Is It Really Sciatica?

That pain in my leg.

Sciatica’s the name, “debilitating lower back pain that extends down the hip and legs” is its game. And you’d probably like to get some relief from the pain that has you recliner-bound.

Hear this! Sitting around is not only getting old, it’s also making your symptoms worse. So, when painkillers and hot packs can’t cut the pain, consider visiting a chiropractor.

A chiropractor? For sciatica? Chiropractors are a great place to start when you have sciatica-like shooting pain or associated symptoms such as leg or foot tingling, numbness, or weakness. “Chiropractors are a portal of entry, meaning you don’t need a referral to see one,” says chiropractor Jason Holmes, DC. “We’re trained to work with musculoskeletal concerns, so we can help identify what’s the root cause of your symptoms.”

Chiropractic care is usually covered under most insurance plans, whether private, Medicare, or Medicaid. And a visit to the chiropractor may save you a step. Chiropractors can quickly identify whether your concern needs to be elevated to the next level and if you need to pursue:

Referrals: A referral to a physical or occupational therapist or an acupuncturist.

Medications: Talking to your primary care physician about a prescription for short-term use of muscle relaxant, steroid, or anti-inflammatory medicines.

Imaging scans: Getting an X-ray or MRI.

“In my office after a thorough history, and physical exam I am usually able to discern whether it is truly sciatica, or another issue,” says chiropractor Jason Holmes, DC.  Often times sciatica can get confused with another commonly known issue, piriformis syndrome. Piriformis syndrome mimics some of the same signs and symptoms that sciatica has but it is usually more related to the piriformis muscle. The piriformis muscles sit just lateral to the glutes. Pressure to the belly of these muscles will usually elicit a painful response, and this generally means the piriformis muscle is hypertonic and pushing on the sciatic nerve. Proper stretching and icing of the affected piriformis muscles generally help to relieve the issue. If the exam finding reveals that it is actually sciatica, then there are options for treatment based on chiropractic care. But first, let's discuss some of the signs and symptoms of sciatica. 

Normally the pain level associated with sciatica is usually pretty high. Normal scales grade pain on a 1 to 10. An inflamed sciatic nerve usually grades around a 7 or higher.  Another symptom of sciatica is what we call antalgia. Antalgia is sideways bending of the torso. When patients see this they usually use the word “crooked” to describe it.  Along with the pain, atalgia is the nerve sensation down the back of the leg and even into the bottom of the foot. 

Sciatica is usually identified with either some type of imaging or certain orthopedic tests administered to the patient. Based on these two variants, imaging usually reveals that there is a lesion of some sort associated with the lower lumbar disc. If imaging comes back negative for any disc issue, then the orthopedic tests usually lead the physician to determine that the culprit is actually the SI joint. It is one of the bony prominences that side to the left and right just above the glute muscle. Sometimes this joint gets moved beyond its range of motion and then causes issues with the sciatic nerve. Pressure from this joint problem leads to sciatic symptoms.

This is where chiropractic comes into play. That is what we do. We induce joint mobility back into the subluxated joint. This frees up the joint, and leads to a better range of motion. When the range of motion is restored to a joint, the pain level goes down, and this allows the sciatic nerve to return to its normal function as well. SI joints are a very common problem. I see patients day in and day out with this condition, and it is usually treated very effectively. So, the next time that sciatic nerve bothers you, think chiropractic!