How to treat your sciatica

Most people will experience one or more episodes of back pain during their lives according to the British Chiropractic Association. Sciatica refers to lower back and often leg pain that is caused by irritation of the sciatic nerve. The sciatic nerve runs down the back of each leg. Several things can lead to sciatic nerve irritation and 'Sciatica' is a general or 'umbrella' term that does not tell us specifically WHAT is making the sciatic nerve unhappy.  We talk about some of the potential causes of sciatic nerve irritation below. Work or lifestyle habits, stress and strain on the back are all factors that contribute to sciatica. 

A visit to the chiropractor can help to determine the cause of sciatic nerve irritation. If you know the cause of something that means you can do the right things to help it to get better. Early treatment can help you get better faster.

Signs and Symptoms

·     Low back pain, which can sometimes spread down the back of the leg and all the way to the feet and toes. 

·     Numbness or tingling in the leg which can cause a feeling of weakness. 

·     Pain when coughing or sneezing.

·     Difficulty walking or 'antalgic' gait which means that you may lean to one side. Often people lean away from their pain. 

Causes 

The three most common causes are disc herniation, spinal stenosis and degeneration of the discs. 

Research suggests that up to 90% of all sciatica is caused by a herniated disc (commonly called a 'slipped disc'). One intevertebral disc, sits between each vertebrae, which are the bones that makes up the spine. The invertebral discs work as shock absorbers for the body's weight. When there is a weakness in the disc it can bulge outwards and put pressure on the nerves that form the sciatic nerve. The sciatic nerves can be compressed on one side causing pain down towards the leg.

Disc degeneration is another cause of sciatica. Degeneration or 'wear and tear' of the intevertebral discs effects how well they are able to function as shock absorbers. 

Spinal stenosis is the narrowing of the spinal canal in the lower back, often seen in older adults. This narrowing can result in the nerves passing through the canal being compressed and this may lead to buttock or lower extremity pain which may occur with or without back pain.

The chiropractor will perform a thorough physical examination including a neurological screen. This will help to determine the cause of sciatica. Often, if examiantion rules out any underlying pathology, there is no need to request  diagnostic imaging (Xray, CT or MRI). 

Treatment

Chiropractic treatment focuses on reducing the severity of symptoms and improving function and movement so that you can return to normal daily activities. The chiropractor may use a varitey of techniques depending on the severity and cause of sciatica. This may include spinal manipulative therapy/mobilisation, soft tissue therapies, acupuncture and home or work advice. Patients are given advice and informed how to self manage the condition by being given either stretching or strengthening exercise and encouraged to be physically active.

The cause will often determine the length of time it will take to get better. The chiropractor will always give you an expected recovery time based on your symptoms, physical examination and any other medical conditions. 

References

·      Saleem, M., 2019. Sciatica: Medical treatment or Physiotherapy?. African Journal of Pharmacy and Pharmacology, [Online]. 13 (14), 203-212. Available at: https://www.researchgate.net/profile/Yasir_Arfat4/publication/335500669_African_Journal_of_Pharmacy_and_Pharmacology_Sciatica_Medical_treatment_or_Physiotherapy/links/5d6919cd4585150886feefb4/African-Journal-of-Pharmacy-and-Pharmacology-Sciatica-Medical-treatment-or-Physiotherapy.pdf[Accessed 22 October 2019].

·      WebMD. 2019. What is Sciatica. [ONLINE] Available at: https://www.webmd.com/back-pain/what-is-sciatica#1. [Accessed 22 October 2019].

·      NHS. 2017. Sciatica. [ONLINE] Available at: https://www.nhs.uk/conditions/sciatica/. [Accessed 22 October 2019].

·      British Chiropractic Association. 2019. Back Pain. [ONLINE] Available at: https://chiropractic-uk.co.uk/back-pain/. [Accessed 23 November 2019].

·      Stuber, K., 2009. Chiropractic treatment of lumbar spinal stenosis: a review of the literature☆. Journal of Chiropractic Medicine, [Online]. 8(2), 77-85. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780929/ [Accessed 18 November 2019].

·      The Royal College of Chiropractors. 2019. Chiropractic Quality Standard Chronic Low Back Pain. [ONLINE] Available at: https://rcc-uk.org/wp-content/uploads/2015/01/Chronic-Low-Back-Pain-Quality-Standard-Short-version.pdf. [Accessed 30 November 2019].