To put this in focus, I see 10-20 new patients a week. Every week a few of those patients are presenting with sciatica. Out of all of those, maybe 1 every couple months is a disk problem. All the rest are stemming from an SI joint problem in the pelvis.
Now, if your sciatica is coming from Piriformis Syndrome secondary to a Subluxated SI-Joint then it will be temporary. Long story short. Something irritated your SI-Joint, the joint between your tailbone and your pelvic bone, so your body is spasming muscles to act as a splint to protect the SI Joint. One of those muscles, the piriformis which connects from your tailbone to the top of your leg and sits deep in your glutes, will spasm pressing the sciatic nerve against the pelvis causing your sciatica. The decompression can help release some tension and pressure which gives some relief as the muscle relaxes a bit. But as soon as you stop treatment and get back to life its just a matter of time before the muscles get tighter again and the sciatica returns. In this case you would need a course of chiropractic treatment to restore the normal function to the SI-Joint to correct the problem. And if this IS your problem, don't stop treatment too early! I see that way too often. These tend to be chronic problems surrounded by the largest most powerful muscles in our body that are always moving. The muscle memory is strongly ingrained. You don't need a lot of treatment and symptoms tend to resolve fairly fast which is why people tend to stop treatment based on how they FEEL. BUT you NEED to continue treatment the better part of a year to resolve it. After the short course of more frequent adjustments to get the function back you need to maintain at around every 2 weeks, so 2 times a month, to make sure you keep the proper function of the pelvis so the brain can relearn how to move the muscles properly to control the joint and how you move. Think of it like it's the retainer you wear after your braces come off. Your brain has to relearn how to control the movement with walking, running, standing, sitting, and anything else you do. SI Joint dysfunction is a common problem and comes about for many reasons, falls, sitting on bad chairs, improper sleeping position, stress playing sports and the list goes on. So not only are we treating this current problem we need to mitigate the continued irritations that are happening during the treatment and stabilization time. Chiropractic care is very good at handling sciatica if done properly.
The reason I'm spending the time to try and explain why and why not you would use decompression treatment for sciatica is for what I see out in the profession. For disk injuries decompression is a great treatment. Whether its inversion, manual decompression in the doctors office (what I do in my office), or teched out mechanical decompression. They all work well for this problem. But there are some very expensive mechanical decompression tables out there marketed to doctors complete with staff training and marketing materials to get the patients in and signed up for treatment. I see offices, not all of them, but some, where now that they are trying to pay the lease on that $90,000 piece of equipment, everyone who walks into their office is now a candidate for decompression therapy. I see this treatment over utilized on patients very often where this is really not the best treatment for them.
So for the right problem decompression can be very helpful and produce lasting results. Used for the wrong problem it most likely will be a temporary solution.
It also depends on how bad the disc started at. Very collapsed means very weak so may not be as effective long term. If your sciatica has been helped, that’s a great sign. Keep it up.
Vishal K. Verma, DC, CCSP