Sciatica is associated with pain, numbness, and muscle weakness. The sciatic nerve is the longest and largest of all the body’s nerves. It runs from the spinal column near the pelvis down each leg and can be as wide as your thumb. Each sciatic nerve is made up of five smaller nerves that branch into the thigh, knee, calf, ankle, and foot. Sciatica occurs when this nerve is compressed, irritated, or inflamed.
The term “sciatica” refers to the inflammation of this nerve and the pain that radiates along its course. Sciatica may feel like a leg cramp or as a numbness, burning or a pins-and-needles sensation.
Although sciatic pain is generally in the legs, patients should understand that the root cause is often compression of the sciatic nerve root, which is the beginning of the sciatic nerve as it exits the spinal cord in the low back. Nerve root compression results from two conditions: vertebral subluxation (misalignment of spinal bone) or sacroiliac subluxation (misalignment of pelvic bones.) When the spinal or pelvic bones are even slightly out of place, spinal movement is restricted, which in turn irritates the muscles, discs and the nerve root – causing pain.
Sciatica is most commonly a result of a misaligned lower spine that is pinching the root of the sciatic nerve. This subluxation can apply a good deal of pressure on the sciatic nerve and cause severe pain. A pelvic mis-alignment could put the gluteal muscles under duress and the sciatic nerve will be pinched as it passes through the buttocks. Piriformis syndrome is inflammation of the piriformis muscle in the buttocks. A slipped or herniated disc is another cause of sciatica and is usually a result of trauma from a fall or accident. Standing, sitting, walking, running, heavy lifting, bending, twisting, or even sneezing can bring on symptoms.
One analysis followed 44 patients with acute low-back pain and sciatica, which impeded them from working. All the study participants were evaluated by orthopedic surgeons and underwent X-rays, computerized tomography (CT) and magnetic resonance imaging (MRI). No pathology was found and medical doctors could not determine the cause of the patients’ discomfort.
Next, the patients received a chiropractic examination. All were determined to have a vertebral subluxation involving the spine of the low back. They also suffered from sacroiliac subluxations. Each patient then received chiropractic care.
According to the study results, “All but two patients returned to work. The period of sick leave among the patients was reduced by two thirds as compared with that associated with conventional medical treatment.” (Journal of Manipulative Physiological Therapeutics 2007;30:135-9)
Spinal discs, which are sandwiched between each vertebra, can also put pressure on the sciatic nerve root.
The intervertebral (between vertebrae) discs give the spine its flexibility and act as shock absorbers between each of the 24 spinal bones. The outer layer of each disc is tough and fibrous, while the inside material is spongy.
If discs degenerate or are subject to trauma, the soft center may bulge to one side. This condition is knows as a herniated disc.
Sciatica ensues as the nerve root becomes trapped against the spinal canal by the disc bulge.
The piriformis muscles extend along both sides of the lower buttocks. Sciatic nerves travel beneath the piriformis muscle on their way from the spine to the back of each leg.
Piriformis syndrome occurs when the muscle becomes inflamed, forcing pressure on the sciatic nerve and trapping it against the bones of the pelvis.
One case study conducted by researchers at the University of Quebec looked at a 19-year-old patient who developed piriformis syndrome and sciatica following a football injury. He received chiropractic care for three months, during which time his condition completely resolved. He remained pain-free five months later (Journal of Manipulative Physiological Therapeutics 2006; 29:486-91)
What doesn’t work?
Traditional medical care for sciatica relief involves bed rest and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as prescription painkillers or over-the-counter drugs like Advil or Aleve. These drugs may seem harmless, but overuse is linked to gastrointestinal problems, heartburn, ulcers, chronic headaches and migraines. And in the end, these drugs don’t cure sciatica.
My job as a chiropractor is to find the source of the nerve blockage and use manual adjustments to correct the spinal misalignment. The adjustments are designed to remove the blockage that is pinching the sciatic nerve and causing the pain. Ultrasound and ice therapies are also used to relieve the symptoms of sciatica. As I mentioned before, pain medications merely mask the symptoms and never heal the cause, and surgery should always be the last resort. In most cases of patients who have received spinal manipulations, x-rays taken after sciatica treatment have shown improvement in the spinal alignment as well as a reduction of symptoms.
Many times people with sciatica wait until the pain becomes unbearable before they contact my office, but waiting can cause long-term damage. It is important that you contact us when the pain originally begins. The good news is that research shows that chiropractic care alleviates common causes of sciatic pain. A number of sciatica treatments can be prescribed to help with your sciatica.
The first thing I will do is review your complete medical history to determine when the problem began and the possible causes. Then a complete physical and chiropractic exam is performed, and x-rays may be taken. I will then review and discuss the results with you and make recommendations for sciatica treatment.
Pain is the body’s way of signaling distress; let us help you pinpoint the cause.