Sciatica is a condition characterized by pain in the lower back, leg, and hip due to compression on the sciatic nerve. The sciatic nerve is the largest and longest spinal nerve in the human body. It runs from the lower back down the back of each leg. Its role is to transmit nerve signals between the muscles and skin of the legs and feet. Pain occurs when something injures, or puts pressure on, the sciatic nerve. Sciatica is often diagnosed by the “straight leg raising test,” where a patient lying on their back lifts a straight leg between 30º and 70º. This movement stretches the sciatic nerve and, if no pain occurs, is useful in ruling out the diagnosis of disc herniation. Sciatica is rather common, with over 3 million cases in the U.S. each year. While it can affect any age group, it is most often found in people between the ages of 40 and 60.
What Causes Sciatica?
- The most frequent cause of sciatica is intervertebral disc herniation. In such a case, a herniated or bulging disc can press on one of the five nerve roots which form the sciatic nerve. Activities featuring heavy impact or lifting can damage discs or repeated impacts such as sitting will exacerbate such cases.
- Spinal stenosis is a condition where the spinal canal narrows and compresses parts of the spinal cord; and in some cases, the roots of the sciatic nerve. The narrowing can come from a number of sources, such as bone spurs or disc herniations. Poor posture is a frequent contributing factor.
- Piriformis syndrome is also characterized by pain in the sciatic nerve, but it is not true sciatica because it is not caused by issues related to spinal compression. Instead, the sciatic nerve is being compressed by spasms of the piriformis muscle—a small muscle located at the side of the buttocks, running from the base of the spine to the top of the thigh bone and directly across the sciatic nerve. Piriformis syndrome can be hard to identify and is often diagnosed only when true sciatica is ruled out as a cause.
Sciatica is a condition that should be addressed at its on set, when the symptoms are less severe. The longer we leave a problem alone the more compensation and damage we do to the area of the body causing the issue, which over time leads to an increase in symptoms. Classically sciatica starts out as a burning or sharp stabbing pain down the back of our legs. However, these symptoms as they progress can lead to numbness and tingling and over time even lead to a lack of motor control of our lower extremity, such as drop foot. The more damage that has occurred means a longer course of treatment, which can limit the effectiveness of conservative care such as chiropractic and physical therapy and ultimately means more time, energy and money to get the problem corrected.
What are Symptoms of Sciatica?
Sciatica symptoms are caused by irritation of the sciatic nerve. Although symptoms can show up in both legs, it’s more common for sciatica to only affect one side of the body. Symptoms include:
- Mild or severe radiating pain down the leg and into the foot
- Sharp, shooting pains in the side of the hip, the outer thigh, the calf and/or foot
- Numbness in the lower extremities
- Pins and needles in the legs and/or feet
- A burning sensation in the lower body
- Muscle weakness in the affected leg
- Lower back pain (a minor symptom, not nearly as acute as those in the legs and feet)
Sciatica is commonly caused by one of two things, repetitive stresses and traumas. The average American sits for 9 or more hours a day. This sedentary lifestyle over time causes a massive amount of repetitive stress, which can damage the tissue surrounding the joint and the nerve, causing sciatica. If you are a ‘corporate athlete’ that sits for a living I encourage you to have an ergonomic set up performed at work. This will allow you to have your work station set up in a way that will cause as little stress as possible on the body. That said, all sitting is an accumulation of stress, which over time breaks us down. So, I would strongly suggest having HR provide you with a standing desk, and try to spend the last twenty minutes of every hour standing. By doing this you will create less stress on our low back and the surrounding tissue, which over time is key to longevity of our spinal health.
The second most common cause is trauma, like a lifting injury, which creates damage to the discs or tissue in our lower back, which can compress the sciatic nerve and create those classic sciatic symptoms. Poor technique at work when performing manual work such as lifting a heavy object is a common culprit, however poor stabilization of the lower back through a weak pelvic floor and core muscles is usually the most common reason we break down when lifting at work. Our bodies are extremely economical, and through our modern day, technology dependent lifestyle our bodies essentially become lazy. This inactivity creates a lack of strength in our core, which leads to over compensation of our lumbar para spinals, or low back muscles, and through them working far to hard to support the spine through lifting we damage them and the surrounding joints and discs. Having a strong and stable core is extremely important to make sure our spine is well supported, so much so we should all be performing regular ‘pre-hab’ at work or at home to maintain this important group of muscles.
How do you fix Sciatica?
- Spinal Manipulation – One way to treat low back pain is through chiropractic care. Spinal manipulation is a therapeutic intervention performed on spinal joints. A chiropractic adjustment applies a controlled force to the fixated joint in order to remove pressure on the sciatic nerve, restore movement and relieve pain.
- Flexion Distraction – This form of spinal manipulation for the lower back and hip area is a gentle, controlled distractive force that stretches individual spinal segments. This treatment utilizes a specialized table with hydraulics that creates smooth, pumping motions to stretch the joints along the spine. This therapy can relieve a pinched nerve or arthritic spinal column by creating a vacuum within the disc, which pulls the disc fluid back into the center of the disc and away from the damaged area such as a protrusion or herniation.
- Exercise and Rehabilitation – Adhering to certain workouts and exercises can help correct body mechanics and posture to minimize the effects of sciatica and help you regain range of motion and stability within the low back and core. Therapy programs involve stretching to improve joint range of motion, stabilizing exercises to stabilize the low back and hips and then strengthening exercises to add longevity and improved function to the area affected. Incorporating exercises involving proprioception and posterior chain activation into your rehabilitation can help stabilize and strengthen the low back and hips, offering a long-lasting improvement.
- Myofascial Release – Damaged tissue to the surrounding joint and nerve, unfortunately, is a misdiagnosed and a mistreated area when treating low back pain and sciatica. When accumulative stresses or a trauma break down or damage this tissue collagen forms within the tissue. This is effectively scar tissue with the muscle, which will limit joint flexibility and stability and adhere to the nerves in our low back causing pain and weakness. This needs to be addressed if providing effective and long-term results. Here at Advanced Health, we are expertly qualified to diagnose and treat the soft tissue to get you back to full health quickly and effectively.
- Electric Muscle Stimulation – This treatment method uses varying voltage currents applied in specific frequency ranges and intensities to increase circulation, modulate cells to assist with repairing damaged tissue, and increase muscle control and coordination. This stimulation also decreases muscle spasms, as well as pain, inflammation, and edema. It’s typically used in the early stages of care to boost healing.
- K-Laser Therapy – This state of the art advanced therapy applies photons at a wavelength appropriate to penetrate your skin and be absorbed into the underlying tissues. The K-Laser speeds recovery, especially in conditions involving inflammation or spasm. K-Laser therapy can be used to treat muscles, discs, nerves, cartilage, tendons, ligaments, bursae, and fascia.
- Ice Therapy – Cold therapy is meant to decrease metabolism and circulation which can reduce pain and muscle spasms. Cold or ice is applied to recent injuries and conditions in order to slow inflammation and relieve pain. Ice can also be used along with muscle stimulation at the end of your visit to reduce soreness.
If you are reading this and are experiencing any symptoms, which we have covered in this blog post, you will certainly need to be receiving the treatment methods mentioned above. Unfortunately, improving office ergonomics and strengthening the core should be a pro-active measure and not a reactive one. If the symptoms have occurred, they should be addressed by a licensed health care professional. Here at Advanced Health Chiropractic we help many of the South Loop and Chicago community and business members with this exact condition and experience a great success rate, with over 80% of our patients returning to a pain free unrestricted life style. To often in life we let our health dictate what we can and can’t do, for example you may love going for walks and runs at the lakeside, however when in pain, especially with something as severe as Sciatica it limits our ability to do the things we love and should be able to do. At Advanced Health Chiropractic we pride ourselves on been able to give you a clear diagnosis through our state-of-the-art diagnosis tools, such as functional movement exams and digital bio-mechanical x-rays. This allows us to pinpoint your issue and to be able to create a unique plan of action for our patients. We incorporate the most effective forms of treatment into all of our patient’s treatment plans, such as manual adhesion release therapy and chiropractic bio physics to be able to get you back to living a pain free lifestyle both quickly and effectively and most importantly offering objective and long lasting results. We do all of this conservatively without the use of drugs and surgery. If you are reading this and have had to give up something you love doing, or the pain you have limits what you feel you should be able to do, we encourage you to give us a call and make an appointment so we can get you back to living a pain free and unrestricted life.