Sciatica is described as a sharp, lightening type flash of pain that jolts the body from the buttocks area to the heel. This pain goes down the back of the leg and can be caused by many different factors. These factors can be corrected with proper chiropractic care and at home exercises. This is common condition that chiropractors treat with great results. Sciatic pain can happen to anybody, at any stage of life, at any level of fitness. Pain is the body’s way of alerting you something is wrong. The more you ignore the pain, the stronger, or louder, the alert will become.
The Sciatic nerve
The sciatic nerve is made up of two Lumbar nerve roots and 3 nerves that exit the sacrum. Together these 5 nerves combine, at about the mid-glut region, to make up the Sciatic nerve. The Sciatic nerve runs down the back of the thigh and leg and braches off at different point along that path.
Sciatica can have 3 main causes:
- The Lumbar spine is out of alignment and is impinging (or squeezing) the L4, L5 nerve roots. This is the origin of the Sciatica nerve, but the pain can be felt all the way to the leg.
- The Piriformis muscle is tight and squeezing on the Sciatic nerve. This muscle is in the glut region and runs diagonal across the buttock region. If this muscle becomes too tight it will squeeze on the Sciatic nerve, similar to the Lumbar spine impinging on the nerve roots. Again this is the origin of the pain, but the pain can travel all the way into the foot and toes.
- A hip could be out of alignment and is stretching the Sciatic nerve, which is irritating the nerve.
- The pain is a combination of spinal and hip misalignment with a tight Piriformis muscle. All three points will have to be treated. Treating one but none of the others will not improve the symptoms. All three need to be treated for Sciatic pain to be relieved.
The Pain of Sciatica
Pain can start off as a dull pain that is one sided in the lower back. This would be the very early stages of Sciatica, but would not be classified yet as Sciatica. This would be the best point to seek treatment, as this is more of a common lower back pain. The pain can then start to become sharp or burning in that region and began to spread out to a larger area. This sharp pain is still one sided but could go from the lower back into the glut region now. This is starting to become sciatica but not all the symptoms are there yet.
This is still a point where treatment would help prevent the onset of Sciatica. If there is no treatment at this point, the condition will progress to sharp, burning, tingle into the back of the thigh with numbness starting to settle in at times. With this quality of pain and the ending point of the pain, this is Sciatica. Once the pain starts to go into the back of the thigh is when Sciatica has developed. The pain is one sided, constant and worsens in some positions. Prolonged sitting is uncomfortable, going from a seated position to standing will increase pain levels and bending over will cause a jolting pain down the whole leg. Treatment that this point is a must to stop the pain from traveling further and decrease the intensity of the pain.
The last part of the Sciatica is when the pain is one sided, goes from the lower back, into the glut, down the thigh, and into the calf, all the way to the floor. This pain is sharp, jolting, burning with numbness or weakness in the foot or toes. At this point the patient has ignored the pain so long that the body is demanding treatment. Sitting, standing, walking, coughing, sneezing and sleeping causes a shooting pain. You might also notice you are tripping more due to foot weakness, called foot drop. This is from the nerve not functioning at full strength and causing the muscles in the foot and toes to function improperly. This is not the point you want the condition to progress to.
Seeking treatment with a chiropractor is going to help with the sciatic pain. At the first visit the doctor will do a full exam and to test the pain, locate where it starts and stops and how long you’ve had the pain. X-rays maybe be taken to rule out under lying causes. During the exam the doctor will test your muscle strength and reflexes. At the end of the exam the doctor will set up a treatment plan with office care and at home exercises. The following is how most Sciatica cases are treated.
- Adjustments at the office 3 times a week for 2-3 weeks for spinal and hip alignment. After 2-3 weeks then care will continue 2 times a week for 3 weeks, then 1 time a week for 4 weeks. The number of treatments a week will all be based on how you are progressing. Some progress faster than others depending on how bad the condition was when treatment first started. Within the first week the pain should be one third of what it was when treatment first started. In the third week there may be no pain, but treatment is still needed to help train the body to keep the adjustment in place. The body has become use to being out of alignment and needs to be ‘retrained’ to being in the correct position again. Even with no pain, keep going to your appointments, the body is not healed yet. At best the nerve is no longer being impinged upon, the irritation is gone, but the spine is still getting use to being in the correct position. One wrong move or action and you’re right back were you started. I’ve seen this happen too many times.
- Trigger point of the Piriformis to “release” the muscle. This is done by pressing into the muscle with the doctor’s thumb, at sore and tender spots, to break up knots in the muscle. As the knots break up the muscle will relax, causing less pressure and irritation to the Sciatic nerve.
- Stretching of the Piriformis muscle, shown at the office, but done at home. This stretch is very easy to do and should be done 2-3 daily. As pain starts to flare up again this stretch can be done to help reduce pain, so daily activities can be continued.
- Foam rolling can also be done at home over the Piriformis muscle to help reduce knots at home. This should be done two times daily. This is can be uncomfortable, yet it is effective for controlling pain.
- T.E.N.S or muscle stim, at the Lumbar and glut regions to help reduce pain. This will help relax the tight overworked muscle in the Lumbar spine and glut regions.
These are just some the treatments options that will help Sciatica. There are many more treatments available that an office may employ. The key, for the doctor, is to find the treatment that best suits the patient with the condition.
Sciatica is a condition that comes about over time. It is best to seek treatment for lower back pain when it begins, before Sciatica can happen. Sciatica pain is sharp, jolting and lightening like in nature. It can and will limit your ability to work, rest and enjoy life. Seek treatment from a chiropractor to correct the muscle and spinal issues. A pill will only stop the pain, but the reason for the pain will not be corrected. Get treatment for the condition causing the pain, and the results will last longer and have no side effects.
-Dr. Travis Early, DC