Here’s something that might surprise you: sciatica—an aggravating ailment most of us have been plagued with at one time or another—is actually a symptom, not a condition. Sciatic is actually just “leg pain”. The condition itself is a compressed (or pinched) sciatic nerve—the largest and longest nerve in the body. The sciatic nerve runs from the low back (where it starts as a cluster of nerve roots), then branches off down both legs and through the feet.

And, since the compression can occur anywhere along the pathway of the nerve, there are many different causes, symptoms, and (thankfully) treatments for sciatica relief.

Most common causes of sciatica nerve pain:

1. Bulging disc in the low back. Because the sciatic nerve starts in the low back, specifically L4-S3, a disc that is bulging (remember that jelly donut analogy?) can put pressure on or compress a portion of the sciatic nerve.
2. Stressed sacroiliac joint. If you have a rotated pelvis, you probably have a stressed sacroiliac joint. Have you ever fallen on your hip? Broken a leg bone or had a major foot, ankle, knee or hip joint injury or surgery? Have you avidly played a sport or done an activity that could have created an imbalance from overuse of certain muscles? If so, you just may have a rotated pelvis and likely a stressed sacroiliac joint. When this joint is stressed it puts pressure on the sciatic nerve. The most common compensation we see in the clinic from our NKT testing is an inhibited Gluteus Maximus from a facilitated same sided iliacus or opposite Quadratus Lumborum causing a compression in the SI joint.
3. Tight piriformis muscle. The third location where pressure is commonly put on the sciatic nerve is as the nerve passes underneath the piriformis muscle. Simple everyday actions, like walking, running, sitting, can place extra pressure on the muscle, if there is muscle imbalance. When tightened, the muscles easily compress the sciatic nerve. In about 12% of the population, the sciatic nerve actually passes through the piriformis, which can cause an increase in intensity and frequency of symptoms.

Identifying Sciatica Symptoms

Symptoms usually occur on one side of the body, and they tend to begin in the lower back and travel down through the buttocks to the back of the legs. Some of the most common sciatica symptoms are:

• Sharp Pain
• Burning
• Cramping
• Muscle weakness
• Tingling
• Numbness

Sudden movements often exacerbate symptoms. You know that feeling—shooting pain radiating down your leg when you cough, shift in your chair, or try to stand up from a seated position. That’s because these motions can aggravate the compressed nerve. And while the severity of the symptoms can vary depending on how inflamed the area surrounding the nerve is, sciatica symptoms can also vary based on where the compressed nerve root is located.

Since more than one nerve root may be compressed, you may have a combination of symptoms depending on the underlying cause of the sciatica. Bending backward or walking long distances often trigger symptoms when spinal stenosis is the cause. And when a lumbar herniated disc is the problem, you’re likely to feel symptoms when you bend forward or sit.

Chiropractic treatment for sciatica

One of the most tried and true outlets for sciatica relief is chiropractic care. We are more than just chiropractors that “adjust” you, five minutes in and out. We are dedicated to finding the root cause of your sciatica–is it from an old injury, a surgery, a faulty movement pattern, or a poor daily habit? The visit will begin with a comprehensive discussion about where the condition may have started, what is the root cause. The treatment plan will include a combination of the following methods:

• Chiropractic adjustments— Adjustments are one of the most common methods used by chiropractors. During an adjustment, your chiropractor will manually manipulate the spine. This can help immediately relieve pain and alleviate pressure caused by dislocated spinal joints.
• Neurokinetic Therapy – We know that 50% of people that have sciatica from a disc herniation have no pain, so when someone walks into our office, we want to go one step further and understand WHY the disc is getting compressed. Is there some “energy leak” or area of instability such that the disc is compressing to help stabilize? It’s a great strategy in a dysfunctional system. Our goal is to figure out where muscles are not firing, get them working again, to take pressure off the disc.
• Mckenzie Method ­– In acute disc herniation cases, we will go through a Mckenzie protocol to drive the pressure of the disc forward to help suck the jelly disc material back into the disc. This usually involves a extension based exercises.
• Dynamic Neuromuscluar Stabilization (DNS) – Once someone is out of the acute phase, we rehabilitate with DNS principles, basically how we learned movement patterns as infants in our first year of life, to get our patients moving better with true core stability.

We are dedicated to finding the root cause of your sciatica

With chiropractic care, you’ll find sciatica relief fairly quickly. While symptoms may lessen in intensity almost immediately, the nerve itself will usually heal within 6 to 12 weeks. To find out more about how chiropractic can benefit a compressed sciatic nerve, or for other information, be sure to check us out Urban Wellness Clinic. If you have any questions, we are happy to jump on a call 212-355-0445, or email us at hello@urbanwellnessclinic.com

Best in Health,

Dr Emily Kiberd