16 January, 2024

Sciatica

16 January, 2024

Sciatica is a pain that travels from the lower back down sciatic nerve to the back of the leg. It can be agonising, debilitating and constant, making sleep very difficult. The resulting exhaustion can then bring on more problems.

Sciatica is a common and often painful condition that affects millions of people worldwide. It is not a diagnosis in itself but rather a set of symptoms caused by compression or irritation of the sciatic nerve, the longest nerve in the human body. In this article, we will delve into the causes, symptoms, and treatment options for sciatica, providing valuable insights for those dealing with this challenging condition.

As professional chiropractors in Solihull and Sutton Coldfield, we work with our patients to understand what may have contributed their sciatica so we treat the underlying cause. We aim to address the long term, rather than just offering short term pain relief. We do this without the use of drugs or surgery.

Causes

Sciatica typically results from pressure or pulling on the sciatic nerve, which extends from the lower back down the back of each leg. The most common cause of sciatica is a herniated or slipped disc in the spine. When the soft inner core of a disc protrudes through the tough outer layer, it can compress the adjacent nerve roots, including the sciatic nerve. Even without direct disc pressure on the nerve there may be inflammation and swelling around the nerve applying pressure.  Other potential causes include muscle spasm/tightness in the buttock, spinal stenosis (narrowing of the spinal canal), spondylolisthesis (a condition where one vertebra slips forward over another), or even a tumour in the spine.

Symptoms

The hallmark symptom of sciatica is pain that radiates along the path of the sciatic nerve, typically from the lower back through the buttock and down the back of the leg. The pain can range from a mild ache to a sharp, burning sensation or excruciating discomfort. Other common symptoms include tingling, numbness, or weakness in the affected leg. The pain may worsen with prolonged sitting, standing, or walking, and sneezing or coughing can also intensify the symptoms.

Diagnosis

To be in a position to diagnose sciatica and produce a treatment or care plan the health professional needs to take a detailed history. This involves asking many questions : some of which may not seem immediately relevant. Amongst other things chiropractors will probably ask about your medical history, lifestyle, physical activity, work activities, stress levels and sleeping positions as well as the more obvious questions about the type of pain and how and when the pain started and progressed. 

Unless some serious red flags are found a physical examination will usually follow. The chiropractor will assess nerve function by checking for reflexes, muscle strength, and sensory changes. They will also perform orthopaedic tests which may include tests to see what affects, and even aggravates, the symptoms. 

To identify the underlying cause of the sciatic nerve compression it is occasionally necessary to order an MRI scan. The chiropractor may also need more information to assess the risk or decide if you need onward referral to another health professional. While X-rays give excellent images of bone they give little information about the soft tissues such as nerves and discs

Treatment Options

Conservative Care

Chiropractic Care: A chiropractor can develop a customized treatment plan to address the underlying issues which will often include and exercise program to strengthen the core muscles, improve flexibility, and correct posture. This approach aims to alleviate pressure on the sciatic nerve without drugs or surgery.

Rest and Physical Activities: While bed rest may be recommended during acute episodes, it’s crucial to resume normal activities as soon as possible. Gentle exercises and stretches can help alleviate symptoms and prevent recurrence.

Cold Packs: Applying cold packs to the affected area may provide temporary relief from pain and but more importantly can reduce inflammation. Never put frozen pack directly on your skin or on for to long as it can “burn” the skin.

Medication

Over-the-counter medication: Non-prescription pain relievers and anti-inflammatory drugs can help manage pain and reduce inflammation but will not address the underlying cause. 

Prescription Medication:  In more severe cases, healthcare providers may prescribe stronger medications, such as pain killers, strong anti-inflammatories muscle, relaxants or nerve pain medications, to manage symptoms. Generally, prescription medication carries higher risks from side-effects than over-the-counter medication.

Invasive Procedures: In cases resistant to conservative treatments, more invasive interventions like epidural steroid injections or surgery may be considered. Surgery is usually reserved for situations where there is a clear structural problem, such as a herniated disc, that requires intervention. Like all interventions there are risks. The more invasive the surgery the higher the risk of scar tissue causing permanent changes.

Prevention

While some causes of sciatica may be unavoidable, certain lifestyle modifications can help reduce the risk of developing or exacerbating the condition. Maintaining a healthy weight, practicing good posture, engaging in regular exercise, and avoiding prolonged periods of sitting or standing can contribute to spinal health and potentially prevent sciatica.

Sciatica can be a challenging and debilitating condition, but with proper diagnosis and a comprehensive treatment plan, the great majority of individuals can find relief and regain their quality of life. It’s essential to consult with healthcare professionals to determine the underlying cause of sciatica and develop an appropriate treatment strategy tailored to the individual’s needs. Whether through conservative measures, chiropractic treatment, or, in extreme cases, surgical intervention, addressing sciatica promptly and effectively is crucial for long-term well-being.

Chiropractic care is a good choice for many of the people who do seek our help so, to arrange a consultation and examination, contact us.

Disclaimer:
This site is for information and discussion purposes only and is not to be construed as practical and / or medical advice.

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