Diagnosis: Sciatica – How I Evaluate and Treat to Get You Relief!

By Dr. Bryen Brown

August 16, 2018


One of the common issues walking into a chiropractic office is Sciatica. You see it on commercials with some new knee brace, back brace, or miracle gel.  It’s marketed by pain management doctors and orthopedic offices displaying their different options of treatment.

We seek out those patients here at CORE Chiropractic, similar to thousands of other chiropractic clinics in the world. Fact is: there are a lot of people who suffer from sciatica.  The bad thing is that most people don’t know what to do to actually get relief.

I get people that walk in with sciatica on a regular basis and I know first hand (literally) how you or a loved one can benefit from the CORE System to get relief or eradicate your sciatica. Our CORE system is a program to evaluate and treat patients, giving them the information to better understand whats wrong and necessary treatment to fix and then prevent the problem from returning.

In the next few paragraphs, I will help put you at ease. We get a lot of people who’s never been to a chiropractor and is usually nervous or afraid of the what their are getting into. This fear has ruined lives. So many people can benefit from chiropractic care, but for various reasons, are afraid to see a chiropractor. Because of this, I’m going to break down my evaluation process to see if you have sciatica, what’s causing it, and how to either get rid of it all together, get life-changing relief, or in worst-case scenario, help you to better manage your symptoms. Follow closely, let’s break it down.

The first step in the process is a consultation.

During the consultation, we have a chance to speak one on one to get all pertinent information about the problem and activities of daily living. The consult is considered one of the most important parts in the process that involves simply talking and listening. A detailed history includes a bunch of questions about the problem such as: location of symptoms, how it started, when it started, and/or how frequently it occurs.

Disclosure of any past traumatic events should be discussed. What type of workouts are you doing or what sports did you used to play? What’s your daily activities now? All plus many more to complete a detailed history about out your life.  A full detailed history can give me all I need to narrow down whats wrong to correctly diagnoses the condition.

The next step in the process is an examination.

The exam may vary but normally include:

  • A postural analysis to access you structure. hip hike, shoulder hike, head tilt, or forward head carriage, to name a few.
  • Range of motion exam to basically see what motions are restricted and if sensations such as pain or tension occurs when performing the task.
  • Palpation is using the hands to see if anything feels out of order. Tenderness, subluxations, swelling, heat, tone of muscle are among the list of exam finds.
  • Orthopedic tests helps to specify the nature of the condition by being able to isolate the joints or muscles affected making it easier to distinguish between what is damaged.
  • Neurological exam checks for nerve damage. Just like most things, nerve compression comes in levels. There’s your common shooting pain, burning, or tingling to more serious foot drop, urinary incontinence, or paralysis.

After the examination there’s a summation of the findings from the exam and a few diagnoses, such as sciatica.

Next a spinal x-ray is taken to get visuals of the spine.

They also give us clear knowledge on any underlying conditions of the spine, such as bad discs, spondylolisthesis, degeneration, or fractures. We all know a picture paints a thousand words.  After full analysis of the x-rays a treatment plan is developed to guide your frequently of in-office visits as well as home care activities. We look at and discuss the findings together so you also know why you’re feeling the way you’re feeling and able to see what’s wrong. The treatment plan outlines the details of the program and financials. All questions or concerns are answered.

An example of what I see during a sciatica case.

An average sciatica case walks in complaining of low back pain and/or pain in the buttocks or pain shooting down the leg. Typically, sciatica only affects one side of the body. Other than pain, sensations such as numbness, tingling, burning, or weakness can also be presenting symptoms. The origin of the condition can vary. Traumatic injuries can damage or herniate the discs which directly compresses a nerve and cause sciatica.

In most cases, its a repetitive abnormal posture or motion re-created again and again over days, months, or years that eventually causes wear and tear over time. The everyday activities at work, the sitting posture at work, the posture when reading, studying, or watching TV, the position you sleep in, pregnancy, or running or exercising with an imbalance. These are a few of the common daily situations that can leave you susceptible to sciatica.

The orthopedic tests can help to distinguish what is compressing and irritating the nerve. The usual suspects are subluxations, disc bulge/herniation, or muscle spasm.  After the history draws out the abnormal posture or activities creating the problem, the orthopedic tests specified what structures are affected, we then focus on fixing the damage to your body that has been done which is in the lower back, sacrum, and pelvis.

Next lets talk about your treatment options.

Treatment consists of a series of adjustments, exercises, therapies, and other postural improvement activities to alleviate the issues at hand. With sciatica, all the evidence leads to compression on nerves due to pelvic/sacral misalignment creating imbalances or vertebral subluxations. People get nervous about seeing a chiropractor due to the second hand knowledge of an adjustment.

Some watch on YouTube while others are just traumatized by what they saw in an action movie. All precaution is taken at this office to ensure that it is safe to treat you. Also, most people after getting their first adjustment state it’s not as bad as they thought it would be.

Advice: don’t let this fear hold you back from getting the best treatment for your problem. Often times, that same fear will lead you to do something more drastic such as getting an unnecessary surgery. (which somehow appeals as less of a danger than a chiropractic adjustment, which blows my mind but that’s just me).

If you’ve suffered with low back pain or other similar pain or symptoms listed above, the recommended option would be to get evaluated by a chiropractor to investigate the cause of the problem. Our CORE system has helped numerous patients figure out what was causing their pain and helped give them relief. Finding the cause makes it easier to find the cure. Chiropractic is also considered the most cost effective treatments for relieving sciatica. Schedule your FREE consultation today!

Dr. Bryen Brown

About the author

Dr. Bryen Brown is married to Dawn and has one son. He grew up in Bogalusa, LA and received his Bachelor of Science Degree in Biology from Grambling State University in 2008. He then attended and graduated from Texas Chiropractic College in 2012. Click Here To Read Full Bio

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