What causes sciatica?
One of the most common things people complain of, when the come to see us, is sciatica. When we ask where is hurts, some point to their leg, some to their back and a few to their shoulder. Clearly not everyone is clear exactly what it is, so what is sciatica? Sciatica is not, strictly speaking, a medical diagnosis, it is a symptom of an underlying medical condition. It is a lay term for pain that extends down the leg; pain that can really, really, really hurt!
Common symptoms of sciatica:
- Most often it starts in the lower back and travels into the thigh; it can travel further down the leg to the foot and toes
- Sciatica is not only felt as pain, it can be felt as a burning or tingling sensation
- In advanced cases there can be numbness or weakness of the leg muscles
- Sciatica mostly affects one leg, rarely does it affect both
What causes sciatica?
A bit of anatomy to begin with. Sciatica gets its name from the sciatic nerve. The sciatic nerve runs from your low back down each of your legs to your toes. It is formed from the nerve roots (nerves that come out of the spine) L4-S3 at the bottom of the spine. All these nerve roots join together to form the largest nerve in the human body; about the size of your index and middle finger together. The sciatic nerves feeds each of your legs with messages from the brain and back again. This allows you to move your legs and walk, feel sensation when something touches your leg, quickly move your leg away when you stand on your kids Lego in the dark, and so much more! In conclusion, it’s a very big and important nerve.
The most common causes of sciatica:
- A trapped nerve in the lumbar spine affecting the sciatic nerve
- A disc herniation – one of the discs in the spine bulges out to the side (‘slipped disc’) and presses on the lower lumber nerve roots (that form the sciatic nerve)
- Piriformis syndrome – the piriformis is a muscle in your buttocks that the sciatic nerve runs under, and sometimes through, and if it gets tight it can irritate the sciatic nerve
- Trigger point referral – knots in the muscles of the buttocks or low back, called trigger points, can cause the sensation of pain down the leg (referral) that can mimic sciatica
How do you treat sciatica?
With the causes listed above, in my humble opinion, a combination of Chiropractic adjustments, massage, stretching and cryotherapy (using an ice pack or Biofreeze). With this approach you are addressing any misalignments of the spine and pelvis through the Chiropractic adjustments; this takes the pressure off the nerves and aides the recovery of any disc herniation (‘slipped disc’). Massage relaxes the tight muscles around the spine and the piriformis if needed, this encourages what the Chiropractic adjustments are doing and relaxes any trigger points in the muscles of the lower back and buttocks. The stretching helps between seeing your Chiropractor + sports massage therapist, and the ice pack reduces the inflammation around the nerve, again aiding a speedier recovery. An important final note. The symptom sciatica can be caused by serious underlying complaints and should be checked thoroughly by a trained physician who performs a complete physical examination of your muscles and joints and neurological examination of your nerves. If you have any change in your bowel or bladder habits (unusually can’t control or go!) or numbness in your ‘saddle’ area, coupled with severe back or leg pain, then you potentially have something called ‘cauda equina’. This is a medical emergency and you should contact the emergency services straight away. As a Chiropractor it is our job to ensure that the complaint you have is a Chiropractic case. At The Chiropractic Centre: Bristol we ensure that we give you the best treatment and advice to help you with your sciatica, and in those few cases that we feel that physical interventions like Chiropractic and massage are not the most suitable option, we refer you to the person who is right for you.