How many of us know someone who has or is currently suffering from sciatica? Sciatica can range from being very mild to almost debilitating pain lasting anywhere from a few days to months or even years. People recognize sciatic pain as pain typically starting in the low back and traveling down the buttocks and into the back of the leg. This pain can sometimes be described as numbness, tingling, burning, shooting, or can even contribute to weakness in the muscles of the leg. Typically sciatica is experienced on only one side at a time. Traditional management of sciatic pain often is over the counter medications (NSAIDS). If that doesn’t work, specialists look at treatments such as prescription painkillers, muscle relaxers, or even injections into the lumbar facet joints (joints between the vertebrae in the low back). These options can be good to manage the pain but they never seem to get to the root cause of the issue.
Conservative treatment options such as corrective chiropractic, massage, acupuncture, and physical therapy programs look for what is causing the symptoms and aims to correct that, not just manage the symptoms. Chiropractors specifically are trained to look at the bony structure of the low back and hips to see if they are biomechanically normal. All of the muscles and ligaments attach to the bony structure, so if the bones are out of place, this can cause the muscles to be tight and irritated as well. Think of this kind of like your car at home. If the wheels are not aligned then slowly the tires wear out, then the struts, the shocks, etc. When evaluating a patient with sciatica, we specifically are looking at the lumbar vertebrae (low back vertebrae), sacrum, and hips. Normal structure in these areas is as follows: nice and straight up and down from the front, but then from the side we need to have a nice C-shaped curve. We also evaluate to see if the hips are level and how the sacrum is positioned. People often ask… how do these structural shifts occur? Oftentimes, people deviate from normal structure with stress or trauma. People usually think of big traumas like car accidents, falling down the stairs, slipping on ice, or even sports injuries. Shifts in the low back and hips can also be a result of repetitive movement (or lack of movement) injuries. Repetitive lifting at work or even constant sitting can lead to a loss of curve in the low back. The L3, L4, and L5 nerves combine to form the sciatic nerve, so losing the normal curvature can lead to irritation of the sciatic nerve and as a result translate into traveling pain down the leg. Realigning and correcting the spinal structure in the low back while working with the muscles such as the piriformis muscle, psoas muscle, and even the hamstrings can lead to resolving the sciatic pain without the use of medications, injections, or surgery. Physical therapists and massage therapists can also work on this group of muscles. If someone you know is suffering from sciatica, share this information with them so they can consider conservative treatment options first.
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