Is Sciatica Getting on Your Nerves?

What is Sciatica?

First things first: Sciatica is a symptom, not a diagnosis! It is a sign of another medical problem, not one on its own! This point is important, because treatment for sciatica or sciatic symptoms often differs depending upon the underlying cause of the symptoms and pain levels.

Sciatica occurs when the sciatic nerve roots are inflamed, irritated, stretched or compressed. Inflammation of this nerve can cause extreme pain. The pain can affect any or all of the regions that the sciatic nerve travels – so, your lower back, hips, legs, and/or feet can be affected. The pain will be different depending on where the nerve irritation occurs.  In addition to pain, there may be numbness, muscular weakness, pins and needles or tingling, and/or difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body, but, on the rare occasion, it can be a bilateral problem.

How can I tell if I have Sciatica?

Sciatic pain can vary widely. It may feel like a mild tingling, dull ache, or a burning sensation. In some cases, the pain is severe enough to make a person unable to move. If you are pregnant, the weight of your growing baby can put pressure on the lumbosacral plexus, which includes those nerves that make up the sciatic nerve, and cause sciatic symptoms. 

One or more of the following sensations may occur:

   -pain in the buttocks and/or leg that is worse when sitting

   -burning or tingling down the leg

   -weakness, numbness or difficulty moving the leg

   -a constant pain in the buttocks

   -a shooting pain that makes it difficult to stand up

Depending on the cause, the pain may get worse when moving from a standing position to a seated one, and vice versa. As well, coughing, sneezing, and laughing can intensify the symptoms.

Sciatica is a common symptom of spinal dysfunction and can be very painful. If left untreated, sciatica may get worse. In the cases where sciatica will improve on its own (pseudosciatica – see below), there is a very high risk that these symptoms will reoccur. 

A Closer Look at the Sciatic Nerve:

The sciatic nerve is made up of five spinal nerve roots (namely, levels L4 through S3) that exit from your lower back, join in your pelvis to form the combined sciatic nerve, and then continue to your thigh, knee, ankle, and end in your foot. This nerve supplies nearly the whole of the skin of the leg, the muscles of the back of the thigh, and those of the leg and the foot. Your two sciatic nerves (running the length of each leg) are the longest and largest nerves in your body.

How do you get Sciatica?

Sciatica is generally caused by the compression of the nerves that make up the sciatic nerve, or by compression of the sciatic nerve itself. There are a number of reasons why these nerves could be compressed – here is a short list of the more common causes:

   Lumbar disc herniation

   Spinal Stenosis

   Piriformis Syndrome

   Disc and/or Bony Degeneration (Osteoarthritis)

   Spondylolisthesis

   Pelvic Injury of Fracture

   Tumors

If you’ve suffered an accident, the reason for your sciatica may be more obvious; however, it can also result from a series of small “injuries” or cumulative stress and degeneration – an unfortunate part of getting older! Poor posture, excessive weight, lack of muscle tone, or other physical chemical, or emotional stresses can all lead to an unhealthy spine and sciatica.

Pseudosciatica causes symptoms similar to nerve root compression, and is mostly a referred pain from damage to spinal joints in the lower back. This type of sciatica rarely causes symptoms below the knee, and is most commonly felt in the low back, buttocks, and back of the thigh. Pseudosciatic pain can also be caused by compression of the nerve as it courses through the buttocks, most often due to tension in the muscles of this area.

How Can a Chiropractor Help?

Proper treatment of any condition involves treating the cause, not just the symptoms. Chiropractors are uniquely trained to diagnose and treat your sciatica. A chiropractor will review your health history and complete a full physical and neurological examination in order to diagnose where the sciatica is coming from – as I mentioned earlier, sciatica is NOT a diagnosis on it’s own! It is not uncommon for further diagnostic testing to be considered, such as an x-ray, MRI, CT scan and/or electrodiagnostic tests.

Many patients are prescribed bed rest or pain killers for their sciatica by their medical doctors. Although pain control medications may be useful at first, bed rest is usually not – it has been proven ineffective and may actually aggravate your condition. Pain killers will mask your pain, but fail to target the root of the problem. Chiropractic offers safe, effective treatment for sciatica, without the use of drugs or surgery. The treatment approach will differ depending on the cause of the sciatica. A chiropractic treatment plan for sciatic pain may include several different therapies, including:

Ice/Cryotherapy - reduces inflammation and helps to control sciatic pain.

Ultrasound  - gentle heat is created by sound waves that penetrates deep into tissues. Ultrasound increases circulation and helps to reduce muscle spasms, cramping, swelling, stiffness, and pain.

TENS unit (transcutaneous electrical nerve stimulation) - is a small box-like, battery-powered, portable muscle stimulating machine. Variable intensities of electrical current control acute pain and reduce muscle spasms. Larger versions of the home-use TENS units are used by chiropractors, physical therapists and other rehab professionals.

Adjustments (Spinal Manipulation) -  the core of chiropractic care! Manipulation frees restricted movement of the spine and helps to restore misaligned vertebral bodies to their proper position in the spinal column. Spinal adjustment helps to reduce nerve irritability responsible for causing inflammation, muscle spasm, pain, and other symptoms related to sciatica. Spinal manipulation is proven to be safe and effective for many conditions causing sciatica.

Chiropractic's Limitations:

Sciatica can be caused by other disorders beyond the scope of chiropractic practice, such as spinal tumors. If your chiropractor determines that the cause of your sciatica requires evaluation or treatment by another type of doctor, then the patient is referred to another specialty. In some cases, the referring chiropractor may continue to treat the patient and co-manage the patient's care with the specialist.