Sciatica

“Sciatica” is a general term used to describe a set of symptoms, rather than being a specific diagnosis itself. These symptoms can include low back, buttock and leg pain, numbness, muscle weakness, pins and needles, and the symptoms are usually one sided.

The symptoms of “sciatica” arise when the sciatic nerve or its nerve root components are compressed or irritated. People often think that this is the result of a bulging or herniated disc. While this is a possible cause, there are many other conditions that can present as sciatic pain. These include misalignment of spinal vertebrae, damage to spinal joints, degenerative discs and muscle tension in surrounding musculature.

The diagnosis of what is contributing to the sciatic pain is made clinically by conducting some specific screening tests to check for nerve damage, these include assessing muscle strength, skin sensation and reflexes. Spinal assessment and sometimes specific imaging of the spine will be required to show if there are any areas of misalignment or damage in the spine which can be corrected or improved with chiropractic care.

Muscle trigger points may result in a distribution of pain which resembles “sciatica” but is not actually caused by true nerve compression. This muscular pain is usually easily relieved with soft tissue releases and chiropractic methods.

If a patient's sciatica symptoms fail to improve within the first few weeks of treatment, more advanced imaging may be helpful. CT and MRI scans can provide detailed pictures of spinal structures particularly intervertebral discs and nerve roots, which will help your chiropractor further tailor your care, selecting the best techniques and at-home-care to suit your needs. Depending on your clinical picture this imaging may have already been ordered at the commencement of your care.

Most causes of “sciatica” usually respond well to chiropractic treatment. Chiropractic care restores normal position and movement to spinal facet joints, and also relieves muscular tension and contraction around the lower back and pelvis.

Surgery is usually not necessary, even with severely painful presentation. Studies have shown that after 2 years, patients who have had surgery had no better outcomes than those who didn't. While perhaps offering short-term relief, anti-inflammatory medications have not been proven to be any more effective than placebo when treating sciatica and are generally not recommended.

Once the initial pain has resolved, your chiropractor can recommend specific stabilising exercises to support your lumbar spine and pelvis. Regular performance of such exercises can be very useful in the prevention of “sciatica” in future.

Allow the team at NT Chiropractic Health & Wellness Centre to help you overcome your symptoms of “sciatica.” You'll be glad you did!

 

1. Jamison JR (1999). Differential Diagnosis for Primary Practice. Churchill Livingstone. 397

2. Terrett AGJ (1998). Clinical Orthopaedic & Neurological Syndromes. Thoracic and Lumbar Spine.

3. DeMyer WE (1994). Technique of Neurological Examination

4 Ed. McGrawHill. 351-3544. Travell JG, Simons DG & Simons LS (1998). Myofascial Pain & Dysfunction. The Trigger Point Manual.

5. Gregory DS, Seto CK, Wortley GC, Shugart CM (October 2008). “Acute lumbar disk pain: navigating evaluation and treatment choices”.Am Fam Physician 78 (7): 835“42.

6. “Non-steroidal anti-inflammatory drugs for low back pain”. http://www.cochrane.org/reviews/en/ab000396.html.