Sciatica is a term that describes the symptoms of leg pain associated with numbness, tingling, and weakness. Sciatica originates from the low back and travels through the buttock and down the back of the leg into the foot. Sciatic is named for the nerve that it follows the sciatic nerve. sciatica is a symptom of an underlying medical condition and is not a medical condition of its own. There can be several causes for sciatic.

The symptoms of sciatica are constant pain in one, or some times both, sides of the buttock or leg, pain that is worse when sitting, Burning or tingling down the leg, weakness, numbness or difficulty moving the leg or foot, a constant pain on one side of the rear, and a sharp pain that may make it difficult to stand up or to walk.

Sciatic pain varies from infrequent and irritating to constant and incapacitating pain. The symptoms are as varied as the pain and may change in location and severity, depending upon the condition causing the sciatica. Sciatica can be very painful but it is rare that permanent sciatic nerve damage will result.

Sciatic neuritis or sciatica is an irritation and inflammation of the great sciatic nerve. This is the largest nerve in the body. The sciatic nerve originates from the lumbo-sacral spine and travels down the leg all the way to the great toe. Sciatica follows the path of this nerve. The pain quality ranges from dull, sharp, burning or electrical and it may be accompanied by numbness, tingling and the feeling of pins and needles. The symptoms may vary in intensity and in the frequency. Classic sciatic pain radiates from your lower back into to your buttock and down the back of your legs. Sciatica may be accompanied by numbness, tingling, and muscle weakness in the affected leg. It’s likely to be worse when you sit, cough or sneeze.

6 Most Common Causes of Sciatica

When discussing sciatica it is important to understand the underlying cause of the sciatica symptoms. There are six primary problems that are the most common causes of sciatica. The first is a herniated disc (see the post on herniated disc). Another common cause is lumbar spinal stenosis, This condition commonly causes sciatica due to a narrowing of the spinal canal and is relatively common in adults over age 60. Next on the list is degenerative disc disease. While disc degeneration is a natural process that occurs with aging, for some people one or more degenerated discs in the lower back can also irritate a nerve root and cause sciatica. Degenerative disc is an earlier stage of disc degeneration. A fourth cause of sciatica is isthmic spondylolisthesis which occurs when a small stress fracture allows one vertebral body to slip forward on another vertebral body. The final two are the lest degenerative cause and highly treatable, as well as the most common two reasons for sciatica. The first of which is piriformis syndrome. The sciatic nerve runs under the piriformis muscle in the rear and if the piriformis muscle irritates or pinches a nerve root that comprises the sciatic nerve, it can cause sciatica-type pain. This is not a true radiculopathy, but the leg pain can feel the same as sciatica caused by a nerve irritation. Finally we have sacroiliac joint dysfunction, which is commonly seen and treated by chiropractors. Inflamation or scare tissue in the sacroiliac joint can also irritate the L5 nerve, which lies on top of the sacroiliac joint, causing sciatica-type pain.

Some other common causes of sciatica are pregnancy due to the changes that the body goes through during pregnancy, including weight gain, a shift on one’s center of gravity, and hormonal changes, can cause sciatica during pregnancy. Also sciatica can be caused by scar tissue, muscle strain, and in rare cases spinal tumor or infection.

It is important to know the underlying clinical diagnosis of the cause of sciatica, as treatments will often differ depending on the cause.

Sciatica Symptoms and Nerve Roots

The sciatic nerve is made up of two lumbar nerve roots L4 and L5 and three sacral nerve roots S1, S2, and S3. When all 5 of these nerve roots bundle together they form the sciatic nerve which innervates the leg from the buttocks to the foot. Sciatica symptoms vary based on where the compressed nerve root is located. L4 nerve root sciatica symptoms usually affect the thigh. Patients may feel weakness in straightening the leg, and may have a diminished knee-jerk reflex. While L5 nerve root sciatica symptoms may extend to the big toe and ankle. Patients may feel pain or numbness on top of the foot, and between the big toe and second toe. Finally in S1 nerve root sciatica the outer part of the foot is involved and it may radiate to the little toe. Patients may experience weakness when raising the heel off the ground or trying to stand on tiptoes. If multiple nerve roots are compromised the patient may experience several of these symptoms at once.

In rare cases sciatica symptoms that worsen quickly may require immediate surgery. The following symptoms indicate a need for immediate medical care may be necessary. Sciatica symptoms that continue to get worse rather than improve, which may indicate possible nerve damage, especially if the progressive symptoms are neurological. Symptoms that occur in both legs and cause either bladder or bowel incontinence or dysfunction, which may indicate cauda equina syndrome. Cauda equina syndrome extremely rare but found in 2% of herniated lumbar disc cases.

Patients should seek immediate medical attention if they experience any of the above symptoms.

Chiropractic Approach

The chiropractic approach to sciatica involves adjustments to the spine & lower extremities. Spinal adjustments and manual manipulation performed by appropriately trained chiropractor are focused on providing better spinal alignment, which helps to address a number of underlying causes sciatic nerve pain. Manual manipulation done to address the right indications by appropriately trained chiropractor can create a better healing environment and should not be painful. In addition to chiropractic adjustment your chiropractor will probably use a combination of physiotherapies, decompression, active care rehabilitation, nutritional support, and laser therapy (to reduce inflammation & provide specific nourishment to the peripheral nerves). This approach is safe, non-invasive and non-toxic. If you have been suffering with sciatica call our office to schedule a free, no-obligation consultation. We can sit down together and discuss your case. I look forward to speaking with you soon!

Medical Approach to Sciatica

The medical approach to treating sciatica is with drugs including anti-inflammatories, analgesics and steroids. Drugs will not cure sciatica. They will only temporarily mask symptoms.

The surgical approach to treating sciatica often involves removing part of the disc (discectomy), or cutting away part of the vertebrae (laminectomy). 50% of all spinal surgeries fail (meaning that the patient’s symptoms are unresolved after a 3 year follow-up). There are always risks involved with surgery including complications, infection and even death. Surgery should ALWAYS your last resort, not your first approach.