By Dr. Adam J. Friedman – Margate, Florida – Often misunderstood to be a diagnosis, sciatica is actually the term for a collection of symptoms, predominantly lower back pain combined with pain that typically extends through the buttocks region and down one leg. It’s one of the most prevalent forms of lower back pain and is regularly treated by chiropractors.
Typically, when we are dealing with true sciatica, the patient will describe the pain as dull, achy, sharp, toothache-like, pins and needs or eerily similar to electric shocks. Sciatica can also manifest itself to include sensations of burning, numbness and tingling. In most instances, sciatica is caused by sciatic nerve compression. In my years of practice, the most common disorders that I’ve encountered known to cause sciatica include, but not limited to, lumbar spine subluxations (misalignment of vertebral bodies), herniated, bulging or slipped discs, pregnancy and childbirth, or other non-spinal disorders such as diabetes or by simply sitting on a wallet when placed in the back pocket.
One of the most prevalent causes of sciatica, that I’ve come across in practice is piriformis syndrome; a very painful condition that afflicts a large, dynamic muscle in your buttocks region. The muscle is essential in aiding in hip rotation. The sciatic nerve runs beneath this muscle. The piriformis muscle is highly susceptible to injury, whether it be the result of a sports injury, falls, arthritis, or even a difference in leg length. These things can lead to muscle spasm and/or sever hypertonicity of the piriformis, putting pressure and even pinching the sciatic nerve; causing inflammation and ultimately pain.
Sciatica can present itself in many different forms from a patient’s perspective and it’s essential that the chiropractor makes the proper diagnosis. The first step is to determine the etiology of the patient’s sciatica. This is done with an in-depth consultation with the patient to determine if we can find any precipitating factors or medical history that may have caused the condition. Once we’ve taken a thorough look at your medical history, we move onto a comprehensive chiropractic exam, which includes a complete musculoskeletal exam, including range of motion testing in addition to orthopedic and neurological testing.
When applicable, the chiropractor may recommend x-rays, an MRI or specialized nerve testing (EMG/NCVs) of the lower legs. Based on all of this information, the chiropractor can make an informed decision as to the etiology of the disorder and the best course of action in terms of treatment options. If there are any reasons that the chiropractor believes that spinal manipulation is contraindicated, the proper referral will be made to the appropriate healthcare provider to determine the most appropriate course of care.
Fortunately, in most instances, chiropractic care can help patient’s suffering from this common, in some cases, very debilitating condition. Using a combination of gentle chiropractic techniques (which are described in great detail to the patient prior to performing), a doctor of chiropractic can help patients restore proper spinal movement and alignment, while at the same time, minimizing pain. This non-surgical, drug-free option aims to address the root cause of the pain while also relieving its symptoms. As opposed to a more invasive approach with medications and injections, chiropractic care is a very conservative treatment option for this condition; with most patients seeing longer lasting relief of symptoms.
In addition to spinal adjustments, a chiropractor may utilize ice / heat therapy to reduce inflammation and/or muscle tightness ultimately leading to less pain. Ultrasound, which utilizes sound waves to increase circulation to the area, while gently therapeutically heating stiff and inflexible musculature, can also be beneficial. Rehabilitative exercises, at the appropriate time, are also utilized to help release endorphins, or pain killing hormones into the bloodstream that will help to relax muscles that are potentially causing the nerve compression. Electrical muscle stimulation may also be utilized to help decrease painful muscle spasms and also help to release endorphins.
I’ve seen thousands of patients over my many years in practice and it can be a debilitating condition when not diagnosed or treated appropriately. Chiropractic care is a safe, affordable, non-invasive approach to this problem and around 90 percent of sciatica cased end up resolving over time; it may take several months, but if the patient remains vigilant and follows the chiropractor’s recommendation, more often than not, positive results are achieved.
If you or someone you know suffers from chronic back, buttocks and leg pain, a chiropractic consultation is essential. A licensed practitioner with strong chiropractic training, like myself, should be consulted to assess the problem and develop an appropriate treatment plan. If you live in the Margate, Coconut Creek, or Coral Springs area take advantage of my free consultations.
Yours In Health,
Dr. Adam J. Friedman
- Palmer College of Chiropractic: “Chiropractic Treatments for Sciatica.” August 26th, 2015.
- Spine Universe: “Chiropractic Treatment of Sciatica.” Ron Grassi, DC MS ACFEI