Sciatica

The Sciatic Nerve


The sciatic nerve which runs from the lower back, through the buttock and into the lower leg, is the longest and widest nerve in the body.  It controls the muscles of the lower leg and provides sensation to the thighs, knees, calves, ankles, and the soles of the feet.


What is Sciatica?


Back pain is the initial stage of a Sciatic condition.  Once the swelling of the spinal joint tissue sets in, the next stage is swelling of the large sciatic nerve, known as Sciatica.


Although sciatica is a relatively common form of low back and leg pain, the true meaning of the term is often misunderstood.  Sciatica is actually a set of symptoms not a diagnosis for what is irritating the nerve root and causing the pain.


Pain is described as dull, achy, sharp, toothache-like, pins and needles or similar to electric shocks.  Other symptoms associated with sciatica include burning, numbness and tingling sensations.  Sciatica is also called radiating or referred pain, neuropathy, or neuralgia.


Sciatica occurs most frequently in people between the ages of 30 and 50 years old.  Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.


The quality of Sciatic pain may vary from constant pain to pain that may let up for hours or even days.  The intensity may also vary.  It may ache, or be knife-like.


Postural movements like lying down or changing positions may also affect the pain, causing a toothache or earache like symptom, always there no matter what you do.


In severe cases, sciatica causes a loss of reflexes or even a shrinking of the calf and or thigh muscles.


Causes of Sciatica


Inflammation of the sciatic nerve in the lower back (lumbar region) due to a herniated or ruptured disc is one of the most common causes of Sciatica.  Located between each vertebra are spinal discs that are shock-absorbing cushions. They have a stronger outer ring and a soft jelly-like center that help to keep our spine flexible.  As we age spinal discs can deteriorate, becoming drier, flatter, and more brittle.  The outer covering may develop tiny tears, which allow the jelly-like substance to seep out (rupture or herniation) and the herniated disc may then press on the nerve root, causing sciatic symptoms such as pain, tingling, and weakness in the legs and feet.  Nerve roots may also be irritated by the chemicals found in the discs’ nucleus.


Other conditions can also put pressure on the nerve, including:


  • Spinal stenosis – A narrowing of the spinal canal, which places pressure on the spinal cord or the nerve roots.
  • Degenerative disc disease – A common part of the aging process, leading to a change in the disc shape and function, which can result in disc herniation or pain.
  • Pregnancy – Extra weight and pressure on the spine can compress the sciatic nerve.
  • Trauma – A fall, car accident, or other trauma can injure the nerve roots.
  • Piriformis syndrome – Spasm of the piriformis muscle can compress the sciatic nerve.
  • Spondylolisthesis – When a vertebra slips forward over another vertebra, the slip can pinch the nerve root.
  • Spinal tumors or infections – Very rare, but both can compress the sciatic nerve.


In rare cases, a herniated disc may press on nerves that cause you to lose control of bladder or bowel functions.  This is an emergency situation and requires an immediate call to your doctor.


Chiropractic Treatment Plan for Sciatica


For most people, sciatica responds very well to conservative care, including chiropractic.  Because sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.  The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation.


Chiropractic treatment of Sciatic is designed to treat the cause of the pain and may include a combination of spinal manipulation, ice/heat therapy, interferential muscle stimulation (IFC), rehabilitative exercises, and low level light therapy (LLLT).


Treating the subluxations of the spine may be the most effective ways to treat the symptoms of sciatica, and the other treatment options can help to restore healthy nerve functioning over time.


Chiropractic spinal manipulation is proven to be effective and has minimal side effects.  Practice guidelines published in the Annals of Internal Medicine (2007) stress a conservative approach to treating low-back pain and recommended spinal manipulation as one treatment with proven benefits.  Unless advised otherwise by your doctor of chiropractic, remain active and avoid prolonged bed rest.  In the long run, inactivity can make your symptoms worse, whereas regular exercise has been shown to reduce the intensity of pain associated with sciatica.  Fortunately, 80 to 90 percent of patients with sciatica will recover without surgery.


If you suffer from sciatica, call us for an evaluation appointment to see what chiropractic can do for you.