The sciatic nerve is the longest nerve in the body. It runs from the pelvis through the hip area and buttocks and then courses down the back of each leg. The term “sciatica” refers to the inflammation of this nerve and the pain that radiated along its course. Sciatica may feel like a leg cramp or as numbness, burning or a pins-and-needles sensation. Sciatic pain can also be a excruciatingly piercing or stabbing pain.
The Root of the Problem
Although sciatic pain is generally in the legs, I want my patients to 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 is frequently the result of one of three conditions: vertebral subluxation (misalignment of the spinal bones) or sacroiliac subluxation (misalignment of the pelvic bones), or lumbar spinal stenosis which is a narrowing of the spinal canal in the lower back and is less common. 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.
The other two main causes of sciatic nerve compression are herniated spinal discs and piriformis syndrome (inflammation of the piriformis muscle in the buttocks). Often, more than one of these situations or conditions can occur simultaneously, so it is vital to identify and address all factors contributing to the pain. The good news is that research shows that chiropractic care, like that provided by me, alleviates all of the common causes of sciatic pain.
Vertebral Subluxations and Sacroiliac Subluxations
Doctors of chiropractic correct both vertebral and sacroiliac subluxations with chiropractic adjustments. These maneuvers, which are safe and effective, successfully realign spinal and pelvic bones. 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. 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 to with that associated conventional medical treatment.” (J Manipulative Physiol Ther 2007; 30:135-9).
Another study enrolled 2,945 patients with sciatica and low back pain, of which 268 patients suffered chronic low back pain and radiating pain below the knee. Patients received either medical care or chiropractic care for the correction of vertebral and sacroiliac subluxations. Researchers assessed the participants’ satisfaction with care and low back status via multiple questionnaires at various intervals. Patients with chronic low back pain and radiating pain below the knee “noted a long-term outcome advantage” from chiropractic care that they didn’t get with medical care.
Over 55% of the chiropractic group employed strategies, such as exercise and self-care education, to reduce symptoms, whereas, the medical care group was far more likely to choose bed rest. J Manipulative Physiol Ther 2001;24:543-51).
Spinal discs, which are sandwiched between vertebrae, 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 known as a herniated disc.
Sciatica ensues as the nerve root becomes entrapped against the spinal cord by the disc bulge. The good news is that research shows that chiropractic care can help sciatica caused by “slipped or prolapsed discs. The good news is that Chiropractic care has shown to be highly effective in treating herniated discs, reducing pain, improving range of motion and getting patients back to work faster than if they had received medical care.
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. Doctors of chiropractic often employ a variety of all-natural interventions for piriformis syndrome. This combination approach is highly effective and may include deep tissue trigger point therapy, electric muscle stimulation, ultrasound therapy or even acupuncture along with spinal adjustments.
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 and he remained pain-free.
What Doesn’t Work
Unlike chiropractic care, research shows that traditional medical care for sciatica is often not effective. For instance, one study of 183 sciatica patients found that bed rest was no more effective than “watchful waiting”. After 12 weeks, patients who were given pain meds and assigned to bed rest had no more improvement than those who were given no therapy or advice (“watchful waiting”). Researchers concluded that there was “no evidence that bed rest is an effective treatment for sciatica”. (NEMJ 1999; 340:418)
Another standard treatment involves masking the pain with continual doses of nonsteroidal anti-inflammatory drugs. (NSAIDs), such as prescription painkillers, or over-the-counter drugs like aspirin, Advil, Motrin, and Aleve. Although these drugs may seem benign, new research shows that overuse (just one dose daily for an on-going length of time) is linked to not only chronic headaches and migraines, gastrointestinal problems, heartburn and ulcers, but to increased incidences of liver damage and heart attack.
Once more, these drugs don’t cure sciatica. One study compared chiropractic care for sciatica to bed rest, massage, electrical muscle stimulation, nonsteroidal anti-inflammatory drugs (NSAIDs) and a muscle relaxant. Patients in the chiropractic care group experienced significant reduction in the length of care, faster improvement from symptoms, less disability at work and fewer missed work days, compared to all of the other groups. (Ann Swiss Chiro Assoc 1989;9:133)
I’m Here to Help
If you currently have back or leg pain, it’s vital to avoid self-diagnosing. The origin may lie in the sciatic nerve root or may be related to another cause, unconnected to the sciatic nerve.
Schedule an appointment with me right away to discover the underlying problems. I’m committed to identifying root causes of impediments to wellness, rather than masking symptoms with unnecessary medication or surgery. Pain is the body’s way of signaling distress; let me help you pinpoint the cause and get you on the road to recovery.(239) 243-8735