Chiropractic Treatment for Sciatica
What is Sciatica
Sciatica, or impingement of the sciatic nerve, is a condition that affects more than 3 million people annually in the United States. It is characterized by pain originating in the lower back or buttock and often extending down the back of the leg and sometimes into the foot.
The characteristics of the symptoms vary greatly from one person to the next, and can range from a dull ache to sharp, debilitating pain. For some, the pain is marked by a burning sensation. For others, numbness and tingling accompany the pain.
Some of sciatica’s most common symptoms include:
Pain in the leg or buttock that worsens upon sitting
- Pain that shoots down the leg
- Numbness, tingling, muscle weakness, or trouble moving the leg or foot
- A burning sensation down the leg
- Pain primarily in one buttock
However sciatic nerve pain presents itself, it is a frustrating and sometimes incapacitating condition that can interfere greatly with participation in and enjoyment of life’s daily activities. Because sciatica is especially painful when seated, many sciatica sufferers have problems both at work and when relaxing at home, and struggle to find relief throughout their daily routine.
Causes of Sciatica
Sciatica is often misinterpreted as a diagnosis or condition in and of itself, but sciatica actually describes a set of symptoms, and not the root cause of the pain. The sciatic nerve is the longest nerve in the body, and it is the impairment or impingement of this nerve that causes sciatic nerve pain, or sciatica. The nerve also provides sensation and strength to the legs, which is why some experience muscle pain, numbness, and weakness as a result of sciatica. These symptoms are the result of something else that has gone wrong in the body, and to treat the sciatica, the root cause must be uncovered.
The first thing that a chiropractor or medical doctor does when assessing sciatica is attempt to determine the cause of the sciatic nerve pain. It is only by determining what is impinging the nerve that a game plan for relieving that impingement, and therefore the pain, can be created.
The most common cause of sciatic nerve pain is a herniated or slipped disc. Other common causes include:
Spinal stenosis (the narrowing of the spinal canal in the lower back)
- Piriformis syndrome (a tightening or spasming of the piriformis muscle)
- Degenerative disc disease (impacting the discs between the vertebrae)
- Spndylolisthesis (which occurs when one vertebra slips forward over another vertebra)
- Pregnancy (which adds pressure and strain on the spine)
- Wear and tear on the lower spine (with age or due to excess weight or poor alignment)
The diagnosis is formed after a review of the patient’s medical history, present symptoms, and a physical and neurological exam. Additional testing, such as an X-ray, MRI, or CT scan, may be ordered to better understand the issue. Chiropractic care may be performed independently, or may be a part of a broader treatment plan involving other doctors or alternative medicine practitioners.
Chiropractic Care for Sciatica
Chiropractic care is an ideal treatment modality for sciatica because it can directly address the root cause of the problem, and thereby both treat the cause and alleviate the symptoms. In fact, chiropractic manipulation is recommended by the American College of Physicians as a first line of defense against lower-back pain, before pain relievers, muscle relaxants, narcotics, injections, and surgery.
What Does Chiropractic Treatment for Sciatica Involve?
When most people think of chiropractic care, they primarily imagine “getting your back and neck cracked” to alleviate back or neck pain. It is true that this process, known as chiropractic adjustments, is a big part of the chiropractic treatment of sciatica, but chiropractors actually use a variety of treatment methods to address sciatic nerve impingement and pain:
- Ice/Cold Therapy -- reduces inflammation
- Ultrasound -- soothes pain via gentle heat created by sound waves that penetrate into muscles, increasing circulation and reducing muscle spasms, stiffness, and pain
- TENS Unit -- this portable muscle stimulation machine applies an electrical current to manage pain and reduce muscle spasms
- Spinal Manipulations -- the most important part of chiropractic care, this process frees the spine to move properly, and restores proper alignment to vertebrae experiencing subluxation
- At-home stretches and exercises -- these help ensure your treatment will be as effective as possible, and last even once treatment has lessened or ended
Spinal decompression therapy can also be an excellent treatment to help reduce sciatica caused by a herniated disc.
How Do Chiropractic Adjustments Help Sciatica Pain?
Chiropractic adjustments, or spinal manipulations, are at the center of the chiropractic method of care. During an adjustment, your chiropractor will use either their hands or a small instrument to apply a swift, controlled force to a joint of the spine.
Because the spinal column encases the nervous system, any improper alignment or slipped or herniated discs in the spine can lead to major problems that present across the body. In the case of sciatica, the sciatic nerve has been compromised due to the position of the spine or other imbalances or misalignments. Your chiropractor applies adjustments to your spine in order to restore the proper alignment of your vertebrae, thereby freeing your nervous system to function properly.
In many cases, because the adjustments quickly take the pressure off of the sciatic nerve, patients find quick and effective relief of their sciatic pain. However, it is important to continue to get routine adjustments as you are retraining your muscles to allow the vertebrae to maintain their new alignment. Until your body fully settles into proper alignment, continuous treatment is necessary.
Practices such as deep tissue massage therapy and acupuncture can help to expedite this process by promoting muscle relaxation and lessening the recoil response.
How Long Does Chiropractic Treatment for Lower Back Pain and Sciatica Take?
The duration of treatment will vary based on the root cause of your sciatica. It is important to tailor each chiropractic treatment schedule to the individual patient and their set of circumstances. You will likely need to see your chiropractor around 3 times per week initially, and then taper off as you feel better. Additionally, maintenance visits are important in order to make sure your body maintains its new alignment and your pain does not return.
In a 2010 study in the Journal of Manipulative and Physiological Therapeutics, sciatica patients saw a chiropractor around 3 times per week for 4 weeks, continuing weekly visits from that point forward, and then tapering off into maintenance or ultimately ending treatment once their symptoms were fully alleviated. In those who responded to the care, benefits were shown to last for up to a year.
We recommend discussing your progress with your chiropractor throughout treatment, and basing your treatment schedule upon that discussion.
Does Chiropractic Care Work for Everyone with Sciatica?
If the root cause of your sciatic nerve pain is determined to be one of the many things chiropractic care can address, then you will hopefully see some improvement through chiropractic treatment. There are instances in which surgery is necessary and chiropractic care should not be attempted, and your chiropractor will let you know if this is the case for you.
In the Journal of Manipulative and Physiological Therapeutics study cited above, it was found that “sixty percent of people with sciatica who didn’t get relief from other therapies and then tried spinal manipulation experienced the same degree of pain relief as patients who eventually had surgery.” Considering the significant risks associated with surgery, chiropractic is a much safer alternative for similar results.
In another study published in The Spine Journal: Official Journal of the North American Spine Society, patients with acute back pain and sciatica with disc protrusion patients who were treated with actual chiropractic spinal manipulations were found to have fewer numbers of days with pain and lower pain scores when compared to those treated with simulated manipulations.
Your chiropractor will work to alleviate your symptoms by addressing whatever is causing the impingement of your sciatic nerve. This can take time, and you may find that you have multiple root causes of your pain. But whether the road is long or short, chiropractic care will help you begin the journey to recovering from sciatic nerve pain.
Can Chiropractic Care Make My Sciatica Worse?
Of course, the last thing you want to do if you are suffering from sciatic nerve pain is somehow make your pain worse through treatment. Many people, unfamiliar with chiropractic care, find it intimidating at first and wonder whether the practice is safe. Chiropractic care, however, is considered a conservative treatment plan for many causes of sciatica, and any risks are minimal.
In a study on the “Safety of spinal manipulation in the treatment of lumbar disk herniations,” the most common cause of sciatica, published in the Journal of Manipulative and Physiological Therapeutics by Drew Oliphant, it was found that the risk of spinal manipulation causing clinical worsening in disk herniation or cauda equina syndrome was less than 1 in 3.7 million. The study concluded that spinal manipulation is safe, particularly when compared to other “medically accepted” treatments for lumbar disk herniations, and supported its practice as a conservative treatment option.
When Treatment Ends
Once the cause of your sciatic nerve pain has been managed through chiropractic care, you may choose to end your treatment or to continue with maintenance visits weekly, twice monthly, monthly, or as advised by your chiropractor.
Throughout your treatment, you will have learned stretches and exercises that can help prevent your injury from recurring. It is important to keep doing these exercises as prescribed in order to minimize the chance of your sciatic nerve pain coming back, and to keep necessary maintenance visits to a minimum.
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