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Discussion on Sciatica

sciatic nerve 2Sciatica, simply put is pain or abnormal sensation along the Sciatic nerve.  The sciatic nerve, the largest nerve of the body is formed by the nerve roots coming out of the lower (lumbar and sacral) portion of the spinal cord into the lower back and  through the buttock, then down the back of the leg to the ankle and foot where the branches of the nerve are named the common peroneal and tibial nerves.

What causes sciatica?

The most common cause of sciatica is something pressing (or encroachment or entrapment) on the nerve.  Where the pressure occurs along the nerve determines the symptoms, the diagnosis, and the treatment.  As a chiropractor where the problem is (also called lesion) often determines how long it takes for symptom relief as well as correcting the problem.   Given below is some different conditions which can cause sciatica.

Subluxation – which is a misalignment of the spine pinching the nerve.  This is the Chiropractic “lesion”.  This is what Chiropractic was based upon over 100 years ago.

Disc herniation – The “intervertebral disc”, the cushion between the vertebra can deteriorate, tear,  bulge, and herniate to pinch on the nerve.

Piriformis Syndrome –  The pirformis muscle is located in the buttocks, the sciatic nerve either traverses under it or through it, depending upon your genetics.  A spasm or laxity of this muscle can irritate the nerve, causing sciatica.

Spinal Stenosis-  Normally we think of the nerve being pinched, but sometimes the entire spinal cord itself can be pinched.  This is a more difficult condition to treat.  So it is far better to prevent this from occurring.  Chiropractic Care with emphasis on the dura such as Sacro-Occipital Technique and Applied Kinesiology are best suited for preventing this difficulty disease of the, typically,  older patient.

Spondylolisthesis.  This condition is either from birth (could be in-utero or within the first year of life) or degenerative and occurs in the 60’s and older.  The normal vertebral is prevented from moving forward by bone, so movement is backwards with rotation and/or tilting, when there is a misalignment.  In spondylolisthesis that boney restriction is not there so the vertebra can move forward,  This can then affect the entire spinal cord at that level.   I was once asked by an Orthopedist “How do you treat a spondylo?”  I mentioned I don’t have to put the vertebra back to its “ideal” position to get relief of symptoms.  Usually all that is required is an impercetible small mpvement in the proper direction to relieve the symptoms.  It is important to note whether the “Spondylo’s” is stable or unstable before we decide how to treat.

Other Entrapments.  Sometimes entrapments along the nerve from fascial adhesions,  muscle spasms,  or muscle adhesions can cause the sciatica.  The technique we use called Active Release Technique is especially suited for this condition.

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