Physical Therapy in Atlanta

1. Atlanta Physical Therapy Sciatica is the most common problem I treat, all day long, every day, since 1987. That’s 35 years of treating sciatica. I have seen many treatments for it over all those years, and the most effective, fastest, and longest lasting treatment for sciatica is traction, but nowadays we have more sophisticated tables for this purpose, which we call spinal decompression. The reason that spinal decompression works the best for sciatica is because sciatica is almost always caused by a disc bulge or herniation that puts pressure on the sciatic nerve. And the only treatment that will make the pain better is to get the pressure off of the sciatic nerve root that is being pinched. That means you have two entities, the nerve and the disc which are pushed together, and only getting those two entities away from each other will relieve the pain lastingly. To get a better mental picture of what is going on, imagine a nerve next to a jelly donut. Compressing the donut more, will make the disc bulge out more and put more pressure on the adjacent nerve root. You can find plenty of images on the internet showing you what happens. So you must use a treatment that reduces the pressure on the disc, so that the jelly goes back, away from the nerve, in order to get relief. No treatment which fails to get pressure off of the nerve root will provide relief. In truth, there is also an inflammatory component to the pain, but that subsides when you get the pressure off of the nerve. You don’t have to get all the pressure off the nerve in order to get relief, but you have to get almost all the pressure off the nerve to feel better. The body also has a tendency to improve with time, but that time can be very long and the pain can be incapacitating until, and if,

2. it improves. Sometimes a cortisone injection will help and can be a blessing, but I only refer about 5% of patients for epidural steroid injections, because most people will improve with spinal decompression treatment, which, in my view, is preferable as treatment, since it only helps by improving the anatomical problem, hence the consequent inflammation. 80% of patients will improve with the first treatment, but a series of treatments is necessary. The number of treatments will usually vary from 6 to 20 treatments, over 2 to 8 weeks. Rarely, one or two treatments will suffice. Also, rarely, more than 20 treatments are necessary.

3. When you experience sciatica, it is usually the endpoint of many years of slowly, progressive, degenerative changes to your disc, and it finally herniated or bulged out far enough to put pressure on your nerve. The cause of the pain was only a very small incremental change in your disc. Accordingly, it only requires a small incremental improvement in the anatomy of your disc in order to feel relief. Usually, we ignore our spines and give them little thought until they give us grief. I understand why. I have a spine too, so I understand if it doesn’t bother me, I don’t bother it. But when you finally have your episode of sciatica or back or neck pain, you should be patient with improving a problem that took decades to finally occur. Patients ask many questions about sciatica and I love answering these questions because it makes me a better doctor. I also understand that sciatica is not a common experience for patients and the pain can be so severe that patients feel as though it is a dangerous problem. That is because our brains are hardwired to construe severe and incapacitating pain as a threat to our survival, as it was prehistorically when incapacity might make you prey to a lion. But nowadays, sciatica is well understood and almost always treated, effectively, without surgery or injections. If you are looking for sciatica pain relief ASAP, call me at 404- 558-4015. To learn more, you can go to backstrong.net or go to my YouTube channel by searching for Dr. Castanet.