People come into the office all the time and say, “My Sciatic Nerve is killing me!” Now I don’t know if the sciatic nerve has ever actually killed anybody, but I do know it is the longest nerve in the body and the thickest, about the diameter of a quarter, so a small amount of pressure on there can kill. However, based on the high frequency of people who have been incorrectly diagnosed with Sciatica, I believe clarification is needed.

What is it really?

Sciatica is low back and leg pain caused by pressure on a nerve due to misalignment of the spine in the lumbar region (lower back) or sacrum. The problem begins in one or all of the nerves from L4 to S3 which coalesce in the buttock region to form the sciatic nerve. This nerve runs the length of each leg from the buttock down the back of the leg into the foot. Most people feel the leg pain is often worse than the back pain. The leg pain can feel like a burning sensation, numbness, tingling, muscle tension in the hamstrings/calves or a general weakness.

If you have pain running down your leg you need to know something important: all nerves from the lower back and sacrum control and regulate not only the muscles of the legs, but also the lower G.I. system, the sex organs, and bladder. So this condition is much more serious then just radiating pain.

Sciatica is often confused with these common maladies:

1. Sacroiliac joint dysfunction: this is a misalignment of the sacrum as it relates with the pelvis and can cause pain in the buttock, tight glutes or pain near the dimples of Venus (at the bottom of the spine).
2. Piriformis syndrome: tension or tightness in the piriformis muscle which crosses from the hip to the sacrum can put pressure on the sciatic nerve which passes under the muscle and cause similar symptoms to Sciatica. This is hard to differentiate from true sciatica because there is rarely just tension in the piriformis muscle without a misalignment of the bones it attaches to.
3. Facet syndrome: irritation of the facet joints in the lumbar spine can cause low back pain and can refer down into the buttock and hip. This often is associated with a catching feeling or an inability to straighten up as the body wants to stay in flexion or slouched.

I have Sciatica, so what do I do?

Chiropractors are highly skilled and trained in the detection of low back and leg pain caused by the sciatic nerve.

According to a 2010 study in the Journal of Manipulative and Physiological Therapeutics, 60% of people with sciatica who didn’t get relief from other therapies and then tried Chiropractic experienced the same degree of pain relief as patients who eventually required surgery. The 120 people in the study saw a Chiropractor about 3 times a week for 4 weeks, and then continued weekly visits, tapering off treatment as they held their adjustments for longer periods of time. In people who responded to Chiropractic care, benefits lasted up to a year(1).

“Spinal adjustments may create a response in the nervous system that relieves pain and restores normal mobility to the injured area,” says study researcher Gordon McMorland, DC, of National Spine Care in Calgary, Alberta. “It also reduces inflammation, creating an environment that promotes the body’s natural healing mechanisms.”

Other therapies like massage, Acupuncture and physiotherapy can help relieve some of the pain and dysfunction. Specifically if there is involvement of the piriformis muscle then muscle release therapy can help a lot. Other things you can try include foam rolling to help with the muscle tension (click here to watch) and even going for a walk. The cyclical motion of walking and swinging the arms can help take tension off the nerve.

All of these therapies can help, but at the end of the day if there is a misalignment in the spine then the only thing that can correct that is a specific chiropractic adjustment. If you or your family need help or have questions please ask and we will find someone to help you start living your life to the fullest.

Dr. Thom

(1) McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ., Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010; Oct;33(8):576-84.