Doctors of Chiropractic are trained and can be an effective treatment source for patient’s suffering with sciatica. Typically, sciatica has different types of pains, which may include: dull, achy, sharp, pins and needles, burning, numbness or even tingling. Each patient will feel a different sensation along with the intensity of the pain. Patients usually describe the pain starting in the low back or buttock and traveling into one or both legs.
Sciatica is generally caused by the sciatic nerve being irritated by some kind of compression. Disorders known to cause sciatic nerve pain may include but not limited: misalignment in the lumbar spine, herniated or bulging discs, pregnancy and childbirth, and non-spinal disorders such as diabetes, constipation, or even placing your wallet in your back pocket and sitting on it for long an extended amount of time.
One of the more common causes of sciatica is due to a muscle known as the piriformis. The piriformis muscle is located in the lower part of the pelvic region (see image), connects to the upper region of the femur, and assists in hip rotation. As you can see in the picture, the sciatic nerve runs beneath the piriformis muscle. This muscle is susceptible to injury from a slip and fall, hip arthritis, or a difference in leg length which may be congenital for structurally (misalignment in the spine/hips). This can cause the piriformis muscle to be hypertonic or spastic which then puts tension of the sciatic nerve beginning the early signs of sciatica.
As stated above when the sciatic nerve starts to be compressed it may result in the loss of feeling (sensory loss), tingling, burning, achy, weakness, etc.
The first step for any doctor is to determine the root cause of the issue causing the sciatic pain. A thorough exam is done on each patient which can include neurological, muscle testing, sensory, and orthopedic test to determine why the sciatic nerve is being irritated. Also if MRI, CT scan, or X-Rays are needed, they may be taken as well to get a more in depth analysis of the patient. These tests also help the doctor detect any contraindications for an adjustment and any other therapies. All this information is then utilized in forming a diagnosis for the patient.
Chiropractors are well diversified in treating patient’s that are dealing with sciatica. If there are no contraindications for an adjustment or therapies, a doctor of chiropractic may begin treatment on the patient as early as the first visit. There are different techniques that can be utilized for a patient; the main goal of an adjustment is to restore movement in regions of the spine that are restricted. When the spine, including the pelvic and sacrum are properly aligned it frees up regions that may have some tension. Adjustments also help to reduce nerve irritability responsible for causing inflammation, muscle spasm, pain, and other symptoms related to sciatica. Adjustments should not be painful. Spinal manipulation is proven to be safe and effective.
If suited, therapies may be used along with an adjustment. This includes a TENS unit which can help reduce muscle spasms that the patient may be having. The device uses electric current to help calm the muscles. Along with the TENS unit, ice may be beneficial for the patient when they are at home. Ice will help reduce inflammation in affected areas. Massages can also be beneficial for patients since this is another way to help calm the muscle spasms, especially the piriformis, in affected region.