The term sciatica describes the symptoms of leg pain—and possibly tingling, numbness or weakness—that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of the leg. Sciatica (pronounced sigh-at-ih-kah) is not a medical diagnosis in and of itself—it is a symptom of an underlying medical condition, such as a lumbar herniated disc, degenerative disc disease, or spinal stenosis.
Sciatica is often characterized by one or a combination of the following symptoms:
- Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
- Pain that is worse when sitting
- Leg pain that is often described as burning, tingling or searing (vs. a dull ache)
- Weakness, numbness or difficulty moving the leg or foot
- A sharp pain that may make it difficult to stand up or to walk
Sciatica symptoms occur when the large sciatic nerve is irritated or compressed in the lumbar spine.
The sciatic nerve is the largest single nerve in the body and is composed of individual nerve roots that start by branching out from the spine in the lower back and combine to form the “sciatic nerve.”
- The sciatic nerve starts in the lower back at lumbar segment 3 (L3).
- At each level of the lower spine a nerve root exits from the inside of the spine, and these respective nerve roots then come together to form the large sciatic nerve.
- The sciatic nerve runs from the lower back, through the buttock, and down the back of each leg
- Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg – the thigh, calf, foot, toes.
The specific sciatica symptoms – the leg pain, numbness, tingling, weakness, and possibly symptoms that radiate into the foot – largely depend on where the nerve is pinched. For example, a lumbar segment 5 (L5) nerve impingement can cause weakness in extension of the big toe and potentially in the ankle.
The incidence of sciatica increases in middle age. Rarely occurring before age 20, the probability of experiencing sciatic pain peaks in the 50s and then declines.1
Often, a particular event or injury does not cause sciatica, but rather it tends to develop over time. The vast majority of people who experience sciatica get better within a few weeks or months and find pain relief with non-surgical sciatica treatment. For others, however, the leg pain from a pinched nerve can be severe and debilitating.
Because sciatica is caused by an underlying medical condition, treatment is focused on addressing the underlying causes of symptoms, such as spinal stenosis or a herniated disc. The goals of non-surgical sciatica treatments are to relieve pain and any neurological symptoms caused by a compressed nerve root. There is a broad range of options available for sciatica treatment. One or some combination of the treatments below are usually recommended in conjunction with specific exercises.
For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn.
Spinal adjustments and manual manipulation performed by appropriately trained health professionals, such as chiropractors and osteopathic physicians , are focused on providing better spinal column alignment, which in turn should help to address a number of underlying conditions that can cause sciatic nerve pain. Manual manipulation done to address the right indications by appropriately trained health professionals can create a better healing environment and should not be painful.
Another practice, acupuncture, is centered on the philosophy of achieving or maintaining well being through the open flow of energy via specific pathways in the body. Hair-thin needles (that are usually not felt) are inserted into the skin near the area of pain. Acupuncture has been approved by the U.S. FDA as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica.
Physical therapy exercises incorporating a combination of strengthening, stretching, and aerobic conditioning are a central component of almost any sciatica treatment plan. When patients engage in a regular program of gentle exercises, they can recover more quickly from sciatica pain and are less likely to have future episodes of pain.
If you have pain that may be caused by sciatica, please call our office at (304) 63-4927 for an appointment today. Dr. Chambers specializes in a multi-faceted alternative medicine treatment plan, consisting of chiropractic, acupuncture and physical therapy, personalized for each patient’s diagnosis.