True Story:
John is a 38 year old new patient who came in yesterday wondering if we can help his sciatica. He’s been in pain off and on for 4 years and occasionally needs to use a sick day because of it. He was diagnosed with sciatica due to the pain in his lower back that travels down this right thigh.
After a thorough examination and some Xrays it became clear that John doesn’t have sciatica!
It turn out that John’s sacroiliac joint (SI) isn’t working properly causing lower back pain that radiates down his leg. He’s doing the wrong stretches and what’s worse is that he’s been feeling like he has to suffer forever and possibly have surgery one day.
Within a few weeks (or maybe even days) he’ll notice a HUGE improvement to his symptoms and with the right self care they’ll never return.
This is an extremely common story in our office. As chiropractors, we often see patients suffering from sciatica and symptoms that mimic sciatica (often called pseudo-sciatica). Differentially diagnosing them is the key to helping patients heal.
What is Sciatica?
Sciatica is characterized by pain in the lower back and/or down the hips, legs and into the feet. It’s caused by a radiculopathy (pinched sciatic nerve) in the lower back.
The pain may be sharp, shooting, or burning in nature, and it may be accompanied by tingling or numbness. Symptoms may be worse when sitting or standing for long periods, or when coughing or sneezing.
How do you know if it’s sciatica?
Sciatica is very commonly mis-diagnosed because many other conditions cause similar symptoms. Without a thorough examination by a professional who treats sciatica (like a chiropractor) it’s virtually impossible to isolate, and therefore correct the root cause.
Many of our patients who were told they have sciatica actually have something else going on.
When it’s mis-diagnosed, it’s usually also mis-treated.
Here are some of the most common causes of sciatica and sciatica-like symptoms:
- Subluxations (very common): Subluxations are misalignments in the spine that can put pressure on the nerves, including the sciatic nerve. The compressed nerve can cause pain, numbness, or tingling sensations in the legs.
- Sacroiliac Syndrome (very common): When the sacroiliac joint becomes inflamed or irritated, it can cause sciatica-like symptoms. This condition is common with excessive sitting.
- Herniated or Bulging Discs: Herniated or bulging discs are a common cause of sciatica. When discs become damaged, they can press against the sciatic nerve and cause pain and discomfort. This cause is over-diagnosed as we see many patients who are told they have a disc issue causing their pain when in fact they have a sacroiliac issue.
- Spinal Stenosis (less common): Spinal stenosis is an arthritic condition that occurs when the spinal canal narrows and puts pressure on the spinal cord and nerves. This is especially common if the pain is down both legs.
- Hamstring Tension- (Mimics sciatica): Long term sitting causes hamstrings to become tense and often painful. Patients may experience a burning pain in the back of the thigh and throbbing behind the knee or in the buttocks.
- Piriformis Syndrome: (Mimics sciatica): When the piriformis muscle, (located in the buttocks) becomes tense it irritates the sciatic nerve causing similar symptoms to those of sciatica.
Can sciatica be cured?
The short answer is usually YES! In most cases sciatica and sciatica-like pain can be completely cured without surgery.
As chiropractors, our focus is on finding the root cause of the sciatica and correcting it so it heals completely and doesn’t return. This is not a “one size fits all” approach as each person has a unique set of circumstances causing their issue.
While medications provide temporary relief, they don’t correct the issue, often allowing it to worsen over time.
Dr. Shulman and Dr. Neely use a variety of techniques to adjust the spine and relieve pressure on the sciatic nerve. By correcting misalignments in the spine and restoring proper function to the affected areas, your pain dissipates as mobility returns.
The doctors also refer to registered massage as needed and provide simple, time efficient lifestyle suggestions (like how to sit properly-see below). We have an entire Youtube playlist that specifically address this issue.
4 Steps to Prevent and End Pain:
Fix Your Posture
Slouching puts a constant excessive strain on the joints of the lower back leading to disc issues, arthritis, tension and pinched nerves. Without question, focusing on your posture is the first step to healing and preventing sciatica.
Practice proper sitting
Sitting in a slouched position reverses the natural curve (lordosis) in the lower back and wreaks havoc on the discs, muscles and nerves in the area. .
Proper alignment when sitting:
- Make sure your weight is evenly distributed on the chair.
- Avoid tucking your pelvis under when you sit. This can cause a decrease in the natural curve of your lower back and can lead to lower back pain.
- Use a cushion, or towel to keep your pelvis in neutral.
- Keep your feet on the ground, (or use a footrest).
- Take breaks from sitting every 30-60 minutes.
Mobilize Your Spine Daily
Isolated stretches aren’t as effective in long term sciatica prevention as full body mobilizations. We have many short routines you can do at your desk.
Strengthen Your Core, Gluts and Lower Back
Strengthening your lower back, core and gluts is the key to supporting your lower back for the long term. It will build a foundation of muscle that creates stability and resilience.
By addressing the root cause of your sciatica, chiropractic care can help you find long-lasting relief and improve your quality of life.
Contact us today and let’s make sciatica a thing of the past.
