Sciatic pain refers to burning, tingling, or a deep dull aching toothache-like pain radiating from the low back and buttock down the back of one or both thighs, and into the legs or foot. Sometimes it can feel like being zapped by an electric shock over and over again.  This extremely common condition, which has four main causes, can be treated many different ways by close to a dozen different types of doctors.  For some, sciatic pain can be completely debilitating affecting regular day-to-day activities while others, the pain is so severe, they become bed ridden for awhile. Fortunately, the chiropractic care we offer at Chiropractic Orthopedic Group can correct all four major causes of sciatica.

The sciatic nerve is the largest and longest nerve in the body. It runs from deep inside the pelvis through the hip area and buttocks and then finds its way down the back of each leg branching into smaller nerves along the way.

The term “sciatica” refers to the inflammation of this nerve and the pain that radiates along its pathway. Sciatica may feel like a leg cramp or as numbness, burning or a pins-and-needles sensation or severe electric shocks.  

The pain can also be excruciatingly painful with a piercing or stabbing quality to it. In one study of patients with chronic pain, sciatica sufferers endured “significantly higher” pain scores and limitation in activities of daily living than any other group, (J Manipulative Physiol Ther 2002;25:162-7).

Although sciatic pain is generally in the buttocks and legs, it’s best to know the root cause of sciatica is often due to a compression of the sciatic nerve root, which is the beginning of the sciatic nerve as it exits the spinal cord in the low back.

Nerve root compression is frequently the result of one of two conditions: vertebral subluxation (fixation or misalignment of spinal bones) or a sacroiliac subluxation (misalignment of pelvic bones) or a sacral fixation. When the spinal or pelvic bones are even slightly out of place, spinal movement is restricted, which in turn irritates the muscles, discs and the nerve root — causing inflammation and pain.

The other two main causes of sciatic nerve compression are herniated spinal discs and piriformis syndrome (inflammation of the piriformis muscle in the buttocks).

Often, more than one of these four causes occur simultaneously, so it’s crucial to identify and address all factors as soon as possible. The good news is that research shows that skillful chiropractic care alleviates all four of the most common causes of sciatic pain.

With the correct manual orthopedic care both vertebral and sacroiliac subluxations can be corrected combined with specialized home exercises.  These maneuvers, which are safe and effective, successfully realign and normalize mobility between spinal and pelvic bones.

One analysis followed 44- patients with acute low-back pain and sciatica, which kept them from working.  All the study participants were evaluated by orthopedic surgeons and underwent X-rays, computerized tomography (CT) and magnetic resonance imaging (MRI). No pathology was found and the physicians could not determine the cause of the patients’ discomfort.

Next, the patients received a chiropractic examination. All were determined to have a vertebral subluxation involving the spine affecting the low back. They also suffered from sacroiliac subluxations.  Each patient then received chiropractic care.

According to the study results, “All but two patients returned to work. The period of sick leave among the patients was reduced by two thirds as compared with that associated with conventional medical treatment.” (J ManipulativePhysiol Ther 2007;30:135-9.)

Another study enrolled 2,945 patients with sciatica and low-back pain, of which 268 patients suffered chronic low-back pain and radiating pain below the knee.

These patients received either medical care or chiropractic care for the correction of vertebral and sacroiliac subluxations. Researchers assessed the participant’s satisfaction with care and low-back status via multiple questionnaires at various intervals of their treatment.

From these questionnaires when comparing chiropractic vs. medical care the people with chronic low-back pain and radiating pain below the knee “noted an advantage when it came to their long-term outcome and improvement.”

Over 55- percent of the chiropractic group employed such strategies as exercise and self-care education to reduce their symptoms. The medical care group was far more likely to choose bed rest. They were also significantly more likely to rely on family and friends for help, (JManipulative Physiol Ther 2001;24:543-51).

The spinal discs, which are sandwiched cushions between each vertebra, can also put pressure on the sciatic nerve root.

These intervertebral (between vertebrae) discs give the spine its flexibility and act as shock absorbers between each of the 24 movable spinal bones. The outer layer of each disc is tough and fibrous like the radial belts of a tire, while the inside material is spongy and jelly like.

If discs degenerate or are subject to trauma, the soft center may bulge to one side through a crack or breech in the fibrous outer layers. This condition is known as a bulged or herniated disc.

Sciatic pain ensues as the nerve root becomes trapped against the spinal canal by the disc bulge. The good news is that research shows how chiropractic care can help sciatica caused by “slipped” or prolapsed discs.

One analysis of 154- patients with sciatic pain found that those with disk-related magnetic resonance imaging (MRI) findings were likely to recover following chiropractic care, (J Manipulative Physiol Ther2007;30:135-9).

Another study, performed in Italy, included 64- men and 38- women ranging in age from 19- to 63- years of age.  This patient group had acute back pain and sciatica with herniated discs (“disc protrusion”).

Only 53- of these patients received chiropractic adjustments, while 49- underwent sham or “simulated” spinal adjustments.

Chiropractors performed the adjustments or simulated adjustments five days per week. The number of sessions depended on pain relief, but was limited to 20 total visits. Patients were assessed at admission and again at 15, 30, 45, 90 and 180 days. At each visit, the chiropractors used standard techniques to assess pain levels and improvement.

So, what was good news?  Patients receiving genuine chiropractic adjustments enjoyed significant improvement in pain severity and duration beyond what patients undergoing simulated adjustments experienced, (Spine J2006;6:131-7).

In another study, a 23-year-old woman suffered from chronic, unremitting symptoms of lower back pain and left-leg pain. After receiving chiropractic care “the patient responded well with a complete resolution of her symptoms and a restoration of her lumbar lordosis [over-  exaggeration of the low back curve (or swayback)].” (J ManipulativePhysiol Ther 2004;27:579.)

The piriformis and other deep gluteal complex muscles extend along both sides of the lower back and buttocks. Sciatic nerves travel beneath the piriformis and gluteal muscles on their way from the spine to the back of each leg. 

Piriformis syndrome occurs when the muscle becomes inflamed, forcing pressure on the sciatic nerve and squeezing it against the bones of the pelvis.

We employ a variety of all-natural interventions for piriformis syndrome and gluteal complex pain that often times mimics the same excruciating pain as a herniated disc. This combination approach is highly effective.

One case study conducted by researchers at the University of Quebec looked at a 19-year-old patient who developed piriformis syndrome and sciatica following a football injury. He received chiropractic care for three months, during which time his condition completely resolved. and he remained pain-free five months later, (J Manipulative Physiol Ther2006;29:486-91).

Unlike chiropractic care, research shows that traditional medical care for sciatica is often not very effective.

For instance, one study of 183- sciatic pain patients found that bed rest was no more effective than “watchful waiting.” After 12- weeks, patients who were assigned to bed rest had no more improvement than those who were in a “watchful waiting” group. Researchers concluded that there was “no evidence that bed rest is an effective treatment for sciatica.”(NEJM1999;340:418.)

Another standard treatment involves masking the pain with continual doses of non-steroidal anti-inflammatory drugs (NSAIDs), such as prescription painkillers or over-the-counter drugs like aspirin, Advil, Motrin and Aleve. Although these drugs may seem benign, overuse is linked to chronic headaches and migraines, gastrointestinal problems, heartburn and ulcers.

In addition, these drugs don’t cure sciatica. One study compared chiropractic care for sciatica to bed rest, massage, electrical muscle stimulation, non-steroidal anti-inflammatory drugs (NSAIDs) and a muscle relaxant. Patients in the chiropractic care group experienced significant reduction in the length of care, faster improvement from symptoms, less disability at work and fewer missed work days, compared with all other groups, (Ann Swiss Chiro Assoc 1989;9:133).

If you currently have back or leg pain, it’s important not to self-diagnose yourself.  The origin may lie in the sciatic nerve root or may be related to another cause, unrelated to the sciatic nerve and pose a much more serious medical problem.

My advice?  Schedule an appointment right away to discover the underlying problem. We’re committed to identifying the root causes and obstacles to wellness, rather than masking symptoms with unnecessary medication or surgery. Pain is the body’s natural way of signaling distress; let us help you pinpoint the true cause.