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Sciatica

Written by: Kristen Bentson, DC, MS

What is Sciatica?

The sciatic nerve is a long, wide and branching nerve that travels from the low back into the buttocks then down to the feet. When this nerve or its roots becomes irritated or inflamed, pain numbness and weakness may ensue along its course. Sciatica isn’t a disorder, per se; rather, it is a set of symptoms. The symptoms include pain (generally pain radiating into the buttock, thigh, and calf), pins and needles/tingling and decreased muscle strength. Often the pain becomes worse with activities that increase pressure including coughing, sneezing and bearing down when going to the bathroom.  Rarely bowel, bladder and sexual dysfunction are reported; this may be a sign of a medical emergency (cauda equine syndrome)-if you are currently experiencing any of these symptoms, a visit to your nearest emergency room is warranted. It is important to recognize and treat the cause of sciatica. The most common cause is disc herniation. Other common causes include piriformis syndrome (spasm of the pirifomis muscle puts pressure on the sciatic nerve), stenosis, pregnancy and bone spurs (osteophytes). Less common and more serious causes of sciatica include bone tumors, nerve tumors and infection.

How is Sciatica Diagnosed?

It is important to determine cause of sciatica. A lot of information can be gathered through a detailed history and physical examination. Often this will be enough to initiate a course of treatment. It is generally after a course of conservative care fails to produce the desired result (generally 4-6 weeks) that further testing is warranted. Magnetic resonance imaging (MRI) is considered the most sensitive test for determining the cause of sciatic pain especially if a disc herniation is suspected. X-rays evaluate bony tissue and are generally useful only in cases of bony impingement. Computerized tomography (CT) may be ordered in certain cases.

What are the Options for Sciatica?

Sciatica is commonly treated at Lehigh Valley Chiropractic. Depending on the cause, treatments may include flexion distraction manipulation, diversified manipulation, rehabilitative exercise, ergonomic/biomechanical advice, and myofascial release. Many patients can attest to the positive pain relieving results of chiropractic care in the treatment of sciatic pain. Please note, if our chiropractors suspect that your sciatic pain is being caused by a more serious underlying condition, the appropriate referral will be made. Other options (not offered at LVC) include acupuncture, epidural steroid injections and surgery. We strongly recommend that patients undergo a course of treatment at Lehigh Valley Chiropractic prior to investigating more invasive treatments. We encourage you to weigh the risks and the benefits of treatment types before making a decision. Chiropractic is an evidence based conservative approach that is safe and effective. It may be the answer you have been looking for.

• Miller KJ. Physical assessment of lower extremity radiculopathy and sciatica. J Chiropr Med 2007 Jun;6(2):75-82.
• Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J. 2006 Mar-Apr;6 (2): 131-7.

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This article is not a substitute for medical advice. The information provided is not intended to diagnose or treat any condition.