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The Sciatic nerve is the largest nerve in the body. This nerve begins from nerve roots in the spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb.

Sciatica is pain caused by tightening or irritation of some nerves exiting the lower spine that make up the sciatic nerve.  Symptoms can include but is not limited to the following:

  • Burning feeling or tingling down the leg
  • Pain in the lower back
  • Numbness, weakness or difficulty moving the leg or foot
  • Severe hip pain
  • Pain that shoots down the leg and is worsened by sitting down
  • Constant pain on one side of the rear
  • Difficulty standing up due to shooting pain.

What causes Sciatica?

Sciatica can be caused by many underlying conditions which may not be detected immediately. Many people only feel sudden pain when bending down or standing up to quickly. The mechanism of sciatic nerve injury is either a result of direct nerve compression, inflammation, an abnormal immune system response of the body, or a combination of all these factorsUnderstanding the causes of sciatica can help focus treatment on addressing the root problem rather than masking the symptoms.

Lumbar herniated disc – Research suggests that up to 90% of sciatica is caused by a lumbar herniated disc. The interior of a spinal disc pushes outward, causing the disc to rupture or bulge onto a nearby nerve root, causing sciatica pain in the buttock and leg that feels hot, sharp or tingling. These symptoms need immediate medical care and should not be ignored.  The pain can be debilitating. A lumbar herniated disc is the most common cause of sciatica. To treat a herniated disc, your chiropractor will suggest a treatment plan that may include spinal manipulation (an adjustment) as well as other chiropractic techniques to help ease your herniated disc symptoms and pain.

Degenerative disc disease –This is the gradual wear-and-tear on a disc that causes instability at the spinal segment, which can pinch or irritate a nerve root. A herniated disc can compress the sciatic nerve on one side causing symptoms in one leg.  Or it can bulge or herniate from both sides causing symptoms on both legs. The ultimate goal of chiropractic care for disc degeneration is to help and improve joint mechanics by reducing cases of inflammation and improving overall spinal motion. Your chiropractor is also going to work on functioning the intervertebral discs, but this is only possible in instances where advanced disc degeneration is not present.  

Facet joint osteoarthritis, Osteoarthritis (degenerative arthritis) can cause breakdown of cartilage between the facet joints. When the joints move, the lack of cartilage causes pain as well as loss of motion and stiffness. Recent research shows that spinal manipulation in combination with exercises is the most effective treatment for both acute and chronic facet joint pain. Chiropractors deals with the underlying neurological, mechanical and muscular problems.

Sacroiliac joint dysfunction, Sacroiliac joint dysfunction is improper movement of the joints at the bottom of the spine that connects the sacrum to the pelvis. It can result in pain in the low back and legs, or inflammation of the joints known as sacroilitis. Sacroiliac joint dysfunction refers to pain in these joints when they move either too much or too little. Hypermobility or too much movement in the sacroiliac joints is a result of loose ligaments supporting the joints. Hypermobility has many causes, including pregnancy or injury to ligaments. Through an adjustment, chiropractors help restore motion in the sacroiliac joint and/or associated joints contributing to the problem. Sacroiliac joint dysfunction typically responds well to chiropractic care ensuring pain relieve quickly after an adjustment.

Piriformis syndrome – is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk and maintain our balance. In short, the piriformis muscle is needed for all lower body movement. The cause is often relating to the spine or sacroiliac joints, or from overuse. This can be a very painful condition and for some people is very disabling. Fortunately, for the majority, chiropractic treatment is very effective.

Isthmic spondylolisthesis is a lumbar spinal condition in which a fracture of the isthmus causes one vertebral body to slip forward on top of the vertebral body below it. The isthmus, or pars interarticularis, is a small, thin segment of bone that connects the facet joints at the back of the spine. A fracture of the isthmus, known as a spondylolysis, is usually a result of stress to the spine. Isthmic spondylolisthesis does not always cause immediate symptoms of pain. When it does, it usually manifests as a deep ache in the lower back making daily movements very painful.  Chiropractors do not reduce the slippage of spondylolisthesis. Instead, they address the spinal joints above and below the slipped vertebra—helping to address the mechanical and neurological causes of the pain, not the spondylolisthesis. This can help relieve low back pain and improve motion in the region.

Now that you better understand the differences between each condition and what it entails, we can look at possible treatment options and exercises for each condition in next week’s article.