Sciatic neuralgia is mostly caused by irritation of the sciatic nerve as it exits the lower spine from between the lumbar vertebrae. These vertebrae can irritate or “pinch” the nerve due to one or more physical scenarios. A loss of normal motion between these bones can result in an irritation of the sciatic nerve. A degenerative process in the intervertebral disc can cause mechanical pressure to the nerve. A misplacement of one of the vertebrae can mechanically pinch the nerve. A swelling, protrusion or herniation of the disc can also pinch the nerve.
All of these conditions respond well to chiropractic care, some quicker than others. An actual herniation of an intervertebral disc, however, is an extremely tough clinical condition for a chiropractor to deal with alone. These patients are generally in very acute difficulty, often completely disabled, barely able to arise from bed and in excruciating pain. These patients require strong analgesics and even narcotics often times do not give them adequate relief. Acute sciatica is said to be the worst pain that a human has to endure next to stones in the renal ureter.
The sciatic nerve arises from the spine in the lower 3 lumbar vertebrae and is the longest and largest nerve in the body. As it passes through the upper gluteal region, it is frequently as thick as your thumb. When it becomes inflamed it creates a condition which we call sciatica. Not all leg pain is sciatica, but virtually all sciatica involves leg pain. Usually felt in the back of the thigh, calf, ankle and top or bottom of the foot, sciatica often causes sensations of burning, cramping, tingling, numbness and depending on the level of acuteness, degrees of pain ranging from an aching nuisance to throbbing to extreme and overt pain. In severe cases, absent or diminished reflexes and wasting or atrophy of muscles can occur. In rare instances, a patient can even lose bladder and bowel control.
Causes of sciatica are varied. It can result from a sudden trauma, a strenuous attempt to lift, pull or push something, a false or sudden rotational motion, or even the jolt of a violent sneeze or cough. Most times, however, sciatica is the result of cumulative or repetitive small traumas. Sciatica may appear suddenly or gradually and may first be noticed while walking or slouching in a chair. It is often the result of some trauma that occurred months or even years before. Generally, I have noticed, the sciatic sufferer has had a history of minor low back occurrences, which they have chosen to ignore. And because that soreness that they felt upon arising each morning always went away after a bit, the person assumed that AM pain was “normal”.
Sciatica can also be related to various non-spinal conditions, such as constipation, advanced diabetes, tumours and even some vitamin deficiencies. Other musculoskeletal conditions can result in a bout of sciatica. Spasms, hypertonicities, and bursitic conditions in and around the hip and gluteal region can also irritate the sciatic nerve.
Sciatica is ultimately about inflammation of the nerve. Therefore, rest, ice when acute and care not to cause further irritation, will cause the pain to eventually resolve by itself. However, if the original cause is not identified and corrected, further episodes are a very real possibility. This process of spontaneous resolution may take weeks and often is not complete; often leaving the individual with residual leg or hip pain, numbness, muscle weakness, and reduced stamina, especially with walking.
It is best with these conditions to get some professional advice as early attention can often mean much earlier resolution. As chiropractors, we have been recognized as experts in the area of low back problems and sciatica for decades. Consequently, it would behoove someone suffering from sciatica to seek the help of a reliable and experienced chiropractor.