What Causes Sciatica? Is Chiropractic Really Your Best Option For Pain Relief?
If you're experiencing low back pain, that can be bad enough to ruin your day and affect your ability to do even the most basic activities. Add in pain that shoots into your buttock and down the back of your thigh and it can become absolutely miserable. Finding the cause of the nerve irritation is critical if you hope to get pain relief. Patients that come to us with this type of pain find walking, running, bending and lifting unbearable.
What Is Sciatica?
Sciatica (Sciatica neuritis) is the name for any irritation to the sciatic nerve. Some patients believe all low back pain is sciatica, but the term is actually very specific to that nerve. The sciatic nerve is the biggest nerve in the entire body and controls the function of several muscles in the lower legs and supplies nerve sensation to most of the lower leg.
Sciatica is a symptom, not the problem itself. Saying you have sciatica is much like saying you have low back pain or shoulder pain. Whatever is causing the irritation of the nerve is the condition that must be addressed, and that's were professional help is needed.
Back pain is not a symptom that should be ignored, but once the nerve is involved, you absolutely cannot ignore it. Nerve pressure over a long period of time can become worse, then lead to permanent changes. Usually, the further down the leg the radiating pain is going , the worse the condition is becoming. When a patient starts chiropractic care, the radiating pain that went all the way down to the foot will improve by just going to the knee, then the hip, then no radiating symptoms at all before the pain goes away. Other patients experience a reduction in the intensity and frequency of the symptoms before the pain goes away all at once. This type of treatment only works if we're able to get pressure off the irritated nerve.
What is Causing the Nerve Irritation?
When patients come to our office seeking relief from sciatica, we start with an examination. We test your ranges of motion and then perform orthopedic tests that will narrow down the source of your pain. We want to find out specifically what is causing the nerve irritation, leading to the sciatic nerve pain. Very commonly, the source of the pain is a bulging or herniated disc. Patients suffering with a disc problem may notice more pain when they sit or bend forward. Another indication of disc involvement is an increase in pain when coughing, sneezing, or bearing down while using the restroom.
Disc problems need immediate attention, even if that just means support with a back brace and frequent use of ice. Patients that apply heat for a disc problem report their pain goes away when the heat is applied, but becomes much worse once the heat is taken away. Bottom line: don't use heat for disc problems. Disc problems, unlike other back pain causes, can get worse to the point surgery is required. Avoiding movements that require bending, lifting, and twisting (especially while holding anything with weight) is helpful in keeping things from getting worse. If symptoms don't go away or improve within the first couple weeks of chiropractic care, an MRI is needed to get more information.
Other areas that can be irritating the sciatic nerve include your sacroiliac joints (SI joints) and your hip rotator muscles (most commonly the piriformis). The SI joint includes your sacrum and the ilium and you may notice more pain when you lean back instead of bending forward. Patients also report more difficulty when walking or lunging. There's an orthopedic test we perform during the examination that will help us see how this joint is moving and how it may be affecting your sciatic nerve. We can also test your hip rotator muscles for areas of tightness or lack of flexibility. Patients with this problem report increased pain when putting on their shoes or socks.
How Do We Know Which Area Is The Problem?
We often find that it's not just one thing that's causing the sciatica. Your disc may be irritated while your hip rotators are tight and your sacroiliac joint is not functioning normally. Our approach is to take massive action and work on all areas that are affecting the nerve. Following your physical examination, we will take any necessary x-rays and assess the areas of potential disc issues and spinal misalignment.
While we can't see discs on x-ray, we can get hints as to how well they're doing. The discs show up on x-ray as a space between the vertebrae. If the spaces between all the vertebrae are consistent, you either don't have a disc problem or you may just have irritation as opposed to bulging or herniation. If one disc height is significantly less than the other discs, you are likely having a problem at that spinal level. We may also see signs of spinal degeneration, like signs of early bone spurs forming or significant degenerative changes. Spinal degeneration will give us a good idea how long the problem has been there, not just the symptom.
We take measurements of the pelvis and each vertebra in your spine to specifically determine how your spine has moved out of place. This allows all of your chiropractic adjustments to help you get the fastest improvement possible. Later in your treatment we will take follow up x-rays to see what's changed and give us information as to what to do next. Your symptoms should start to improve in a few weeks but making lasting changes takes more time. We know your goal is to get out of pain quickly, but you also want to keep it from coming back again.
What Type of Treatment Do You Use For Sciatica Relief?
Since the problem is what's causing the irritation, not the irritation itself, we utilize multiple therapies and approaches to help you get fast relief and then lasting results.
We have several chiropractic techniques available to address the spinal alignment and function and provide personalized chiropractic care. Most often, we use our hands to feel along your spine and determine which area to adjust. We combine what we find on the evaluation with the information we learned from your x-ray examination to determine which vertebra needs to be adjusted and which direction to adjust it. The adjustments are comfortable and are the foundation of your care plan.
Non-surgical spinal decompression therapy is particularly helpful to alleviate the compression on the discs and the pressure being put on the nerve root because of it. Our spinal decompression unit not only pulls the spine straight down, but has the ability to pull to the side. This allows us to open up the spinal joint on the side that is putting the most pressure on your nerve root. This is an option not available on other spinal decompression units, but one we've found to be particularly helpful with sciatic nerve pain.
Muscle stimulation using our machine is different than a TENS unit you may have used in the past. While TENS units are helpful for providing temporary pain relief, interferential electric stimulation helps reduce pain, inflammation, and spasm. The electric stimulation will be placed over the source of your pain to reduce the symptoms at the disc and nerve root level. We will place ice on your back while you're doing this therapy to further reduce the inflammation during your treatment time.
Once your pain has begun to subside, we will move you to the mechanical traction table. This therapy helps restore blood flow between the vertebrae. Many patients call this therapy their "favorite part" of coming in for treatment, but it's not a therapy we can do at the beginning of your care when you're still in pain. This treatment is helpful in reducing stiffness and improving range of motion in your spine.
Muscle Work & Stretching
Your muscles are an integral part of making sure your spine works like it should and is supported. We utilize the Hypervolt to reduce muscle tension and stiffness prior to your adjustment. Then post-adjustment, we will work on stretching your hip rotator muscles to reduce the pressure on your nerve root as well as help your adjustment stay in place a little longer.
Finally, we will give you home recommendations to improve the speed of your results. At the beginning of your care, you'll be coming into the office frequently. As you improve, you'll come in less and less often. The less often we see you, the more important it is to have things you can do at home to keep this problem from returning. Home recommendations may include ice, stretching, exercises, and mobility work (including foam rolling).
What Can I Do At Home To Help My Sciatica?
While neck pain, back pain, and headaches are the most obvious side effects of working at a desk job, spending your day sitting also increases your risk for developing several other diseases. The most important thing you can do to get better is be consistent with your treatment. We've seen good treatment programs go bad simply because the patient was inconsistent with their care. Spinal adjustments build on each other and the more consistent you are, the better your results.
The same consistency goes for your home care recommendations. The more consistently you add these to your daily routine, the better you'll feel.
- Ice - Your spine has a lot of inflammation at the beginning of care. Using an ice pack 2 - 3x per day will provide a lot of relief and reduce swelling.
- Relief - This cream also reduces inflammation. Icing may not always be a convenient option. Using Relief cream is helpful, especially at night.
- Stretching - Your doctor will provide specific stretches for your hip rotator muscles. The recommended stretches will be based on your current flexibility levels and how comfortable the stretch is to perform.
- Strengthening - It's not enough to just stretch, you'll need to get stronger if you want to keep the pain from coming back. Exercises will be recommended based on your current activity levels, access to gym equipment, and ability to perform the exercises without pain.
- Mobility - In addition to muscles, ligaments, and tendons, your body is filled with fascia. Problems with your fascia can severely limit your ability to get better. Your doctor will show you simple techniques that use a foam roller and a ball (lacrosse ball, baseball, or softball) to break up the fascia and get you feeling better for long periods.
Chiropractic care is designed to locate the areas of your spine that are stuck, misaligned, or both. Finding these misalignments and restoring function is key to better health, pain relief, and a better functioning nervous system. When dealing with sciatica, I don't think you can attain true changes without making sure your spine is working as it should. Covering up the symptoms of sciatic nerve pain with medications won't change how you feel long-term. You have to work on the structure in order to make a lasting change.
At CORE Chiropractic, we utilize several adjusting techniques to help you get the best, most comfortable results possible. We take spinal x-rays to make sure you don't have any underlying conditions that will stop us from working on you, but also to establish a baseline as to where you are at the beginning of care. Later we can do follow up x-rays to show you how much has improved. We love helping our patients get great results in a professional and friendly atmosphere.
Having back pain or sciatica doesn’t mean you are doomed to a life of pain.
Let CORE Chiropractic help you get back on track with personalized chiropractic care, spinal decompression therapy, and a custom treatment plan. Call today for your consultation, or schedule an appointment online.