Chiropractic treatment for sciatica

Are you experiencing Sciatica-like symptoms?

Have you got pain radiating into your buttock, hip or legs?

Do you experience numbness or tingling into your legs?

Have you got reduced mobility due to your sciatica pain?

Our Chiropractors at The Hanham Clinic are more than familiar with the discomfort and frustration that sciatica can cause.

Sciatica is not just limited to the more typical pain that extends from the lower back and pelvis down into a leg; it comes in many sorts, some of which can be more disabling than others. Research shows that supto 40% of individuals could experience sciatica at some point in their life.

We also know that experiencing acute or chronic low back pain also increases susceptability to developing sciatica! (As well as being sedentary, obese or smoking).

Sciatica symptoms can include:

• Severe, shooting pain into the buttock, hip, thigh and leg
• A feeling of a deep dull ache
• Increased pain upon prolonged sitting or standing
• Pins and needles, numbness or tingling in the leg(s)
• A sense of weakness in the leg or foot muscles
• Difficulty in walking and standing for extended periods of time
• Often patients experience a combination of the above factors
• It also comes in varying degrees of discomfort, from agonising, crippling pain, to just a slightly unpleasant feeling.

What actually is sciatica?

In strict medical terms, “sciatica” is a pain or discomfort that originates from the sciatic nerve, or nerve fibres that travel down to become part of the sciatic nerve (referred to as nerve roots).

However, in every-day terms, the word sciatica is commonly used to described a variety of pains in the leg, many of which are not “true” sciatica.

What are the most common causes of sciatica?

There are a wide variety of potential causes for sciatica, however the three most common causes of sciatica that we see in our clinic are:

A herniated or bulging disc in the lower back:

• This is when part of the disc causes irritation against, or compression of one of the the "roots" of the sciatic nerve, as they pass out between the spaces between the vertebrae.
• The discs form one boundary of this canal space and when bulging or herniated, narrow the normal amount of space.

Stenosis in the lumbar spine:

• This is often more of an age related change that occurs gradually over many years, resulting also in a narrowing within the spinal column. Stenosis often has more than one component that is accompanied by some bony encroachment around the exiting nerves.
• Stenosis can be a result of ligamentous thickening ("hypertrophy") and bony enlargement, but may also co-exist with some changes to a disc at the level of involvement!

Piriformis syndrome: entrapment of the sciatic nerve underneath or between fibres of the piriformis muscle

• There is disagreement in the literature about piriformis syndrome, but typically this conclusion is made by excluding other causes of sciatica. • There are documented cases within research where the source of the sciatic nerve pain is said to orignate from irritation or compression of the nerve, where it runs through, or underneath the piriformis muscle as it passes down through the buttock region. Anatomically, 15% actually have a sciatic nerve that passes both under- and through the piriformis muscle, where it splits into two branches instead of one within the pelvis!

Each of these conditions can affect each individual differently and they may have features in common. Usually a detailed history and examination will indicate the most likely cause of your symptoms.

Can a Chiropractor help with my sciatica?

The first thing a chiropractor can do is performed a detailed assessment to determine the cause of your sciatica.

Following that they can discuss potential treatment options with you.

Some cases of sciatica respond well to Chiropractic, and some may need a combined approach alongside other ways to manage the condition.

Will I need an MRI to diagnose my sciatica?

Most of the time an MRI scan is not needed to confirm whether you have sciatica. It is often clear where the source of your symptoms is originating from without specialist imaging.

When will I need an MRI scan for my sciatica?

We don’t routinely send our patients for MRI scans for their sciatica, mainly because A- it does not change the plan of management for that patient and B- research shows that early and excessive investigation of lower back complaints can actually potentially lead to a poorer outcome in the long term!

However there are certain situations where we will discuss the potential need for an MRI in order to help with the situation.

For sciatica, an MRI might be required if:

1. You have an associated change to bowel or bladder function: change to urinary frequency, altered sensation when going to the toilet etc
2. Symptoms that travel into both legs
3. Significant loss of strength in muscles of the leg, ankle/foot or toes
4. There is the presence of other red flags that indicate further investigation is necessary

Please not this list is not exhaustive and should not be used to determine when to consult a professional. If you are concerned about your condition then please speak to a medical professional.