Sciatica can be a very painful and disabling problem. It involves pain in the leg, which is caused by irritation of the sciatic nerve, the largest nerve in the body.
The sciatic nerve is formed by lumbar (lower back) nerve roots, where the nerves emerge from the spine. These nerve roots join together at the sides of the spine to form the large unified bands, which are the right and left sciatic nerves. These nerves course downward from the lower back, through the buttocks, and into the thighs, each one eventually splitting into two major branches (the tibial nerve and the common peroneal nerve) just above the knee. These smaller nerve branches provide the nerve supply to the lower leg, which is essential for controlling the movement of the leg muscles. Sciatica can involve pain at any point along the course of the sciatic nerve and its branches, from the lower back to the tip of the big toe, but it most commonly refers to pain in the leg.
Though most nerves are threadlike in appearance, the sciatic nerve is more accurately visualized as a thick, smooth gray rope, often approaching an inch in diameter. The bulk of the nerve (and the many layers of nerve fibers within it) make it particularly susceptible to pressure and irritation.
Modern Medical, Osteopathic and Chiropractic Explanations of Sciatica
The current conventional understanding of sciatica is that it most frequently occurs as the result of pressure on nerve roots, due to a bulging or ruptured spinal disc. These discs are composed of a strong outer layer of circular fibers and an inner layer of a gel-like material. Spinal discs act as shock-absorbing cushions between the vertebrae (spinal bones).
If the outer fibers of a spinal disc give way due to a traumatic injury or long-term gradual weakening, the gel can slip out through the tear in the outer layer. In most instances, it remains connected to the main mass of gel in the disc (this is called a protrusion), but in other more severe cases, it breaks off (this is called a prolapse) to form a "free fragment." Protrusions and prolapses usually occur in the area of the nerve root. Because the root is exquisitely sensitive, this results in the classic sharp leg pain of sciatica. If a large disc rupture occurs, and a significant amount of the gel breaks loose, there may be no good alternative to back surgery. Fortunately, most cases of sciatica are less severe and can be treated less invasively.
Sciatica caused by mild to moderate disc bulges can be treated by chiropractors and osteopaths with specialized forms of traction (the McManis and Cox methods), spinal adjustments or manipulations, and stretching exercises for the lower back.
Sciatica-like leg pain can also come from spinal problems not directly related to the spinal discs. Spinal imbalances, which chiropractors call "subluxations" and osteopaths call "lesions," may involve the locking of joints (places where two bones meet) of the lumbar vertebrae or of the sacroiliac joints, located in the back of the pelvis. These are a common source of both lower back pain and the leg pain that sometimes accompanies it. Such subluxations and lesions are best treated with manual manipulation by a chiropractor or osteopath.
The Cayce Readings Approach to Sciatica
The Cayce readings that are related to sciatica are consistent with the modern health perspective, insofar as they demonstrate a recognition that the symptoms relate to nerve irritation in the lower back.
But the Cayce readings go further. They rarely conclude that the mechanical problems of spinal alignment, joint motion and nerve pressure are the whole story. Instead, they point toward potentially deeper levels of causation, particularly with regard to the organs of digestion, elimination, and circulation.
The Cayce health readings always evaluate the primary symptom (in this case sciatica) in relation to the rest of the body, with its many interdependent systems. Cayce's full-body, all-systems' approach is an excellent early example of holistic medicine. Readers of the Cayce material find that symptoms are never viewed in isolation, but rather as part of a whole system, which includes not only the entire body, but also the mind and spirit that infuse the body.
Commitment to Healing:Making a Choice
Before delving into Cayce's physical recommendations for the sciatica-sufferers who consulted him, its important to remember the underlying body-mind-spirit context of the readings. As Cayce said in reading 3138-1:
"...unless there is the determination in self, as well as those who may be necessary to make the applications for corrections with this body, we would not begin, but rather rely upon the sedatives ... [which] are not curative forces at all."
In other words, patients face a choice between suppressing their symptoms on the one hand, and, on the other, pursuing deeper levels of healing. Making this choice requires the individual to examine his or her goals. The Cayce readings are saying that unless these goals include a commitment to pursuing deeper levels of the healing process,suppressing the pain with medication may be all that can be hoped for. The readings by no means endorse such a course of action, but recognize that each individual has free will in this matter.
These deeper levels of healing may involve much more than the disappearance of a particular pain or malfunction, and the healing process may be demanding of both the patient and the doctor. In some of the cases in this file, the patient did not follow Cayce's recommendations, and in other cases the directions were followed only in part. Those cases in which the greatest success was achieved appear to have involved people who made a commitment to healing and then followed through.
Causes of Sciatica According to the Cayce Readings
The Cayce readings on sciatica refer consistently to three key causes of the condition:
- Injuries to the spine or spinal muscles
- Congestion in the colon (large intestine)
- A general condition of acidity in the body
Interestingly, the readings indicate that while a back strain or other back injury usually plays a role in the development of sciatica, it is not often the primary role. Instead, a more wide-ranging condition of acidity and toxicity is seen as the central cause. Cayce is saying that the sciatica stems from an overall imbalance in the body, which takes the form of a specific symptom (in this case sciatica) as the result of a particular injury sustained by the body. Reading 2516-2 states this concisely:
Q: What produced these poisons and nerve pressures in the first place?
A: Unbalanced condition and lack of proper eliminations.
Q: Is the condition due to an injury, a wrench in my back, which I received in the spring?
A: This, of course, only localized it.
In reading 404-12, the questioner asks why the colon affects the sciatic nerve. Cayce replies, "Because the nerves connect directly from one to the other!" Modern medical textbooks recognize this phenomenon, referring to it as the viscero-somatic reflex (viscera=internal organ, soma=body). Other examples of such reflexes occur when people with heart problems experience pain in their left arm, or people with gall bladder trouble have right shoulder pain. (It should be noted that most cases of left arm and right shoulder pain are not caused by the heart and gall bladder.)
Cayce's approach expands the conventional view of sciatica. The inclusive and holistic context mapped out by the Cayce readings is more akin to the approach of Eastern healing arts than of Western medicine.
Cayce Recommendations for Treatment of Sciatica
Among the physical treatments Cayce advised for sciatica are:
- a natural diet low to moderate in fat, including plenty of vegetables
- colonic irrigations
- spinal manipulation
- massage with oils including olive and peanut
- low-power electrical stimulation with the Wet Cell Appliance, which was used to electrically transmit gold chloride ions into the body
- external herb and mineral applications, including mullein, Glyco-Thymoline, and hot Epsom salts
- low-power electrical stimulation with the radio-active [radial] appliance
Massage, manipulation, the electrical therapies, and the external applications can be understood, for the most part, as methods of balancing the muscular, skeletal, and nervous systems. As such, Cayce's recommendation to use them is largely consistent with methods of healing widely accepted today in the health professions, though the form of electrical stimulation favored by the Cayce readings is of a different nature than the higher-intensity electrical therapies in common use today.
Where the Cayce readings differ most significantly from current conventional treatment is with regard to the emphasis they place on diet, and the roles of circulation and elimination. Most contemporary doctors who deal with sciatica consider diet, circulation, and elimination largely irrelevant. The Cayce readings, consistent with the osteopathy of Cayce's era, consider it to be crucial.
The readings assert that poor diet (high in fats, low in nutrients) creates a drag upon the overall system. This results in a buildup of toxins in the system, particularly in the colon. The levels of the spine that provide the nerve supply to the colon also supply the sciatic nerve.Nerve distress signals from the colon are transmitted to the spine at these levels, which in turn activates pain pathways in the sciatic nerve. This feedback loop goes in both directions, further reinforcing the vicious cycle.
Cayce's therapies seek to interrupt the cycle at several points along the way, through colonic irrigations to cleanse the colon of toxic matter, spinal manipulation to correct structural imbalances and normalize the nerve supply, massage to stimulate circulation and relax tense muscles, and electrical therapies to balance body energies. These, combined with a non-toxic natural diet, provide a program for both symptom relief and improved overall health.
[NOTE: The above commentary was written by Daniel Redwood, D.C. and is included in the Circulating File for Sciatica.]