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. The term “sciatic” actually translates to “leg pain”. The condition itself is a compressed (or pinched) sciatic nerve—the largest and longest nerve in the body. This nerve runs from the lower back (where it starts as a cluster of nerve roots), then branches off down both legs to the feet, feeding these areas their nerve supply as it goes.

With such a long route of travel, the sciatic nerve is susceptible to compression at many different sites 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

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.

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 may have a rotated pelvis and likely a stressed sacroiliac joint.

This puts excess pressure on the sciatic nerve. In clinic we use NKT testing to tell us the effect this has on musculature. A common compensation we find is inhibited (or weak) Gluteus Maximus from a facilitated same sided iliacus (hip flexor muscle) or opposite Quadratus Lumborum (back core muscle) causing a compression in the SI joint.

This helps us to target exactly which muscles need to be released or worked on with soft tissue, and which need to be strengthened.

Tight Piriformis Muscle

The third location where pressure is commonly put on the sciatic nerve as the nerve passes underneath the piriformis muscle. Simple everyday actions, like walking, running and sitting, can place extra pressure on the muscle on top of an existing 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 piercing the muscle belly, 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.

What a Session at Urban Wellness Clinic Looks Like

We use a variety of tools to assess and treat sciatica. The first step is finding the cause of the sciatic symptoms. We use specific orthopedic and neurological tests, pain pattern history and a Selective Functional Movement Assessment to screen for the root cause of sciatic nerve compression. Neurokinetic Therapy is a way in which we assess which muscles are overworking and need to be released and which muscles are underworking and need to be strengthened. Typically with sciatica, the iliacus, quadratus lumborum or piriformis are tight and the gluteus maximus is weak.

A recent case that presented to the clinic was a middle-aged male on vacation. He reported cramping and sometimes sharp pain in the right buttock region and numbness and tingling to the back of the leg. The symptoms were getting worse with increased walking and sight-seeing around NYC. After ruling out disc compression, orthopedic tests and muscle evaluation found right sacroiliac joint stress. NKT evaluation found his right piriformis to be overworking for his right gluteus maximus. Active release technique was used to release the specific area of the piriformis muscle and he was given exercises to strengthen the glutes. Core exercises and toe and ankle mobility were also part of the patients’ particular case – which may attribute to tendency towards a stressed right sacroiliac joint.

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 whether it’s from an old injury, a surgery, a faulty movement pattern, or a poor daily habit.

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. Find out more about how chiropractic treatment can benefit a compressed sciatic nerve.

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