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What is Sciatica?

Although Sciatica is a relatively common presentation to chiropractic clinic, the true meaning of the term is usually misunderstood. Some people often associate lower back pain as Sciatica or Sciatic pain, or they believe it is a diagnosed condition that they have, this is not the case. Sciatica is actually a set of symptoms, not a diagnosis.

These symptoms include:

  • Pain in the lower back
  • Referral pain into leg; back or front of thigh, down to ankle, foot and even toes
  • Burning sensation
  • Pins and needles
  • Tingling
  • Prickling or crawling sensations
  • Tenderness
  • Numbness

Pain from Sciatica often begins slowly, gradually intensifying over time. Additionally it can worsen after prolonged sitting, sneezing, couching, bending, or other sudden movements.

What causes Sciatica?

Sciatica often occurs in people between the ages of 30-50, and is usually a result of general wear and tear rather than the result of a specific incident or injury, although this is sometimes the case.

There are a multitude of causes for Sciatica, with the most common cause being an irritation and inflammation of the sciatic nerve. The sciatic nerve begins as five smaller nerves originating from L4-S3, which join together and extend to your pelvis, thigh, knee, calf, ankle and toes. Irritation of the sciatic nerve can be cause by:

  • Misaligned vertebra – a misaligned vertebra could pinch or put pressure on one or some of the nerves
  • Spinal stenosis – a narrowing of the spinal cord canal, could place pressure on the spinal cord or nerve
  • Degenerative disc disease – common in aging, better described as ‘wear and tear’ which may cause pressure on the nerve
  • Pregnancy – extra weight and pressure on the spine can compress the nerves
  • Trauma – a fall or car accident, or other trauma can injure the nerve
  • Piriformis syndrome (sometimes considered ‘false sciatica’) – spasm or tightness of the piriformis muscle which can compress the sciatic nerve
  • Spondylolisthesis – when a vertebra slips forward over another vertebra which can pinch the nerve
  • Spinal tumours or infections – very rare; both can compress the sciatic nerve
What are my treatment options?

The medical approach is usually to treat sciatic pain with painkillers, muscle relaxers, or orthopaedic treatment such as traction, physiotherapy and bed-rest. Unfortunately these are often treating the symptom of pain and not the cause of the issue. In fact bed rest can largely exacerbate the nerve causing more pain!

The Chiropractic approach is to treat the cause, not the symptom. This is a non-invasive (non-surgical), drug free treatment option. The goal of Chiropractic care is to restore spinal function, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a Chiropractic treatment might include spinal adjustments, ice therapy, rehabilitative exercises and possibly soft tissue treatment (massage therapy). Chiropractic treatment has been shown to limit the length and severity of symptoms, and reduce the amount of time away from regular activities, such as work and regular exercise. In fact movement is a key component to recovery! Unless advised otherwise by your Chiropractor, remaining active and avoiding prolonged bed rest (which can make your symptom worse), has been shown to reduce the intensity of pain associated with sciatica.