As a chiropractor, one of the most common conditions that I see in my office is sciatica. Lower back pain with radiation into the leg is very common in North America.
In fact, just last week, I had a patient come into my office in such excruciating pain that he actually had to crawl through the hallway on his hands and knees.
What exactly causes Sciatica and how can we get rid of it? We must begin by understanding the meaning of the word sciatica.
What Sciatica Really Means
Sciatica is a term that describes symptoms of pain that begin in the lower back and extend down through the buttock, thigh, and into the lower leg and foot. These symptoms can occur when a nerve or nerve root is compressed or pinched in the lower back leading to the sensation of pain, numbness, and weakness into the leg. There are multiple locations where the nerve or nerve root can be pinched.
The most common cause of sciatica is lumbar disc herniation. Repeated mechanical stress to a spinal disc can cause the outer layers of the disc to tear and allows the inner substance to herniate, or push its way out of its enclosed space.
Lumbar disc herniations occur most commonly at the weakest point of the disc, which is the area where the nerve root exits from the spinal canal. When a disc herniates in this location, it often directly contacts the nerve root which is exiting through the space, thus activating the nerve and causing the feeling of numbness and pain radiating into the leg.
There are other conditions which can mimic the effects of a lumbar disc herniation including degenerative disc disease and piriformis syndrome, a condition in which the piriformis muscle becomes tight and compresses the sciatic nerve as it passes through the gluteal region.
So how can we treat Sciatica?
All health care professionals agree that conservative care should be performed first and that surgery is a last resort for this issue. This is where health care professionals like chiropractors and physiotherapists come in.
1. Heat/Ice Therapy
In the early stages of sciatica, using heat packs or ice packs may help to reduce pain and inflammation at the source of the problem. Heat helps to loosen muscles while ice helps to reduce inflammation and swelling.
2. Chiropractic Care and Physiotherapy
Both chiropractors and physiotherapists use a range of treatments to help relieve pain and promote proper motion. These can include electrotherapy, ultrasound and other modalities, soft tissue therapy, exercises, joint mobilization, and manipulation. Speak to your health care provider about what treatment is right for you.
3. McKenzie Exercises
These are exercises prescribed by chiropractors and physiotherapists that are effective in decreasing leg pain and centralizing the pain (bringing it into the lower back). Speak to your physiotherapist before starting this therapy.
4. Acupuncture and Traditional Chinese Medicine
I have successfully used acupuncture to significantly reduce the symptoms of sciatica for many of my patients. Acupuncture relies on the use of small needles inserted through the skin and into muscles at specific points along our meridian channels. These needles cause micro-trauma to the muscles leading to the release of hormones called endorphins. Endorphins help to calm nerve and muscle pain and reduce symptoms of pain.
5. Lumbar Spine Traction and Decompression Therapy
Some therapists use manual and instrument assisted traction therapy to help spread the lumbar vertebrae and allow disc material to become re-absorbed into the outer disc material. This is a good option to consider if your pain is not improving with other treatment types
6. Pain Medications like NSAIDs and Anti-inflammatory Supplements
If nothing else works, you can talk to your physician about painkillers and anti-inflammatory medications to help temporarily reduce the pain and inflammation. However, these medications have been linked to heart problems and should be used with caution.
Anti-inflammatory supplements, like curcumin and fish oil, are great natural alternatives to consider.
These medications can interact with other prescribed medications that you may be taking so make sure to consult with your physician and pharmacist before taking pain killers.