Sciatica is a condition characterized by pain that originates in the low back or gluteal/buttocks that can travel into one or both legs. Sciatic nerve pain varies in intensity and frequency, from minimal to severe and occasional to constant.
Pain can be described as dull, achy, sharp and/or pins and needles (similar to electric shocks). Other symptoms that are associated with sciatic nerve irritation or injury include burning, numbness and tingling sensations.
Sciatica is also called radiating or referred pain, neuropathy or neuralgia. A misconception is that sciatica is a disorder—however, sciatica is really a symptom of a disorder.
Sciatica is generally caused by sciatic nerve compression. Disorders known to cause sciatic nerve pain include lumbar spine subluxations (misaligned vertebral bodies), herniated/bulging discs or slipped discs, pregnancy and associated childbirth, tumors and non-spinal disorders such as diabetes, constipation or even sitting too long on uneven surfaces. Further consideration would also be kidney diseases or urinary tract infections, which can give referred pain or even irritate the sciatic nerves. Laboratory testing or urine testing should be considered with persistent or intense pain.
One common cause of sciatica is known as piriformis syndrome. Piriformis syndrome is named for the piriformis muscle. The piriformis muscle is located in the lower part of the spine called the sacrum, connects to the femur (upper leg bone) and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle but in a small percentage (12%) of the population this nerve courses directly through the muscle. This muscle is susceptible to injury from trauma, hip arthritis or even a difference in leg length. Such situations can cause cramping and spasm to develop in the piriformis muscle, thereby pinching the sciatic nerve and causing inflammation and pain. Sciatic nerve compression may result in the loss of feeling or function of the affected leg muscles.
Since there are many disorders that cause sciatica, the chiropractor’s first step is to determine what is causing the patient’s sciatica. Reaching a diagnosis involves a thorough review of the patient’s medical history and both a physical and neurological examination. Diagnostic testing that may be ordered, as needed, include X-rays, MRI, CT scan and/or electro-diagnostic tests for nerve conduction.
The purpose of chiropractic treatment is to help the body’s potential to heal itself. It is based on the scientific principle that restricted spinal movement leads to pain and reduced function and performance. Chiropractic care is non-invasive (i.e. non-surgical) and drug-free.
The type of chiropractic therapy provided depends on a number of factors, including the cause of the patient’s sciatica. A sciatica treatment plan may include several different treatments: spinal adjustments/manipulation or a variety of non-manipulative modalities.