Sciatica is caused by varying degrees of compression on the sciatic nerve, most often associated with a disc protrusion or herniation – a ‘slipped’ disc. The lowest discs are the most commonly affected as they carry the most weight, and the nerves have the least amount of space as they exit the spine.
Initially the compression of the nerve causes pain in the leg, with or often without back pain, and then if this compression continues, tingling, pins and needles and eventually numbness and muscle paralysis ensues, which if not relieved can cause permanent damage.
Unfortunately sciatica is often misdiagnosed. This could be due to the fact that 40% of normal adults have a disc bulge that is asymptomatic, and a lot of leg pain caused by other problems, for example a lumbar joint problem, or piriformis muscle syndrome, is called sciatica, but does not show up on an MRI scan. So if the asymptomatic disc bulge is blamed for the sciatica and subsequently removed, the leg pain is of course not resolved as the actual problem is still there.
Sciatica pain can start in the back and travels into the buttock, then down the back or side of the thigh and calf into the foot, and sometimes toes. The pain may skip certain areas. If the pain is in the front of the thigh then it is not sciatica, and if it doesn’t go below the knee then it may not be sciatica either, but a referred pain from a back joint or muscle. It is important to diagnose the cause properly as the treatment is different.
GP’s will often prescribe anti-inflammatory medication and painkillers, which can help, but if this does not settle down the pain in a few days then a more proactive approach may be needed. Chiropractors often use manipulation to the joints in the pelvis or lumbar spine, which loosens up stiff joints and may help reduce the tension on the sciatic nerve, or even reduce the size of the disc bulge. It is also important to try and stay active to promote healing, and exercises to strengthen the core muscles such as sit-ups or back extensions help to reduce the mechanical strain on the discs and prevent relapse as well as improving recovery.
From the team at Barron Chiropractic Clinic - celebrating 30 years of providing natural healthcare to the people of Walton-on-Thames