it shifts this way, she's had that for her whole life, we can't just put a lift in and have it be perfect if she were a little starting that, that's the case with a lot of the little kids that we see, that we just need to put the lift in and their body compensate so well, but she's also gonna have to shift her ribcage to the left here on block, so that's gonna have to shift over and bend and strengthen those muscles in the right planes, so those are just...
There's a million different exercises, but that's one example of the right exercises, the second thing is adjust. We're gonna specifically... We've already measured exactly what her alignment is like, Dr. Clare and I are gonna adjust her too without those vertebra even individual vertebra like the upper neck, the Atlas bone is the most important in the body, or C5 or C6 or T-10 or L5 in her case, is shifted backwards, we have to adjust a shift that forward, but it's not gonna hold permanently and in fact, it won't even move, we know from those x-rays where we tipped backwards that no matter what she does in strengthening or physical therapy or whatever, it's not gonna move her neck properly, so we have to adjust those right in the right plane in the right way, we get them adjusted, she warms up, does the exercises then she gets adjusted, and then we're gonna do traction in her case that's necessary. It's not necessary in everybody's case, but because she had 25 years of degeneration in her neck, we're gonna have a traction. Fortunately, we used to have to do these all three separately and people would have to spend a lot of time here, but her neck curve goes backward, so we're gonna have a strap or a pulley here on her neck and weight hanging off the back of her head.
She's most likely gonna be lying on her back, it depends on what she tolerates best, but she's gonna have a strap or pulley to increase that curve, she's gonna have her ribcage shifted forward on blocks because her ribcage shifts back and then she's gonna have a traction at that lowest L5, the one that shifted backward back there, it's about 8 millimeters, that's a lot, that's a lot of pressure on that nervous system, so she's gonna have a traction in that exact area that's gonna stretch that forward and traction that while we strap low on her femur, on her thigh bones so that her tailbone can correct to the proper pelvic tilt.
Now, it's very, very likely that she's gonna have that sciatic pain go away as we get this corrected, the pain may go away very, very early in her care program, but unless we actually correct it permanently, she's not gonna have a permanent resolution of her problem and how those other challenges go away with her health that come from the nervous system being under so much stress, so that's a common question we get is, what is sciatic pain? And it varies so widely from person to person, that's why I stated the art analysis, and not just having someone roll you around and crack your spine is not a very good idea, so you want... If you want the best then come see us, and again, if you live somewhere where we don't exist, we'll find the best doc for you, so thanks for listening and have an awesome day.