Sciatica is defined as buttock/thigh/leg and foot pain of spinal origin. It is most commonly a result of nerve root irritation/compression from a lower back disc. An internal injury to a disc will result in local lower back pain with no leg pain. If discs are injured to the degree that they bulge and irritate a nerve root as it exits the spine patients will experience back and leg pain. In layman’s terms this is called a “slipped disc” and in medical terms it is called a herniated disc.
Anti-inflammatory medication, pain-killers and bed rest, which reduces the weight bearing function of the lower back are often prescribed. If symptoms are not settling down within a few days more active treatment may be needed.
Most chiropractors will use low back manipulation which frees up stiffened joints, reduces adhesions and decreases pain. Another technique which we use at our clinic is called Flexion-Distraction, in which a few preliminary studies have demonstrated meaningful pain relief. This gentle repeated movement is repeated for 5-10 minutes and is carried out 2 to 3 times a week for 2 to 4 weeks. If meaningful improvement has taken place continuing treatment for another 2 to 4 weeks may be recommended. If no improvement has been noted you will be referred to one of the medical consultants at our clinic.
Patients with sciatica must be monitored very closely and they must be made aware of signs of worsening which require immediate medical attention. These include the “cauda equina” syndrome signs such as progressive leg weakness, loss of bladder control and so forth.
A majority of patients (approximately 60-70%) will recover from sciatica within a period of 3 months. As symptoms improve it is vital to begin comprehensive exercises to strengthen the area and to promote healing. Unfortunately, some patients must undergo surgical intervention.