Leg pain or sciatica is a common complaint. The question arises, is the pain true sciatica or is it caused by something else other than a pinched nerve in the spine. There is bountiful literature regarding with the use of drugs or surgery for treatment for sciatic nerve pain. Granted there are times when this may be necessary, but chiropractic care has proven effective in the care of low back and leg pain.
What is Sciatica?
Sciatic pain can vary from a dull to a sharp shooting and stabbing pain going down the back of the leg. To be true sciatica, it must go below the knee. Sciatica may start out as an ache or pain in the back, buttock, and upper posterior thigh and eventually become intense and extend below the knee. True sciatica can compass one or more of the following nerve roots:
- 4th and 5th Lumbar Nerve Roots
- 1st Sacral Nerve Root
- To a lesser extent 2nd and 3rd Sacral Nerves
What Causes Sciatica?
One of the most common causes that contributes to sciatic pain is a herniated or bulging disc.
However, there are other conditions such as narrowing of the opening where the nerve root comes out of the spine or narrowing of the vertebral spinal canal that the spinal cord passes through from the brain downward. As the spinal cord gets choked by the narrowing, it is called stenosis. Also, altered or poor mechanical movement or facet syndrome of the lower spinal segments or vertebrae may cause irritation to the nerve producing an inflammatory response that develops leg pain. Trapping the nerve outside of the spine due to muscle compression can cause leg pain. One of the most common non-spinal causes of compression is from the piriformis muscle. This condition has been called “pseudo-sciatica” in literature. To complicate sciatica even more, conditions such as diabetes can cause nerve problems in the legs and contribute to a much slower response to any treatment.
Where is Sciatica Located?
True sciatica is located at the back of the leg. Interestingly, the left side seems to be the more common of the two legs. Many people call any form of leg pain sciatica, but the true sciatic pain is primarily in the posterior aspect of the thigh and calf. It may radiate around the lower leg below the knee to the top of the foot and toes. Where do the nerves cause pain and discomfort?
- The 4th lumbar nerve radiates pain to the inside of the foot and big toe area.
- The 5th lumbar nerve radiates pain to primarily the top of the foot in the middle toes.
- The 1st sacral nerve primarily radiates pain to the small toe and outside of the foot.
- The 2nd and 3rd sacral nerves are smaller contributors to the sciatic nerve, but they radiate pain to the pelvic muscles to include the floor of the pelvis. These sacral branches extend downward with the larger lumbar nerves.
How is Sciatica Treated?
Sciatica can be relieved quickly; however, a more complicated problem may resolve over a lengthy treatment period. The causation of sciatica determines the length of time for healing to occur. Sciatica could resolve with a few sessions of treatment or may take a few months. Again, the length of treatment depends upon the cause. There are various methods to care and treat sciatica. This includes not only chiropractic care, but medications and surgery. This article references only the chiropractic approach.
- Chiropractic Adjustment or Manipulation – Flexion-distraction adjustment or decompression reduces the intradiscal pressure and helps restore normal movement to the injured segments. This helps to reduce swelling.
- Side Posture Adjustment – Treatment helps to reduce joint fixation and improve spinal segment motion. This reduces swelling and controls pain. This is called diversified technique, one of the most common chiropractic treatments.
- Supportive Treatment – Chiropractors will use other treatment modalities to help alleviate the pain, reduce swelling and assist the healing process. This includes but not limited to the following:
- Electrical Muscle Stimulation – helps to reduce muscle spasm and ease muscle pain
- Ultrasound – reduce swelling
- Exercises – Strengthen weakened muscles and tendons as well as promote joint motion.
- Cryotherapy or Ice – Reduce Swelling and Control Pain.
- Heat – Improve circulation and help reduce muscle stiffness.
The doctors at Coon Rapids Chiropractic Office have experience in caring for low back pain, leg pain, and sciatica.