Sciatica

Written by Dr. Jason Ngan, DC

What is Sciatica?

Sciatica (aka sciatic neuritis, pinched nerve) is a debilitating condition that causes pain along the path of the sciatic nerve (L4-S3).  This nerve is the largest nerve in the human body.  It comes from the lower back and goes through the hips, buttocks, and legs. It controls movements and sensation in the lower extremities.

What causes Sciatica?

Since sciatica is from irritation of the sciatic nerve, it can be caused by a variety of sources.

  • Herniated disc at the lumbar spine compresses the sciatic nerve.

  • Overgrowth of bone of the lumbar spine can also put pressure on the nerve.

  • Overweight/obesity increases stress of the spine.

  • Poor posture/ergonomics can attribute to compaction of the sciatic nerve.

  • Inflammation and muscle spasm pinches the sciatic nerve.

What are the Signs and Symptoms?

Symptoms can occur in one or both legs. It can affect the path of the sciatic nerve which runs through the lower back, buttocks, to the back of the legs.

  • Pain, numbness, tingling, weakness that travels down the back of the leg.

  • Symptoms worsen with movement, coughing, sneezing, or performing a bowel movement.

  • In severe situations, bowel and bladder function is disrupted. This can be a sign of cauda equina syndrome and would require an emergency room visit.

How is Sciatica Diagnosed?

Sciatica is diagnosed with a thorough medical history, physical examination, orthopedic testing, x-ray diagnostic imaging, CT scan, EMG/NCV, and MRI.

  • Muscle weakness.

  • Abnormal sensation (pain, numbness, tingling) down the back of the legs.

  • Diagnostic imaging looks for disc herniation, osteophytes (growth spurs), spinal canal stenosis (narrowing of spinal cord).

  • EMG/NCV checks for function of nerve and muscles.

What are the Treatment Options?

At Ngan Chiropractic, we properly diagnose the cause of the sciatica and we treat the source. Some options we provide are:

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic/postural counseling

  • Rehabilitative exercises

Other treatments that patients may seek (not provided at Ngan Chiropractic) include physical therapy, acupuncture, epidural steroid injections, and surgery if severe.  

References

  1. Alrwaily M, Almutiri M, Schneider M. Assessment of variability in traction interventions for patients with low back pain: a systematic review. Chiropr Man Therap. 2018;26:35.

  2. Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

  3. Miller KJ. Physical assessment of lower extremity radiculopathy and sciatica. J Chiropr Med 2007 Jun;6(2):75-82.

  4. Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J. 2006 Mar-Apr;6 (2): 131-7.