Back Pain - Sciatica
Sciatica describes a collection of symptoms that can arise with sciatic nerve compression. This nerve is the largest and longest in the body, running from the base of the spine and down through both legs. Sciatic nerve compression can lead to pain that begins in the lower back and moves through the buttocks, legs and feet. It is also characterized by other symptoms like burning, cramping, muscle weakness, tingling and numbness. Sciatica generally occurs on one side of the body, but it can affect both sides.
The sciatic nerve is about an inch wide and consists of multiple nerve bundles. Sciatica is produced when this nerve is being compressed, or pinched. Compression is often caused by a herniated disc or a bone spur, most commonly in the area where the nerve passes out of the spinal column in the lumbar (lower back) region.
Most sciatica treatment methods are non-surgical. These methods include brief periods of rest, specialized exercises and stretching, Chiropractic treatment and non-steroidal anti-inflammatory supplements. Your Chiropractor can give further information regarding the best way to treat these symptoms.
Sciatica, a form of nerve dysfunction (peripheral neuropathy), occurs when there is compression on, or damage to, the sciatic nerve. This nerve innervates the muscles behind the knee and lower leg. It provides sensation to the back of the thigh, part of the lower leg and the sole of the foot.
Sciatica arises most frequently because of pressure being placed on the sciatic nerve caused by a degenerative spine condition such as a herniated disc, a bulging disc, a protruding disc or a bone spur. The condition often is diagnosed as radiculopathy. This means that the damaged disc or excess growth of bone is positioned in such a way that it places pressure on the nerve root.
Sciatica might also be caused by an injury, including a fracture of the pelvis or trauma to the buttocks or thigh.
Another factor could be prolonged external pressure on the nerve, and pressure on the nerve from nearby anatomical structures, including certain muscles. Sciatica might also arise in cases of nerve entrapment, which entails pressure on the nerve where it passes through an opening (foramen) between two vertebrae to exit the spinal column. The underlying cause of the symptoms is the prevention of the passage of proper motor and sensory impulses along the length of the nerve.
Diseases that affect the entire body, such as diabetes, can damage many different nerves, including the sciatic nerve. The sciatic nerve also may be harmed by pressure from a tumour, abscess or other mass, or by bleeding in the pelvis.
Sciatica symptoms include sensation changes, numbness, tingling, burning and pain in the buttocks, down the back of the legs and/or into the soles of the feet. Sciatica can also cause weakness in the legs, knees and feet, and, in severe cases, can cause a loss of mobility. In many cases, sciatica affects just the right or left side of the body, but it can affect both.
Many people with sciatica find the pain to be so debilitating that they are forced to miss work and social gatherings. Among patients with lower back pain, those with sciatica experience the highest level of disability.
1 According to public health records in Norway, patients with sciatica are disabled for an average of 72 days a year.
A recent study offers hope to patients suffering from sciatica pain. The new research suggests that chiropractic treatments may speed sciatica recovery, enabling patients to return to work faster.
2 The researchers evaluated 44 Norwegian workers who had visited the hospital with severe sciatic pain. Most of the participants had been experiencing pain for at least three weeks before visiting the hospital.
In the hospital, a chiropractor evaluated each patient’s posture, gait, range of motion, and palpation of the lumbar spine. The chiropractor then performed joint adjustments to the spine, in addition to other joints that had been injured as patients compensated for the pain. Soft tissue soreness was relieved with ice treatment. Patients received daily treatments while in the hospital, and then three times a week for a period of two weeks. Some patients also underwent additional follow-up treatments, but most did not receive more than 14 treatments.
Within 21 days, 91% of patients had returned to work full-time. An additional 2 patients were back at work part-time. The researchers concluded that the study demonstrates the potential benefit of chiropractic care for sciatica patients.
2. Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.