Sciatica means pain originating from the lower back and radiating down to one of the lower limbs. This pain is generally caused by bending, twisting, lifting weights or exercise. The pain is worsened by coughing, sneezing or straining at stools. The pain typically radiates from the lower back to the back of the thigh, leg or foot. At times, it may also be associated with numbness, tingling and weakness of the leg muscles. The sciatic nerve is the largest and longest nerve in the body. During its course from the buttocks to the feet, it gives off a number of branches. When the sciatic nerve or its branches are compressed, pinched or irritated, symptoms of sciatica are produced.

The syndrome is known to cause agonizing pain which may start in the lower back and radiate along the back of the leg to the foot. The pain is quite severe and disabling. The pain relief is quite difficult and a visit to the emergency room occurs in most cases.

Sciatica is almost always caused by some pressure on the nerve or its branches. Most common cause includes dislocation of the vertebral joints, fractures of the vertebral joints, slipped or herniated discs, arthritis, tumor, diabetes or long term degeneration of the joints. In younger individuals, traumatic events are often the cause of sciatica. Standing, sitting, walking, running, heavy lifting, bending, twisting, or even sneezing can exacerbate the symptoms. In all cases, the nerve or its roots are impinged upon, resulting in pain.

Sciatica can present with numerous symptoms such as pain, numbness, tingling and weakness in the lower extremities. Pain is usually the most common symptoms and is localized to the back of the buttocks, thigh, leg or foot. The pain is constant and worsens with any activity. The pain is continuous and unremitting. The pain may last days to weeks and is disabling. The pain is easily aggravated by any activity such as walking, sitting or bending Even taking over the counter pain medications fail to resolve the pain. Pain is the most common cause of a visit to the Emergency room.

Sciatica is generally due to subluxed or dislocated vertebrae and almost never correct spontaneously. Chiropractors have the art and technique to manipulate and realign the vertebral column, thus relieving the irritation on the nerve. The art of chiropractic does not require the use of drugs but treatment of the underlying cause. The manipulations and adjustments take time to maintain the joints in proper position.

Suspicion of sciatica may be obtained by a physical exam and the presentation of the patient. However, confirmation of the diagnosis of Sciatica is always made by appropriate x rays and MRI of the spine. In some cases such as peripheral neuropathy, additional investigation in the form of nerve conduction studies- to assess the function of each of the various nerves in your limbs may be required.

The majority of individuals with sciatica present late to their chiropractor. The longer the delay, the longer the time it takes to decrease the symptoms and time to recovery. The delay in seeking help often causes long-term damage. The treatment of sciatica begins with a complete history, physical examination and x rays of the spine. Following this the chiropractor will discuss the non surgical treatments which are available to treat sciatica.

Bed rest is an essential part of the treatment. In most cases, if bed rest is done soon after the pain starts, most individuals will recover faster. Bed rest for 2-3 days and limiting any stressful activity for 2-4 weeks are the key to recovery. One may need to curtail activities such as bending, lifting and twisting until the pain has disappeared.

The treatment would depend on the duration of your problem, presence of similar episode in the past, neurological function, response to previous non-operative treatment and lastly, the subjective severity of your pain. Massage therapy has been known to decrease the spasms associated with sciatica. Massage therapy however, is long term therapy and is done in combination with the chiropractic manipulations. Other treatments may include ultrasound and ice- both of which can decrease the pain and irritation of the nerve.

Physiotherapy modalities may be used. This consists broadly of passive and active physiotherapy. During acute pain, generally, only passive physiotherapy would be used. Once the pain relief has been obtained, you will be prescribed active physiotherapy such as spinal exercises. Additional modalities to complement the physiotherapy may include short-wave diathermy, transcutaneous electrical nerve stimulation and interference therapy.

Unfortunately chiropractors are unable to prescribe pain medications and the manipulations are generally not very painful and can be dome without pain killers. However, for pain control at home, one may need to see an MD to obtain a prescription of pain killers. Painkillers allow for a smoother and easier return to normal function. You will be prescribed pain killers for a short term so as to guard against possible over dependence and limit the side effects.

Once the chiropractic treatments have started, follow up X-rays or MRI are obtained at 3-6 month intervals to ensure that both healing and alignment have occurred.

Surgery would be indicated when there is no pain relief despite symptomatic treatment as mentioned above or, when there is significant neurological deficit or, repeated episodes of sciatica so as to get a permanent solution to the problem.