What is Sciatica?

Sciatica is a general term used to describe nerve pain in the leg that is caused by irritation and/or compression of the sciatic nerve. Sciatica originates in the lower back, radiates deep into the buttock, and travels down the posterior or lateral leg. It is important to note that any type of lower back pain or radiating leg pain is not sciatica. Sciatica is specific to pain that originates from the sciatic nerve.¹

Your Chiropractor is a musculoskeletal health expert who can diagnose the underlying cause of your sciatic nerve pain and offer relevant treatment options to help restore your health.

The Cause of Sciatica

Sciatica nerve pain is a set of symptoms caused by an underlying medical condition; it is not a medical diagnosis.²

Often, a particular event or injury does not cause sciatica—rather it tends to develop over time. Sciatica affects 10% to 40% of the population, typically around the age of 30 to 50 years.¹ Sciatica is found to be common in certain types of occupations where physically strenuous positions are used, such as machine operators or truck drivers. Specifically, people who often bend their spine forward or sideways or raise their arms frequently above shoulder level may be at risk of sciatica.^1,5

The vast majority of people who experience sciatica typically get better within 4 to 8 weeks with nonsurgical sciatica treatments.¹ If severe neurological deficits are present, recovery may take longer. An estimated 33% of people, however, may have persistent symptoms up to 1 year.⁶ When severe nerve compression is present with progressive symptoms, surgery may be indicated.

Common Symptoms

The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:

• Pain. Sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.
• Numbness. Sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.
• One-sided symptoms. Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg.¹Rarely, both legs may be affected together.
• Posture induced symptoms. Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing. The symptoms may be relieved by walking or applying a heat pack over the rear pelvic region.

Common medical conditions that may cause sciatica include¹:

• A herniated lumbar disc
• Lumbar spinal stenosis
• Lumbar degenerative disc disease, general degenerative changes in vertebrae or discs
• Spondylolisthesis
• Muscle spasm and/or inflammation of the lumbar and/or pelvic muscles
• Sacroiliac joint dysfunction

Rarely, tumors, blood clots, or other conditions in the lumbar spine may cause sciatica however, they require prompt medical attention and intervention.

Treatment

Because there are many possible underlying causes of sciatica nerve pain and dysfunction, such as disc herniations, sacroiliac joint dysfunction, and piriformis syndrome, it is important to visit your Chiropractor as soon as possible once you begin experiencing symptoms as they can provide advice on appropriate courses of action to treat the problem.

References
1.Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/.
2.Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, Whitford M. Risk Factors for First Time Incidence Sciatica: A Systematic Review. Physiotherapy Research International. 2013;19(2):65-78. doi:10.1002/pri.1572.
3.Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/.
4.Ohnishi Y, Yuguchi T, Iwatsuki K, Yoshimine T. Entrapment of the fifth lumbar spinal nerve by advanced osteophytic changes of the lumbosacral zygapophyseal joint: a case report. Asian Spine J. 2012;6(4):291–293. doi:10.4184/asj.2012.6.4.291.
5.Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. British Journal of Anaesthesia. 2007;99(4):461-473. doi:10.1093/bja/aem238.
6.Fernandez M, Ferreira ML, Refshauge KM, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. 2015;25(11):3495-3512. doi:10.1007/s00586-015-4148-y.