Throughout episode 7, scoliosis and sciatica, CLEAR-certified Dr. J Hartley answers common questions and shares his experience with treating the conditions.
Questions and topics discussed during the episode include:
Scoliosis, in and of itself, is a complex and confusing condition. When you add the pain associated with sciatica on top of an already complex condition, it can be frustrating, aggravating, and uncomfortable. If you find yourself struggling with this, know that there are steps you can take to proactively treat the cause of your sciatica and treat your scoliosis at the same time.
We hope you'll tune in to learn more. Enjoy the show!
Learn more by reading Dr. Hartley's blog article on The Relationship Between Scoliosis and Sciatica.
If you have questions or topics you would like us to cover on a future episode of Life Beyond the Curve, please leave us a comment below.
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Hello Life Beyond the Curve listeners. I'm Ashley Brewer, Executive Director of CLEAR Scoliosis Institute, and I'm going to keep this intro short and sweet because I don't have much of a voice today. But I'm excited for you to hear Episode Seven, Scoliosis and Sciatica. When I recorded this episode with Dr. J Hartley from St. Augustine, Florida, he said his favorite part about being a chiropractor is hearing the patient success stories. Today, you'll hear some of those stories and if scoliosis and sciatica is something you're struggling with, you'll learn some important steps to take. Episode seven, here we go!
You're listening to Life Beyond the Curve, a podcast brought to you by CLEAR Scoliosis Institute. Each week, we interview experts in the industry, answer your pressing questions, and empower you to take control of your scoliosis diagnosis and live life to its fullest. Enjoy the show.
Alright, so Dr. Hartley, welcome back to Life Beyond the Curve. We are so glad to have you again today.
Good morning, Ashley. Glad to be here!
So, Dr. Hartley, now you actually have a diplomat in Chiropractic Neurology, which makes you a great person to discuss our topic for today because it verily very heavily involves the central nervous system. So today's topic is scoliosis and sciatica also known as sciatic nerve pain. Before we start talking about just the relationship between these two things, I'd like to hear you, in your own words, just define both of those terms. So what is scoliosis and what is sciatica?
Well, sciatica itself is an inflammation of the sciatic nerve, which is some nerves that come out of the low part of the back. And they typically are motor nerves going down the back of the leg, but there's a description of sciatica that's more like a, a slipped disc, meaning slipped disc is something some people say, but it's just doesn't really exist, right? So sciatica describes more of a clinical picture and that clinical picture is usually pain down the back of the leg. And it may also be associated with numbness, and if it gets severe enough, the person may actually also have weakness. But the thing people will say is it's almost like they have a toothache, um, you know, or a pinching behind the leg that just won't go away, just like a nagging, um, pain. And sometimes it can be severe where the person's antalgic and they have that pain going down the leg, or it's just more chronic where it's almost like a bee sting or a toothache just in the back leg that just won't go away.
Well, that sounds pretty miserable. I don't even like toothaches, I can't imagine something like that going on in, in my legs. So, um, now scoliosis, obviously something we've talked about before, but I'd like you to define scoliosis for me as well, too, before we jump into the relationship between the two.
Sure. So if you're looking at somebody's spine straight on and you notice that they have a curve, the top vertebra and the bottom vertebra, if you measured the steepest part of their angles and where those two lines intersect, do you make a 90 degree? And that is going to be a 10 degree curve or more, and scoliosis can be defined as mild, moderate, or severe. Ten degrees to 25 is mild, 25 to 40 is moderate, 40 and above is severe. And there's also a rotational component. So you'll also see a twisting of the vertebra at the same time. So you'll have to have those two components, the tilting and the twisting.
That makes sense. Now, when we look at, uh, scoliosis and sciatica, what is the relationship between those two, and does everyone with scoliosis experience sciatica?
Yeah, so it's very interesting. So when we do our exam and somebody's complaining of sciatica complaints, there's some standard orthopedic test that we look for somebody that just has sciatica, whether they have scoliosis or not. And those would be like the straight leg raiser, where somebody's sitting, we straighten her leg, or if they're laying on their back, we straighten the leg and then see how far we can bring it toward their head. And that may or may not produce pain. If, if in tractioning the sciatic nerve, there's an increase in pain, that's one of the ways we look to see if the person has sciatica. And what we find is that with scoliosis patients, a lot of times we do those orthopedic tests that would normally be positive for sciatica, but they're not positive. And so when we find that those orthopedic tests are negative, but they have sciatic symptoms and then we do the scoliosis exam and we see they have scoliosis, in my experience that pain is more related to the scoliosis than a true sciatica.
That's interesting. So you, they are experiencing the pain, they're experiencing the symptoms, but the orthopedic tests that you're doing are coming back negative. Correct. Interesting. So we talked a little bit about the symptoms. I mean, you compared sciatica to a really bad toothache, going down your back in your leg. Let's dig just a little bit more into that symptomatically. What are some other things that someone with sciatica specifically related to scoliosis as well may be experiencing?
Well, it's going to affect the way you, you know, you walk, it's going to affect your pelvic alignment. So you're going to tend to have more hip problems, knee problems. If it gets bad enough, they may start to experience weakness in the foot or foot drop. They may have numbness in the toes or the feet or numbness progressing down the back of the leg.
So when they have that, yeah, yeah, no, when they have that going on and they also have scoliosis, obviously, which is something that you specialize in, what is the recommended treatment approach?
Okay. So when we find, if we feel that it's just pure sciatica and not related to scoliosis, it's really more of a traditional chiropractic approach where we may be doing, um, traction to offload the nerve, we may be doing some muscle work, adjustments, ice, and that relieves the nerve. And usually the sciatic gets better. So we still see non scoliosis patients that that will work for, if it seems to be coming from the scoliosis, then the approach is to directly work on stabilizing and reducing the scoliosis. And what we find is that then the referral of the pain to the leg decreases. So it's really amazing. So when we do the corrective traction, the Eckard table, the scoliosis traction chair, we do the specific exercises, which are training the brain to hold the spine in a better position. If it's a severe case, we may do, um, ScoliBrace, which is a specific scoliosis brace that we use. We find that those things are very good at reducing the symptoms of sciatica caused by scoliosis.
All right, now I feel like we need to back up a little bit, cause I think, I feel like I missed something here, just in talking to you about this topic in general. You see patients of all ages in your clinic. Is sciatica with scoliosis, more common in kids or adults, or when do you typically see this happening?
So kids with scoliosis usually, um, the care is more preventative. So the school nurse or the pediatrician, or the parent may know a rep--may, may notice a rib arch developing or an abnormal posture. And then, um, they may go to a children's hospital. They may recommend bracing or surgery. Then the parent may be looking for an alternative, but the care is more cosmetic and preventative in children. It would be very rare for a child to have scoliosis, although, because scoliosis is, you know, an indication of instability in the spine, in my experience, kids with scoliosis tend to have more symptoms. I mean, no kids should have any symptoms, but it would be rare for a child to have scoliosis and sciatica. Usually they're not going to have sciatica. In an adult, it usually happens just the opposite. The patient has symptoms. They go get an x-ray, then all of a sudden they realize that they have scoliosis or their scoliosis has gotten worse. So the adults with scoliosis, usually they're getting older. So, you know, um, usually late fifties, early sixties, you know, up into their eighties and nineties, that they're, have this relationship between the scoliosis and the sciatica.
So is it safe to say then that it appears to have something to do with just the aging process?
Well, a lot of patients, um, as they get older, they develop some instability in the spine, the scoliosis. So it's called a lateral listhesis, the bone kind of shifts sideways in the lower lumbar spine. And then they just get a lot more stress on the lower back. And so those sciatic nerves starting start to be affected and, so it's like a car, if you drive a car and it's out of alignment, the tires are gonna wear unevenly. And so it's just a process that kind of catches up with the person, but they may or may not even know that they have scoliosis, they get the leg pain, then they go get an x-ray and then they find out they have the scoliosis where with the kids, um, somebody notices the postural change, then they get the x-ray, so it's much more symptomatic in, uh, older adults.
Now you have a bit of an interesting perspective when it comes to scoliosis because you, and then a couple of your family members have scoliosis as well. So is sciatica something that any of you have personal experience with?
Fortunately not.
Well, that's good. That's great news. I didn't know how you were going to answer that question and that that's good news for you, I guess. So, um, you know, one of my favorite parts we were talking before we started recording the show here, but just when I worked in a chiropractic clinic was hearing the stories. And you said the same thing that you just love seeing the results that your patients get. You love hearing the stories. And so part of Life Beyond the Curve is sharing real life success stories with people so that we can hopefully provide them with hope that there are alternative ways to treat scoliosis. So I want to talk about, um, some of your patients or one or two of them that have come in with sciatica and had just a transformation and kind of what that process looked like in your office. So if you can share with me, I'd love to hear stories.
Yeah. So one thing that's very common is the person with scoliosis thinks that they have sciatica, like the traditional type of sciatica and there'll be putting ice packs on their leg, um, trying to make their leg feel better and they'll try a bunch of different things, injections. And when we start to work on the scoliosis, the leg pain goes way, and that's awesome. And we have a one that's on our, uh, we have a video testimonial from a patient Fay, who had sciatica and foot drop. And within a few weeks she did the intensive care and did the ScoliBrace and within a week or so, her foot drop went away, and then her sciatica went away. And it's really interesting because when she kept up with her home exercise and bracing, even though she spends half the year in New York, we went almost a year without seeing her, and
Our symptoms stayed gone even with her working on her brace and exercises. So she goes to New York the next summer and forgets her spinal waiting and her brace. And she gets up there and she's like try some different things, but eventually the symptoms come back and they start getting worse. And then she comes back to Florida and we get her back on the exercises and her bracing and adjustments and the symptoms went back away. So she actually did a followup testimonial telling patients, look, you have to do your exercises and wear your brace, you know? Um, and so you can see people that really make big changes. We had another patient who had a degenerative adult scoliosis, and they were only able to do about 10 minutes of yard work, washing the car and things like that at a time. And then they had to sit down, Oh, wow.
They went through our intensive care and with utilizing the brace and keeping up with the home exercises and scoliosis traction chair, they now will do two or three hours of yard work, um, without any symptoms. From 10 minutes to three hours, that was pretty good. Um, I can think of another person who they're, they're really thing is they wanted to, we're near the beach. And so they wanted to be able to walk on the beach and they were only able to walk about a hundred feet before the sciatica started developing down the leg. And once they got the ScoliBrace and went through the intensive care, they were able to get back to walking, um, you know, a couple of miles on the beach every morning, um, without any symptoms.
Now I want to go back to something that you said when you were talking about Fay's story, um, because you mentioned something that actually strikes super close to home with me, which is foot drop. Um, I was actually diagnosed with foot drop when I was only 14 years old. And so for some of our listeners, they might not exactly understand what this is, but for me, um, being a 14 year old and I had an underlying neurological condition that I wasn't aware of, but I was a cross country runner. And because of my foot drop, I kept tripping while I was running cross country. Which if you can imagine being 14 years old and tripping in front of all of your friends, that's like super cool, right? Not at all. Um, it was terrible, but just hearing that, that you did you say that went away after just a week of care in your office for Fay? Yes. That is remarkable. Um, because for our listeners who don't know, like having personally had it, I was walking toe heel instead of heel toe, which was causing me to trip all the time. And it's such a nuisance. So just hearing that a week of care in your office was able to make that go away for her. I can not imagine how different her life was having experienced that. So that's awesome. Do you see things like that in your office often?
Yeah. I mean, foot drop is a more complicated situation. Um, you know, some people get surgery to get a disc repaired, to remove the pinched nerve for foot drop. Um, in my experience, some people actually get foot drop from lower back surgery. So when you see somebody walking and they're dragging one foot, usually they've either had a stroke, they've had low back surgery and a damage to the nerve, or they have a damaged disc and they just didn't do anything about it. So, um, we see, uh, probably about 75% of people that I've seen with foot drop. It is, it is resolved and it is something we have to monitor closely, because sometimes those people do end needing surgery. But, um, the thing about it is even if you talk to a surgeon, if you have foot drop and then you have surgery, it doesn't mean the foot drop's is going to go away because that nerve is, is being damaged. And when you repair the disc, it doesn't mean the nerve is better. Um,
Yeah. And I think that like what you're talking about there, just because you have surgery doesn't mean it's going to get better. That's kind of why this show exists. Like we want people to know that there are alternative options to treating things like scoliosis, like sciatica. Um, and that's, we just want to provide a message of hope to our listeners. And so knowing that and kind of hearing that, if we have a listener today who is experiencing sciatica, whether alone or as a result of scoliosis, if you had just one piece of advice for our listeners like that, what would that be?
Well, I would go on the CLEAR website and find a CLEAR doctor. Um, they are trained to do a very specific exam and determine whether they think they would be able to help to get that pressure off the nerve. Um, and if they think they can help you, they will let you know, if they think you need to get a surgical consult, they'll let you know that, too.
Awesome, Dr. Hartley. So any closing thoughts on this topic or any things you want to wrap up on this topic for our listeners today?
I think the biggest thing with scoliosis and sciatica is things may not appear as they feel, okay? You know, you're running around with a icy hot patch on the back of your leg, an ice pack on the back of your leg. Um, when it's actually higher up in your nervous system, that's causing the problem to occur. And so, um, unless you get the scoliosis, the brain and the spinal cord working better, then the sciatica is just going to keep coming back.
I think that speaks to just the importance of getting checked out by a professional because just me as a human being, if my leg hurts, I tend to think it's a leg problem. And from what I'm hearing from you, that's not always the case. So I think that is phenomenal advice. And I'm very glad that you were able to join us again on another episode. And we hope to have you again in the future.
Thanks, Ashley.
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