What is sciatica? Sciatica is a set of symptoms and not the disease itself. If you have some or all of the following symptoms you may have sciatica. These symptoms include leg pain associated with numbness, tingling, and weakness but the pain id coming from the nerve and it is a nerve pain. Sciatica is caused by pressure on nerves located in the lumbar spine or the sacrum, and is often present in conjunction with low back pain.  Sciatic pain and numbness is felt along the path of the nerve and travels trough the buttock and down the back of the leg into the foot. Sciatica is named for the nerve that it follows the sciatic nerve. sciatica is a symptom of an underlying condition and is not a condition of its own.  While often simple in nature there can be sever underlying factors associated with sciatica and medical intervention may be required  A chiropractor can diagnose and treat sciatica and will let you know if there is any immediate danger. There can be many causes for sciatica and many of them are simple.

What is the sciatic nerve?

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. There are two lumbar nerve roots and three sacral nerve roots that are involved in the sciatic nerve. These nerve roots are the 4th and 5th lumbar nerve roots and three sacral nerve roots which are the 1st, 2nd, and 3rd sacral nerve roots. These are the five nerve roots involved in creating the sciatic nerve. The sciatic nerve is what supplies the nerves to the leg from the buttocks to the foot.

The Six Common Sciatica Causes

It is important to understand the underlying causes of sciatic when treating it. There are six common causes of sciatica and several less common causes. The first 4 causes can be more difficult to treat but the final two are the lest degenerative cause and highly treatable, as well as the most common two reasons for sciatica.

1. Herniated disk is one of the first causes to rule in or rule out.
2. The second cause of sciatic that must be check out is lumbar spinal stenosis. Due to a narrowing of the spinal canal pressure is put on the nerve roots that make up the sciatic nerve. Stenosis is relatively common in adults over age 60.
3. Degenerative disc disease is the next culprit to check out. Disc degeneration as people place stress on there low back over a life time disc’s can be damaged. When someone has one or more degenerated disc’s they can put presure on the sciatic nerve causing sciatica. Degenerative disc is an earlier stage of disc degeneration.
4. The fourth cause of sciatica is isthmic spondylolisthesis. This condition occurs when a small stress fracture allows one vertebral body to slip anterior on another vertebral body.
5. The next cause is piriformis syndrome. The sciatic nerve runs under the piriformis muscle and the muscle can irritates or pinches the sciatic nerve . This is not a true radiculopathy, but the leg pain can feel the same as sciatica caused by a nerve irritation.
6. Finally we have sacroiliac joint dysfunction, which is commonly seen and treated by chiropractors. Inflammation or scare tissue in the sacroiliac joint can also irritate the fifth lumbar nerve, which lies on top of the sacroiliac joint, causing sciatica-type pain.

Sciatica may also be cause by changes in the body that occur during pregnancy, including weight gain, a shift on one’s center of gravity, and hormonal changes. Sciatica can also be caused by scar tissue, muscle strain, and in rare cases spinal tumor or infection. It is important to know the underlying cause of sciatica so it can be properly treated. The cause of sciatica may change or modify the treatment used.

Symptoms of Sciatica

The symptoms of sciatica are different from muscle aches and pains. Some of the clues you many have 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. These are all related to the pressure on the nerve and not due to actual dysfunction of the leg. Sciatic pain comes in many forms and flavors.  It varies from infrequent and irritating to constant and incapacitating pain that affects every day life. 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 important to note that it is rare that permanent nerve damage will result. It should be noted at this time that the one symptom that should never be ignored when sciatica is present is loss of bowl or balder control if this happens seek immediate medical attention and call 911, this can be a life threatening condition.

Sciatic neuritis or sciatica is an irritation and inflammation of the great sciatic nerve which is also the largest nerve in the body. The pain quality ranges from dull, sharp, burning or electrical and it may be accompanied by numbness, tingling, muscle weakness in the affected leg 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. Sitting, coughing, or sneezing will increase the symptoms of sciatica by increasing inter abdominal pressure.

Sciatica symptoms vary based on where the compressed nerve root is located. The forth lumbar nerve root symptoms usually affect the thigh. Patients may feel weakness in straightening the leg, and may have a diminished knee-jerk reflex. While fifth lumbar 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 first sacral nerve root includes 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 (Treatment for back pain and sciatica)

Most chiropractor use several treatment to treat sciatic and it is often based on the location and cause of the sciatic. Chiropractic adjustments to the spine & lower extremities are some of the most common types of treatments used by chiropractors. 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, 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.