Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.
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. The actual cause of Sciatica can be one of many things, or a combination of things. Disc herniations, vertebral joint facet impingement (subluxation), piriformis muscle syndrome, to name a few, can all cause the symptoms of Sciatica. When treating Sciatica, it is most important to find the cause of the pain (symptom), and not just treat the pain(symptom) itself.
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.
What are the symptoms of sciatica? The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.
Some patients also report:
- A pins-and-needles sensation, most often in the toes or foot
- Numbness or muscle weakness in the affected leg or foot
Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.
How is sciatica diagnosed? Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.
In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.
What are my treatment options? For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.
Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, myofascial treatments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises. An Ounce of Prevention Is Worth a Pound of Cure While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.
- Maintain a healthy diet and weight
- Exercise regularly
- Maintain proper posture
- Avoid prolonged inactivity or bed rest
- If you smoke, seek help to quit
- Use good body mechanics when lifting