What Is Sciatica and What Are the Treatments For Sciatica

Living with sciatica presents numerous challenges as it brings about pain, numbness, and discomfort in the lower back, buttocks, and legs. However, there is a range of treatment approaches that can help alleviate symptoms, promote healing, and improve one’s quality of life. As a Chiropractor in West Vancouver, I’ve treatment numerous patients with sciatica over the years and hope that this article can offer various treatment options for sciatica, empowering you to make informed decisions about your health and well-being. These options span from conservative measures to more advanced interventions.

Thankfully, there are conservative measures that can provide relief and aid in healing for mild cases of sciatica. Rest and activity modification are essential. By avoiding activities that worsen symptoms and engaging in gentle exercises and stretches, you can prevent further aggravation of the affected area and promote the body’s natural healing process.

What is true Sciatica?

Sciatica refers to the pain, numbness, or tingling that originates in the lower back and radiates through the buttock and down the leg. It occurs when the sciatic nerve, which is the longest nerve in the body, becomes compressed or irritated.

True sciatica, also known as lumbar radiculopathy, is a specific type of sciatic pain caused by the compression or irritation of a spinal nerve root in the lower back. The most common cause of true sciatica is a herniated or bulging disc in the lumbar spine, where the inner gel-like material of a spinal disc protrudes and presses or irritates a nerve root.

Other conditions that can lead to true sciatica include spinal stenosis (narrowing of the spinal canal), spondylolisthesis (a condition where one vertebra slips forward over another), spinal tumors, or injury to the sciatic nerve itself.

True sciatica typically affects one side of the body and can cause varying degrees of pain, ranging from mild to severe. It may also be accompanied by additional symptoms such as muscle weakness, difficulty in moving the leg or foot, and changes in reflexes.

To diagnose true sciatica, doctors may perform a physical examination, review the patient’s medical history, and order imaging tests such as an MRI or CT scan to identify the underlying cause.

Treatment for true sciatica aims to relieve pain, reduce inflammation, and address the underlying cause. It may include a combination of manipulations, pain medications, specific therapy exercises, hot or cold therapy, epidural steroid injections, and in severe cases, surgical intervention to remove the source of compression on the nerve.

It’s important to note that there are other conditions that can mimic sciatica symptoms, so it is essential to consult a healthcare professional such as your Chiropractor in West Vancouver for an accurate diagnosis and appropriate treatment options.

Symptoms of Sciatica

The typical symptom of sciatica refers to the pain that radiates along the path of the sciatic nerve, which extends from the lower back through the hips and buttocks and down each leg. The most common symptom of sciatica is pain, but other symptoms may also be present.

Here are the typical symptoms associated with sciatica:

• Pain: The hallmark symptom of sciatica is a sharp, shooting, or burning pain that starts in the lower back or buttock and travels down the back of the thigh, calf, and possibly even to the foot. The pain may vary in intensity, from mild to severe.

• Numbness and tingling: Many individuals with sciatica experience numbness, tingling, or a “pins and needles” sensation in the affected leg or foot. This sensation can be felt along the path of the sciatic nerve.

• Muscle weakness: Weakness in the leg or foot muscles may occur in severe cases of sciatica. This weakness can affect your ability to walk or engage in normal activities.

• Radiating pain: The pain from sciatica typically follows a specific pattern, radiating from the lower back or buttock down the back of the leg. It may worsen with certain movements or positions, such as sitting or standing for prolonged periods, bending forward, or coughing/sneezing.

• Worsening pain with specific activities: Certain actions or movements, such as bending, lifting, or twisting, may worsen the pain or trigger a flare-up of symptoms.

• Difficulty with sitting or standing: People with sciatica often find it uncomfortable to sit or stand for extended periods. Changes in position or movement may provide temporary relief.

It’s important to note that sciatica is a symptom of an underlying condition, such as a herniated or bulging disc, spinal stenosis, or a bone spur pressing on or irritating the sciatic nerve. If you suspect you have sciatica or are experiencing any of these symptoms, it is recommended to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

Treatment options for Sciatica:

I.          Conservative Treatment

Conservative treatment for sciatica focuses on relieving pain, reducing inflammation, and promoting healing.

Here are some conservative treatment options:

• Rest and limited activity: It’s important to avoid activities that worsen your pain, but you should also aim to stay moderately active. Prolonged bed rest is generally not recommended.

• Pain medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation associated with sciatica. Always follow the instructions on the label and consult your doctor or pharmacist if you have any concerns.

• Hot and cold therapy: Applying a cold pack or ice wrapped in a towel to the affected area for about 20 minutes several times a day for the first and second day can help reduce inflammation. After a few days, you can switch to using a heating pad or warm compress to relax the muscles and increase blood flow.

• Chiropractic care: A chiropractor can teach you exercises and stretches to alleviate pain and strengthen the muscles supporting your back. They may also recommend techniques such as spinal traction, flexion distraction therapy and gentle mobilization.

• Stretching exercises: Gentle stretching exercises, such as lumbar flexion stretches, knee-to-chest stretches, piriformis stretches, and hamstring stretches, can help relieve sciatic nerve compression and improve flexibility.

• Posture correction: Maintaining proper posture, especially while sitting or standing for extended periods, can help reduce strain on the lower back. Use supportive chairs, sit with your feet flat on the ground, and consider using a lumbar roll or cushion for additional support.

• Weight management: Maintaining a healthy weight can alleviate stress on the spine and reduce the pressure on the sciatic nerve.

• Alternative therapies: Techniques like acupuncture, chiropractic adjustments, and massage therapy may provide relief for some individuals. However, consult with a qualified practitioner before trying any alternative treatments.

• It’s important to note that these conservative treatments may not provide immediate relief, and individual results may vary. If your symptoms worsen or persist despite these measures, it’s advisable to consult with a healthcare professional for further evaluation and possible additional treatment options.

II.         Interventional Procedures

• Chiropractic Care: Chiropractors perform spinal adjustments and manipulations with the goal of realigning the spine, relieving nerve pressure, and reducing symptoms of sciatica.

• Transcutaneous Electrical Nerve Stimulation (TENS): TENS units employ low-voltage electrical currents to the affected region, disrupting pain signals and providing temporary relief.

• Acupuncture: This age-old practice involves the insertion of thin needles into specific points on the body to stimulate healing and alleviate pain. It can be used in conjunction with other treatments.

• Epidural Steroid Injections (ESIs): These injections are a minimally invasive procedure where corticosteroids are directly injected around the affected nerve root to decrease inflammation and alleviate pain.

III.        Surgical Interventions

• Microdiscectomy involves the removal of a herniated disc fragment that is compressing the sciatic nerve, resulting in pain relief, and decreasing the likelihood of future occurrences.

• In cases where spinal stenosis is the underlying cause, a laminectomy can be performed to alleviate pressure on the nerve roots by removing excessive bone growth.

• Spinal fusion surgery may be considered for individuals with significant spinal instability or recurring disc herniation. It involves joining adjacent vertebrae to establish long-term stability.

• Laser surgery utilizes minimally invasive techniques to reduce the size of herniated discs and alleviate pressure on the sciatic nerve. This procedure aims to reduce pain and facilitate the healing process.

IV.        Complimentary and Lifestyle Approaches

• Engaging in yoga and performing gentle stretching exercises can enhance flexibility, alleviate muscle tension, and offer relief from the symptoms of sciatica.

• Daily Stretching as a habit can reduce joint inflexibility and allow for a greater normal range of motion with daily activities, whether it be household chores, gardening, sports, and general activity.  It reduces the stress on the spine and supporting soft tissue and allows for normal movement of the spine, discs and ligaments.  Normal and natural movement of the spine greatly reduces early osteoarthritis of the spine and formation of bone spurs and vertebral degeneration.

• Utilizing professional massage techniques can effectively relax muscles, enhance blood circulation, and alleviate the pain associated with sciatica.

• Practicing good posture and maintaining ergonomic positioning during activities such as sitting, standing, and lifting can help prevent lower back strain and reduce the likelihood of compressing the sciatic nerve.

• Managing weight effectively contributes to reducing the burden on the spine and diminishing pressure on the sciatic nerve, potentially leading to the alleviation of symptoms.

Conditions That Mimic Sciatica:

I.          Sacroiliac Misalignment

Our Chiropractor in West Vancouver probably sees this very common condition on a daily basis.  A patient would come into the clinic complaining of low back pain that refers down through their buttocks, back of their thigh down to the leg on one side.  It’s unusual to have this complaint happening to both legs simultaneously.  The most common symptom is pain, but sometimes it’s accompanied by both numbness and tingling.  In most cases, there is pain in the low back with a secondary referral down the buttocks to the thigh and leg.  Weakness in the leg in question is not noted. The pain is usually worse when sitting and in the transition from sitting to standing. 

This common condition is the results of very tight and chronic thigh and leg muscles that will invariably cause the pelvis to rotate into an abnormal position thus causing the low back pain and referral pain down the legs.  The muscles in the buttocks will then compress and irritate a portion of the sciatic nerve and create these symptoms.  If treated early, a few simple manipulations to re-align the pelvis and the sacroiliac joint is all that is needed.  The patient will most likely return to a pain-free and active lifestyle within 1-2 weeks with no restrictions.

II.         Tight muscles in the glutes and thigh:

1.         Piriformis

A muscle called the Piriformis can be a problematic muscle if it’s too tight due to overuse or lack of flexibility.  The sciatic nerve lies just beneath this muscle.  If the Piriformis muscle is overstretched and touches or compresses the sciatic nerve, glute and leg pain can result.  The symptoms are usually worsened with sitting and walking.  Flexibility exercises and stretching of the Piriformis muscle will usually resolve the sciatica.

2.         Hamstrings

Other leg muscles such as the hamstrings can also mimic sciatica as the sciatic nerve runs underneath these group muscles.  The hamstring muscles, comprising the semimembranosus, semitendinosus, and biceps femoris, are located in the posterior thigh between the hip and the knee. These muscles are prone to injuries and being overly tight from overuse and lack of stretching. 

The sciatic nerve, which is the large nerve extending from the lower back to the legs, can be affected by a condition known as hamstring syndrome. This syndrome occurs when the nerve experiences pressure due to being compressed between the hamstring muscles and the pelvic bone or by the connective tissue band that links the hamstring muscles.

Symptoms of this condition include pain in the hip and buttock, accompanied by occasional numbness along the back of the leg. Discomfort may be felt when sitting or stretching the hamstrings, while lying on the back might provide some relief.

It is most commonly observed in individuals engaged in sports activities that involve running, kicking, or jumping.

Conclusion

Treating sciatica requires a comprehensive approach tailored to the individual’s specific needs. Conservative treatments such as rest, chiropractic, manual therapy and medication can often provide significant relief. For those who require more advanced interventions, interventional procedures or surgical options may be considered. Complementary therapies and lifestyle modifications can also play a valuable role in managing symptoms and promoting long-term recovery.

It is crucial to consult with healthcare professionals and your Chiropractor in West Vancouver to determine the most appropriate treatment plan based on the underlying cause, severity of symptoms, and individual circumstances. With the right approach and a proactive mindset, individuals with sciatica can find relief, regain functionality, and improve their overall well-being.  Feel free to call our clinic at Ambleside Chiropractic in West Vancouver if you suspect you have a sciatic problem.  Remember that the sooner you deal with this condition the faster you can return to a pain-free lifestyle.