Sciatica

Sciatic pain is pain that shoots down the back of the leg. It is caused by an irritation to the sciatic nerve. This can be quite painful and unrelenting. Quite often this is due to a pinched nerve in the lower back and is accompanied by low back pain. The sciatic nerve is the largest nerve in the body and comes out of the spine from L4-S3.

What Causes Sciatica

Sciatic symptoms are mainly caused by irritation to the sciatic nerve. This does not necessarily  mean that the nerve is “pinched” just that there is an irritation in the form of compression, rubbing, inflammation or facial restrictions. True compression of the nerve can cause complete numbness in the foot and muscle loss in the leg. This is actually not as common as an irritation of the nerve. This causes more of hyperactivity of the nerve. This manifests as  tingling, pain, cramping and muscle fasciculation. Some patient also call any pain down the glute or leg region sciatica. This is not necessarily the case though.  Other problems such as dicogenic pain, trigger points, iliotibial band syndrome or even hamsting stains can cause similar symptoms.

  1. Nerve Root Irritation – Sometimes you can irritate a nerve without any severe pathologies. Muscle spasms or swelling can pinch the sciatic nerve and cause sciatica.
  2. Disc Bulges and Herniations – The cartilage between the lumbar vertebra can breakdown and bulge out toward the nerve and pinch it as it passes threw the spine.
  3. Arthritis – If the bones become arthritic than there is often bone spurs and increased tissue around the hole where the nerve passes through. This is called spinal stenosis.
  4. Piriformis Syndrome – On some people the sciatic nerve passes through a muscle in your glute region and can get pinched as it passes threw the belly of the muscle.
  5. Sacroiliac Joint Dysfunction.  – If there is a subluxation or injury to the tailbone area than there is a possiblity of nerve impingment at the tailbone region. The sciatic nerve does exit the tailbone as well as the lower back.
  6. Other Non musculoskeletal factors – On rare occasions, tumors, infections, artery and vein problems can pinch the sciatic nerve or mimic sciatic symptoms.

What does sciatica feel like?

The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:

1. Pain. Sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.

2. Numbness. Sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.
3. One-sided symptoms. Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg.1 Rarely, both legs may be affected together.
4. Posture induced symptoms. Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing. The symptoms may be relieved by walking or applying a heat pack over the rear pelvic region. Sometimes the pain will pull you off to one side. This is called an antalgic posture

Can Chiropractic Help?

Absolutely. Most causes of sciatica usual respond well to chiropractic care. This can depend on the severity and cause of the sciatica, but for the most part getting adjusted can really help out. Sciatica is something that does take time to treat. Typically we see people up to a month depending on how severe it is. We typically adjust the spine, use passive therapies and instruct light stretching during an acute bout of sciatica. Once the leg pain has subsided we can focus in on adjusting and core strengthening.

Will I need surgery?

Most cases of sciatic pain that come into our office do not require surgery. This can depend on what is actually causing the sciatic pain. Some large disc herniations just do not heal up enough that it relieves the pressure on the nerve. However, conservative care is always the best choice before jumping into surgery. Surgery is permanent and cannot be undone. If chiropractic treatment does not work there is always that option. Just remember that some cases can take a very long time to heal up if there is a large herniation. This does depend on what is irritation the nerve as well. Some cases will only take a week or two until the sciatic pain is relieved other cases can take months.