4 Steps to Understanding and Treating Sciatica.
According to The British Journal of Anaesthesia, the lifetime incidence of Sciatica is estimated to be between 13% and 40%. But what exactly is it? How is it caused? And how can it be treated?
Quick Anatomy:
Your sciatic nerve is formed by the connection of no less than five lumbosacral nerve roots; L4, L5, S1, S2, and S3, after they exit the spine. These nerve roots group together on the front surface of the piriformis to form the Sciatic Nerve. This nerve then descends into the thigh and splits above the back of your knee to form two smaller nerves that supply the lower part of your leg. The Sciatic nerve carries motor and sensory fibres which allow you to move and feel your leg.
Step One:
Understand the Terminology
The term “Sciatica” literally means that a person is experiencing pain from irritation or compression of the Sciatic nerve. It describes a symptom rather than a cause and is therefore not a diagnosis, but rather a description of the location and type of pain caused by irritation of the sciatic nerve.
The most common presentation of sciatic type pain is as follows:
- Pain Radiating from the lower back, into the buttock, down the back of the thigh and into the lower leg or foot (Usually only on one side).
- Pain is experienced as sharp, searing or burning and may be associated with numbness and tingling and even weakness.
- Pain is worse on sitting and standing still and may be relieved by walking or lying down.
Step Two:
Sciatica Incognito – Be aware of other conditions in Disguise
Although Sciatica has a technical definition, it has been widely adopted as a loose term used to describe pain anywhere along the distribution of the sciatic nerve. If the cause of the pain is not irritation or impingement of this nerve, this term is technically incorrect.
There are many conditions which can cause pain and discomfort in the same pattern, even though they have nothing to do with the sciatic nerve! Pain can be referred down the leg from joints and muscles in a phenomenon known as referred pain. Referred pain can be attributed to various muscles in the buttock region and joints in the lower back and is actually more common than true sciatica.
Step Three:
Know the True Sciatica Culprits
True Sciatica is caused when one of the nerve roots that combine to form the sciatic nerve, or the sciatic nerve itself, becomes compressed, “pinched” or irritated.
The most common causes include:
- Bulging of a disc that compresses a nerve root as it exits the spine.
- Chemicals released from a ruptured disc leading to nerve inflammation.
- Narrowing of the intervertebral “tunnels” through which the nerves exit the spine, otherwise known as “Stenosis”.
- Forward slippage of one vertebra over another, known as “Spondylolisthesis”.
- Compression or squeezing of the sciatic nerve by the piriformis muscle over which it runs.
- Spinal or soft tissue tumours which compress the nerve roots. These tumours can be malignant or benign and are fortunately extremely rare.
Step Four:
Sayonara Sciatica – How Chiropractic Treatment can help!
All these different causes can get confusing, and know exactly where your symptoms are arising from is tricky. Luckily, it is not up to you to determine. Distinguishing between the different causes of sciatic type pain requires the skill of an astute clinician with a certain degree of orthopedic finesse. Diagnosing the origin of your pain is the first and foremost responsibility of your healthcare advisor, as this knowledge is essential in creating an effective treatment plan.
Your Chiropractor will use many different manual muscle, joint, and nerve tests in an effort to determine the origin of your pain, and if necessary, they may even send you for diagnostic imaging.
If the cause of your sciatic pain is deemed appropriate for conservative chiropractic treatment, various techniques which address the joints and surrounding soft tissue will be used in order to relieve pain and restore function. These techniques may include:
- Manual or assisted manipulations to relieve pain and ensure the joints are moving the way they should.
- Positional relief techniques which create additional space to relieve pressure from your nerves.
- Soft tissue techniques to relieve muscular spasms and correct muscular imbalances.
- Neural stretches to ensure the nerves are mobile as they travel through layers of muscle and fascia.
- Various anti-inflammatory and analgesic techniques such as icing.
- Strengthening and Stretching conditioning programs to prevent recurrence.
In cases where the cause of your symptoms is not appropriate for conservative treatment, your chiropractor will be able to refer you to a health care practitioner who is able to administer suitable treatment for your specific condition.
The goal of any painful condition should always be to correctly diagnose and effectively treat the root of the problem to enable you to move comfortably and efficiently. Choose a health care provider you trust, and work together to keep your body healthy and moving as it should!
Move Well. Live Well.