Sciatica is a severe pain in the leg caused by compression, irritation, or inflammation of the sciatic nerve. The sciatic nerves are the largest and longest nerves in the body, reaching about the size of your thumb in diameter, and running down the back of each leg. Each sciatic nerve is composed of five smaller nerves that leave the spinal cord from the lower spinal column, join together and then travel down each leg. It then divides into many smaller nerves that travel to the thigh, knee, calf, ankle, foot and toes. When these nerves are irritated or affected by the inflammation of nearby soft tissues, doctors refer to this as sciatica.
Symptoms of Sciatica
People with "sciatica" can suffer from a wide range of symptoms. Often the pain will come and go. At times, it may be constant, but then it may subside for hours or days. Some people may feel only a dull ache or numbness, which travels down the back into the upper leg. For others, it may be intense "shooting pains" down the leg into the foot and toes.
Many factors affect the pain of sciatica. Sitting in one position for long periods of time as when driving or working at a computer can increase the pain. Working out or running, or even simple things like walking, bending, turning or standing up may be difficult and painful. Tennis or golf and other twisting activities can cause sciatic pain to flare up. For some, the pain may be in both legs or change from side to side. For a number of others, back pain may occur before the sciatica itself.
In the most severe cases, sciatica can damage reflexes, or even cause a wasting of the calf muscles.
Causes of Sciatica
Because the sciatic nerve is so long, irritation can occur at many points. The first place is the lower back. Commonly, a misalignment of one or more of the lumbar vertebra causing pressure on the nerve is responsible.
This condition is known as a subluxation, one underlying cause of sciatica as well as many other health problems.
Another source of sciatica can be disc involvement. Discs are the cartilage-like cushions occupying the spaces between vertebrae. Serving as spinal shock absorbers, they allow the back to turn and bend normally. Trauma or injury from car accidents or falls can cause a disc to bulge to one side resulting in what many people call a "slipped disc." The proper term is disc herniation.
Sciatica has also been linked to various non-spinal conditions. Arthritis, advanced diabetes, tumors, constipation, and even vitamin deficiencies have been reported as causes.
Finally, degeneration of the spine resulting from long-standing or neglected back problems can also irritate the sciatic nerve. Cases of sciatica have even been reported following childbirth, usually due to pressure on the spine.
Treatment for Sciatica
The medical approach managing sciatica is to treat the symptoms. This may include using painkillers, muscle relaxers or anti-inflammatory drugs. Traction, physical therapy or injections directly into the nerve roots may also be used. In severe cases, even surgery may be tried.
The chiropractic approach to treating sciatica is to find the source of nerve irritation and relieve the pressure causing the pain. By correcting the source of the problem, the body can heal naturally without nerve interference. Sciatica, like other health conditions that can be traced to the spine, often responds dramatically to the restoration of normal spinal function through chiropractic care.
Your chiropractor's methods will vary according to the specific source of sciatica in each case. First, a complete history is taken to determine when the problem first appeared and possible sources. Next, a complete physical and chiropractic exam is performed, and x-rays may be taken. These tests are reviewed and discussed with you along with recommendations for treatment.
Treatment will vary according to the severity of the condition. With most patients, a series of adjustments to move the related vertebra back to a more normal position is helpful to reduce the pressure on the nerve. In some cases, the use of ultrasound and ice is needed. Massage therapy to reduce the pain related to muscle spasms is frequently helpful. Combining adjustments with physical therapy has proven very successful in treating most sciatica.
Whatever the cause of sciatica, it is important to seek treatment promptly. Too many people wait, hoping the pain will go away or get better by itself. However, it is usually easier to treat a problem when it is first noticed. Too many people wait until the pain becomes unbearable, suffering needlessly. Long-term nerve damage may result from this delay in seeking treatment.
A 1990 British study compared patients who received traditional medical treatment for a variety of back-related problems with others who received chiropractic care. Of 741 patients followed over three years, researchers found that those seen by chiropractic doctors experienced better results and missed less time from work.