May 2021 Chiropractic Newsletter

How do Chiropractors Approach Sciatica?

If you feel pain, numbness, or tingling between your lower back and your leg, you’re not alone. Sciatica, one of the most common forms of back pain, occurs in about forty percent of the American adult population at least once in their lives, and is often recurring. But sciatica is merely a description of a problem with a particular nerve, which could be impinged for all sorts of reasons. At a chiropractic office, a musculoskeletal health expert would be able to diagnose the most likely cause of sciatica and develop a treatment plan to aid the body’s natural recovery with as little pain and intervention as possible.


What is the Sciatic Nerve?

Sciatic nerves are the largest nerves in the body. There is one in each leg, and they bundle together out of multiple nerves that emerge from the spinal cord in the lower back. They run through the muscles of the pelvic region and down each leg until they typically split in two behind the knee. Each section then continues into the foot. Compression in a sciatic nerve may result in pain or loss of function along its length, but usually occurs near its roots or as it weaves through the pelvis.


How Can the Sciatic Nerve be Injured?

The sciatic nerve can be compressed if the tissues surrounding it swell up after an acute injury, but it is more common for compression to result from slow, degenerative conditions. In either case, only one sciatic nerve would usually be compressed at a time. The sciatic nerve has five roots; two from the lumbar spine and three from the sacrum. If one of the soft discs between the lumbar vertebrae has ruptured, its gelatinous center may bulge outward and compress a nerve root. A fracture in the joints connecting the lumbar vertebrae could also result in one of the vertebrae slipping out of place and pressing down on the nerve, or in the release of chemical signals that would prompt the nearby muscles to swell.


Compression, or impingement, of the sciatic nerve, could also occur further down if one of the muscles or tendons in the pelvis is frayed. The lumbar vertebrae are connected to the upper femur by a deep wedge-shaped muscle called the piriformis. Usually, the sciatic nerve skirts around it, although in some people it goes straight through, and occasionally it divides in two and loops around it before bundling back together. In any configuration, if the piriformis muscle swells, it can impinge the sciatic nerve, and swelling in other muscles could also push the piriformis onto the sciatic nerve.


How Chiropractic Offices Treat Sciatica

Chiropractors would perform a variety of manual, range-of-motion, and imaging tests to verify that impingement of the sciatic nerve is the most likely cause of a patient’s distress. Our focus would then turn to relieving pressure on the nerve through means such as chiropractic adjustments and anti-inflammatory therapies. Adjustments can be performed both on joints and on soft tissues to move them back into place. Therapies such as electric muscle stimulation, low-level laser application, and ultrasound prompt increased blood flow, bringing fresh nutrients to injured muscles.


Sciatica usually clears up within six weeks, but preventing a relapse would require a patient to put their spinal discs, joints, and hip muscles under less stress. This would usually mean building up their core muscles to be able to take on more weight, or reducing their overall weight. Stretching exercises would also make the hip muscles less vulnerable to fraying, and we can provide advice on posture when standing and seated that will distribute a person’s weight more evenly.