Back Clinic Sciatica Chiropractic Team. Dr. Alex Jimenez organized a variety of article archives associated with sciatica, a common and frequently reported series of symptoms affecting a majority of the population. Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or burning sensation. In some cases, the pain is severe enough to make a person unable to move. The pain most often occurs on one side.
Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower back and runs down the back of each leg as it controls the muscles of the back of the knee and lower leg. It also provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot. Dr. Jimenez explains how sciatica and its symptoms can be relieved through the use of chiropractic treatment. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
The hamstring muscles attach, through a tendon called the proximal hamstring tendon, to the ischial tuberosity, the bones used to sit deep in the buttock muscles. When the tendon is subjected to overuse/repetitive stresses and strains, the internal structure can become compromised, leading to weakness and pain symptoms. This is known as proximal hamstring tendinopathy. Tendinopathy is an overuse injury where the tendon is repeatedly strained until microscopic tears form. It is common in athletes that do a lot of running but also in individuals that sit for prolonged periods. If left untreated, high hamstring tendinopathy can lead to progressive degeneration of the tissues, leading to chronic weakness, pain, and dysfunction.
High Hamstring Tendinopathy
The hamstrings are a powerful muscle group that extends the hip and flexes the knee. They experience stress and pressure during activity and inactivity/sitting and are susceptible to strain injuries. Tendons attach muscle to bone and are designed to take compressive and tensile weight/loads that stretch or flex. A tendon is made up of fibrous tissue containing organized type 1 collagen. Tendons receive blood; however, the supply is less where the tendon attaches to the bone and is commonly where tendinopathy occurs.
Injury
A hamstring injury involves the bruising, irritation, or tearing of the hamstring tendon or muscle tissue. Severity can range from:
Microtears that cause stiffness and pain symptoms but heal fast on their own.
Severe ruptures that cause debilitating pain, dysfunction and require medical intervention.
The tendon attaches to the ischial tuberosity or sitting buttock bone. Tendons can have a spasm-like reaction to sudden or quick shift changes. A sudden change can cause adverse changes to the tendon. Too much load on the tendon beyond its ability to recover can cause the structure to change and the collagen to break down/tear like a rope tearing and unraveling. High hamstring tendinopathy happens around the hip area and presents as buttock or upper thigh pain. Individuals report deep, dull, radiating buttock pain during walking, running, and prolonged sitting or driving. Sometimes the sciatic nerve can become irritated or entrapped by an affected tendon’s scar tissue, causing sciatica-like symptoms.
Stages of Tendon Pathology
Reactive Phase
Caused by an acute overload of physical activity or inactivity.
The tendon will thicken temporarily to decrease the stress; however, there may be no inflammation.
The tendon can return to normal if the load is reduced or sufficient time for recovery and repair is allowed.
Disrepair
Chronically overloaded.
Unsuccessful healing.
More negative tendon changes occur.
Reversibility is possible with load management and targeted exercises to stimulate the tendon and surrounding tissues.
Degenerative
Continual progression of adverse tendon changes.
More common in older individuals.
Continue load management and strength training to maximize the tendon’s tolerance.
Chiropractic Treatment
A chiropractic therapy team will develop a personalized treatment program to improve tendon structure and strengthen the hamstrings, gluteal, and side abdominal muscles. They will begin with tendon symptom-relieving massage to loosen the muscles and get the blood circulating, MET-targeted stretches to lengthen the muscles, and spinal and pelvic adjustments to realign the body.
Sciatica Explained
References
Buckley, Mark R et al. “Distributions of types I, II and III collagen by region in the human supraspinatus tendon.” Connective tissue research vol. 54,6 (2013): 374-9. doi:10.3109/03008207.2013.847096
Lempainen, Lasse, et al. “Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy.” Muscles, ligaments, and tendons journal vol. 5,1 23-8. 27 Mar. 2015
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments, and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
Ono, T et al. “Estimation of tensile force in the hamstring muscles during overground sprinting.” International Journal of sports medicine vol. 36,2 (2015): 163-8. doi:10.1055/s-0034-1385865
White, Kristin E. “High hamstring tendinopathy in 3 female long-distance runners.” Journal of chiropractic medicine vol. 10,2 (2011): 93-9. doi:10.1016/j.jcm.2010.10.005
Wilson, Thomas J et al. “Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.” Orthopedic Journal of sports medicine vol. 5,7 2325967117713685. 3 Jul. 2017, doi:10.1177/2325967117713685
Wobble cushions are small round inflatable support pillows made of a flexible material that can be used to stand and sit on. The cushion creates instability, hence wobble, to engage the lower back, hips, and core muscles. They promote core stability, strengthen muscle tone, and improve balance and body posture. A flexible body helps in injury prevention. At Injury Medical Chiropractic and Functional Medicine Clinic, we utilize innovative techniques and therapies to reduce stress, assist in healing musculoskeletal damage from injuries, disease, or conditions, and keep the spine and whole body healthy.
Wobble Cushions
A common reason for back aches and pains is sitting for long periods. Individuals unintentionally slouch or hunch over as they go through their day, causing strain to the back muscles, gluteal muscles, core muscles, hips, and spine. This causes the lower half of the body to weaken and causes the top muscles to take up the slack to support the torso and lower body.
Muscle Spasms
Muscle spasms can be the acute type that is forceful and involuntary, and chronic sustained stiffness, tightness, cramping, and pain. Lower back discomfort and/or sciatica symptoms vary depending on the cause, location, and severity of the strain or injury. Signs could be dull, burning, or sharp at a single point or over a broad region that could spread into one or both legs. Types of low back discomfort:
Acute symptoms last less than three months. Most individuals with acute episodes will have at least one recurrence.
Recurrent means the acute symptoms return.
Chronic symptoms last longer than three months.
Cushion Benefits
Encouraging active sitting improves posture allowing individuals to sit and stay focused for longer as their body awareness improves, reducing hunching, slumping, slouching, and fidgeting. Other wobble cushion benefits include:
Decreased muscle stress and strain on the joints and ligaments, which improves proprioceptive sense or body awareness.
Increases blood circulation and oxygenation throughout the body.
Helps rehydrate the discs and circulate spinal fluid. Spinal discs do not have a direct blood supply; therefore, movement is required to pump and circulate healthy fluids.
Allows more flexibility in the spine, hips, and core muscles.
Improves overall posture.
The purpose of wobble cushions is not to provide comfort. They are supposed to be uncomfortable and unstable to make the individual sit up straight. The cushion can be placed on a chair or the floor to effectively practice balancing without putting pressure on the back, knees, or feet. They can also be used for practicing standing balance. Various factors to consider when looking for a cushion include:
Stability
Comfort
Resilience
Alignment
All play a role in determining the best option.
Discussing options with a doctor or chiropractor is recommended to ensure that the cushion meets your needs and preferences.
Spinal Hygiene
References
Alrwaily, Muhammad, et al. “Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial.” Brazilian journal of physical therapy vol. 23,6 (2019): 506-515. doi:10.1016/j.bjpt.2018.10.003
Haksever, Bunyamin et al. “The Dynamic Innovative Balance System Improves Balance Ability: A Single-Blind, Randomized Controlled Study.” International journal of sports physical therapy vol. 16,4 1025-1032. 1 Aug. 2021, doi:10.26603/001c.25756
Honert, Eric C, and Karl E Zelik. “Foot and shoe responsible for the majority of soft tissue work in the early stance of walking.” Human movement science vol. 64 (2019): 191-202. doi:10.1016/j.humov.2019.01.008
Ostelo, Raymond Wjg. “Physiotherapy management of sciatica.” Journal of physiotherapy vol. 66,2 (2020): 83-88. doi:10.1016/j.jphys.2020.03.005
Shahvarpour, A et al. “Active-passive biodynamics of the human trunk when seated on a wobble chair.” Journal of biomechanics vol. 49,6 (2016): 939-945. doi:10.1016/j.jbiomech.2016.01.042
Sciatica can range from mild to severe. Most individuals are familiar with severe cases because of the intense shooting throbbing pain. On the other hand, mild cases can present with little to no discomfort or pain but involve tingling, pins and needles, electrical buzzing, and numbing sensations. This can make individuals think there is nothing wrong and their foot just fell asleep. It can come from nowhere, as there was no obvious back or leg trauma causing injury. However, somewhere along the nerve’s path, the nerve has become compressed, pinched, trapped, stuck, or twisted, most likely from a spasming muscle group in the low back, buttocks, or legs causing the sciatica foot symptoms. Chiropractic, massage, and decompression therapy can relax the muscles, relieve the symptoms, release the nerve, and restore function.
Sciatica Foot Symptoms
The sciatic nerve extends from the lower spine to the feet. Sciatica foot symptoms could be caused by several possibilities that range from piriformis syndrome to a developing slipped disc or spasming muscles. The symptoms travel through the nerve and can be felt anywhere along the nerve’s path, not necessarily at the source. This is why mild cases may only present with slight pricking/tingling sensations. However, left untreated, the cause can progress and develop into a severe case of sciatica.
Symptoms
The length of time that sciatica foot symptoms last will depend on the underlying cause. For example, if a herniated disc is the cause, the numbness may last for a few weeks or months until the disc heals. However, the numbness may be more long-lasting if sciatica is caused by degenerative disc disease. Sometimes, the nerve can be permanently damaged, leading to chronic pain and numbness. This is more likely to occur in individuals with diabetes or another condition that causes nerve damage.
A varying degree of leg weakness can present as the spinal nerve root issues interfere with effective signal communication between the brain and the leg muscles.
Leg weakness may also be interpreted as a pulling sensation in the leg.
Weakness in the foot or toe muscles can also present.
Leg movements such as walking, running, lifting the leg, or flexing the foot can also be affected.
The tingling and numbing sensations may worsen when sitting or standing for long periods or moving the back in certain ways.
Treatment
Chiropractic care is an excellent option for treating sciatica foot symptoms and starts with a personalized plan based on individual symptoms, injury, and medical history. Chiropractors are neuromusculoskeletal experts on the spine, vertebrae, surrounding muscles, tissues, and nerves. Treatment includes spinal and extremity adjustments to realign the body, decrease inflammation, relieve pressure, release the nerve, and ultimately allow the body to activate its natural healing processes.
Massage
Massage therapy can relieve muscle tension and spasms in the back and legs, reducing pressure on the sciatic nerve.
Massage also increases blood circulation and relaxes the muscles, speeding healing and recovery.
Electrical Stimulation
Electrical stimulation activates the nerves and muscles and reduces symptoms by blocking signals.
Physical Therapy
Physical therapy exercises can help stretch and strengthen the back and leg muscles.
Targeted exercises can be done at home to continue strengthening and maintaining the muscles.
Foot Orthotics
Using orthotic devices such as arch supports or heel cups can help relieve pressure on the feet.
Arch supports are especially helpful if sciatica foot symptoms are exacerbated by flat feet or other foot conditions.
Heel cups can help with the frequent use of high heels.
Emary, Peter C. “Evidence-based prognostication in a case of sciatica.” The Journal of the Canadian Chiropractic Association vol. 59,1 (2015): 24-9.
Frost, Lydia R et al. “Deficits in foot skin sensation are related to alterations in balance control in chronic low back patients experiencing clinical signs of lumbar nerve root impingement.” Gait & posture vol. 41,4 (2015): 923-8. doi:10.1016/j.gaitpost.2015.03.345
Shakeel, Muhammad, et al. “An uncommon cause of sciatica.” Journal of the College of Physicians and Surgeons–Pakistan: JCPSP vol. 19,2 (2009): 127-9.
Tampin, Brigitte, et al. “Disentangling ‘sciatica’ to understand and characterize somatosensory profiles and potential pain mechanisms.” Scandinavian journal of pain vol. 22,1 48-58. 2 Aug. 2021, doi:10.1515/sjpain-2021-0058
Hamstring syndrome is a condition where the sciatic nerve gets pinched between the hamstring muscles and the pelvic bone or by the tissue bands that connect the hamstring muscles causing compression on and around the nerve. It is seen in individuals that play sports that involve running, kicking, or jumping, in middle-aged individuals engaged in daily activities that have suffered falls, and in individuals that sit for many hours. Chiropractic care, massage, and decompression therapy can relieve the symptoms, release the trapped nerve, relax and stretch the muscles, and restore function.
Hamstring Muscles Trapped Sciatic Nerve
Three muscles make up the hamstrings in the back of the thigh. The sciatic nerve runs from the low back down the leg into the foot. A trapped sciatic nerve can cause various symptoms and sensations in the back of the leg, hip, buttock, and foot. It may hurt to sit down or stretch the legs out, and there is usually tightness in and/or around the buttock and back of the leg. The symptoms typically recede when lying on your back.
Cause
Regular wear and tear on the back muscles and hamstrings can contribute to the condition.
Often the sciatic nerve and/or the sheath surrounding the sciatic nerve gets trapped and irritated as it travels around the ischial tuberosity. The ischial tuberosities are known as the sit bones.
The area where the sciatic nerve runs down the back of the leg can become narrowed, leading to nerve irritation and stinging, numbing, and tingling sensations.
The injury often happens during sudden, quick, forceful movements that overstretch the tendons and/or muscles but can also happen during slow movements.
Movement agitates the pulling and rubbing of the nerve on the muscles.
A non-painful pull or pop of the hamstrings can cause the muscles to spasm and wrap around the nerve.
Symptoms
Symptoms usually include the following:
Leg pain that worsens when sitting.
Intense electrical shooting pain that makes it hard to stand or move.
Difficulties moving the leg or foot.
Numbness and weakness in and around the leg.
Tingling or burning sensations running down the leg.
Persistent pain on one side of the lower back.
Chiropractic Care
Chiropractic treatment can relieve the symptoms and release the trapped nerve. Treatment includes:
Accurate Diagnosis – A chiropractor will examine and review physical activity, work, and medical history.
Ice and Heat therapies will stop the swelling and increase blood flow.
Massage therapy relaxes the muscles and increases circulation.
Decompression therapy incrementally and gently stretches the body.
Chiropractic adjustments realign and reset the body.
Targeted stretches and exercises will keep the muscles loose and increase strength.
Nutritional recommendations will help reduce inflammation and prevent flare-ups.
Hamstrings and Sciatic Nerve Relationship
References
Lohrer, Heinz, et al. “Nerve entrapment after a hamstring injury.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 22,5 (2012): 443-5. doi:10.1097/JSM.0b013e318257d76c
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
McGregor, Catriona, et al. “Traumatic and overuse injuries of the ischial origin of the hamstrings.” Disability and rehabilitation vol. 30,20-22 (2008): 1597-601. doi:10.1080/09638280701786138
Saikku, Kari, et al. “Entrapment of the proximal sciatic nerve by the hamstring tendons.” Acta orthopaedica Belgica vol. 76,3 (2010): 321-4.
Sciatica From Working Out: There are benefits from strenuous exercise and a level of acceptance of the discomfort that goes with exertion. While this is true to a certain degree, when individuals feel the pump and are in the workout zone, it can be very easy to take off and overdo it. This is when the body and the back become susceptible to injuries. Sciatica from working out occurs when added pressure on the sciatic nerve results in a compressed/pinched nerve. Left untreated can lead to further back problems and other health issues. The Injury Medical Chiropractic and Functional Medicine Team can relieve the compression, release the nerve, relax the muscles, and restore function.
Sciatica From Working Out
Microtrauma
Building muscle and increasing strength require a certain amount of physical damage to the muscles for successful progress. Intense and heavy exercise tear the muscle tissues causing microtrauma that triggers a healing response that creates muscle mass. These micro-injuries can cause the back muscles to tighten up, shifting the spine out of alignment, causing the discs to slip and compress nerves, or by tight leg muscles like the piriformis swelling and squeezing the sciatic nerve.
Causes
Rest and Recovery
It’s important to understand that proper recovery is essential to an exercise program.
It can take up to 72 hours to recover from the microtears.
Individuals that go right back for a similar workout can aggravate existing micro tears while creating more, resulting in a downward cycle of symptoms that can lead to other problems or become a chronic condition.
Rotating to exercises that go easy on the back and leg muscles assists in the normal healing and development of muscle tissue.
Not Warming up Before Workout
Not warming up before exercising can cause injuries.
When muscles are cold and not warmed up properly, they can become stiff and inflexible, causing them to strain and tear when exposed to sudden, intense exertion.
Before performing any exercise, always start with a low-impact, gentle warm-up.
Not Stretching Properly or at All
Full-body stretching is necessary as the torn, tight muscles need to be relaxed and kept loose.
Make sure to stretch the hamstrings and hips thoroughly.
After each workout, take 10 minutes and stretch.
Not Stretching After
Always do some stretching after a workout.
Stretching after can help prevent muscle fatigue and soreness from a lactic acid buildup.
Starting With Heavy Weights
Many injuries happen because individuals start too heavy.
Challenging the body’s performance is part of the process but should be done in small steps.
Start with lighter weights and add more gradually.
Improper Posture and Form
A leading cause of back problems is poor posture and form.
Curving the back while lifting weights is the most error.
Overarching can also cause injury.
When performing push-ups or planks, avoid sinking the hips.
Hard Surfaces
For runners, hard surfaces like concrete or asphalt force the body and back to absorb most of the impact.
This compresses the vertebrae, which can irritate the sciatic nerve.
Rotate by using running trails or a treadmill.
Work on running with a shorter stride to reduce bounce and impact.
Incorporate cross-training.
Rotate upper body strength training to give the legs, gluteals, and back muscles a rest.
Chiropractic Rehabilitation
Chiropractic care, massage, and decompression therapy can relieve sciatica pain. Using spinal manipulation techniques and other therapies, chiropractors can alleviate the pressure on the nerve. Treatment involves:
X-rays are taken so that the chiropractor can understand the cause.
Massaging the muscles to relax and release them and increase circulation.
Stretching and applying controlled pressure to the joints.
Specific exercises and stretches will be recommended to do at home.
Health coaching and nutrition and wellness recommendations.
Personalized Sciatica Treatment
References
Bonasia DE, Rosso F, Cottino U, Rossi R. Exercise-induced leg pain. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(3):73-84. doi:10.1016/j.asmart.2015.03.003
Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, Whitford M. Risk factors for first-time incidence sciatica: a systematic review. Physiother Res Int. 2014 Jun;18:65-78. doi:doi:10.1002/pri.1572
Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313‐1317. doi:10.1136/bmj.39223.428495.BE
Lewis RA, Williams NH, Sutton AJ, et al. Comparative clinical effectiveness of management strategies for sciatica: a systematic review and network meta-analyses. (PDF). Spine J. 2015;15(6):1461-77. doi:10.1016/j.spinee.2013.08.049
Salehi, Alireza, et al. “Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.” International Journal of community-based nursing and midwifery vol. 3,4 (2015): 244-54.
A certified/licensed massage therapist performs chiropractic therapeutic massage under the direction of a chiropractor to soothe tense muscles, release pressure on the nerve/s, break up scar tissue, and stimulate the release of endorphins. Studies have shown that a therapeutic chiropractic massage is as effective as nonsteroidal anti-inflammatory medications for pain relief caused by various musculoskeletal conditions, including sciatica. Although medications can work for a time, they do not deal with the underlying cause of sciatica.
Sciatica Massage
A sciatica massage offers several benefits that include the following:
Improved and increased blood circulation.
Lowered blood pressure.
Release of hormones that help reduce anxiety, depression, and pain.
Relieves body discomfort and soreness by decreasing the activation of pain receptors in the spine and muscles.
Inflammation alleviation.
Muscle stress relief.
Muscle relaxation.
Flare-up relief and prevention.
Improves sleep.
Massage Types
Each type of massage is designed for a different purpose.
Manual Manipulation
Improves mobility and reduces pain.
Stretches tendons, ligaments, and muscles.
Mobilization
Focuses on the musculoskeletal system to improve mobility.
Connective Tissue
A deeper massage that targets connective tissues like ligaments and tendons.
Deep Tissue Massage
Designed to reach the deep layers to realign the muscles and fascia.
Myofascial Massage
Releases trigger points, adhesions, and nerve endings.
Healing Phases
Most cases of sciatica resolve in less than 4 to 6 weeks with conservative treatment. More severe cases with neurologic symptoms can have a longer recovery period.
Phase One
Alleviates discomfort, numbness, tingling, pain, and other symptoms.
The pain is reduced so the chiropractor and therapists can begin to address the cause, although the other symptoms and sensations could still be experienced.
If muscle spasms are present, they will be less frequent and with less intensity.
Phase Two
The individual can focus on functioning within their normal environment.
The chiropractor and therapists examine if they can get up and stand from a chair without problems, get in and out of a car, sit for longer periods, and walk with less discomfort.
A reflex test will be performed to analyze how the healing process is coming along.
If there is significant nerve damage, reflexes could be lessened.
For example, if sciatic inflammation is present, and the Achilles tendon is tapped with a reflex hammer, there could be little or no movement of the calf muscles.
If there is an improvement, there will be a healthy reflex.
The straight leg test will show if the individual can lift their leg with little or no pain.
Phase Three
The final healing phase provides the ability of normal movements and full strength.
This is when the individual can resume normal activities, specifically, those stopped because of the pain.
This can include walking, driving, house chores, sports, or working out.
Contact our office for treatment options customized to the individual and their injury.
Sciatica?
References
Camino Willhuber GO, Piuzzi NS. Straight Leg Raise Test. [Updated 2022 June 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK539717/
Chang C, Jeno SH, Varacallo M. Anatomy, Bony Pelvis, and Lower Limb, Piriformis Muscle. [Updated 2022 October 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK519497/
Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/
Marian Majchrzycki, Piotr Kocur, Tomasz Kotwicki, “Deep Tissue Massage and Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain: A Prospective Randomized Trial,” The Scientific World Journal, vol. 2014, Article ID 287597, 7 pages, 2014. doi.org/10.1155/2014/287597
Miller, Kenneth Jeffrey. “Physical assessment of lower extremity radiculopathy and sciatica.” Journal of chiropractic medicine vol. 6,2 (2007): 75-82. doi:10.1016/j.jcme.2007.04.001
It didn’t happen at work, school, or exercise, and there haven’t been any trips and/or falls, but you can’t pinpoint what is causing foot and ankle discomfort and sensations. However, the cause could be originating in the lumbar spinal region. Sciatica is a set of symptoms that refer to pain, numbness, and tingling radiating down the leg from the lower back, affecting the legs, hips, buttocks, and feet. Injury Medical Chiropractic and Functional Medicine Clinic can release the compressed nerve, massage circulation back into the nerve, and restore mobility and function.
Sciatica Foot and Ankle
Sciatic nerve sensations can run down the back of the leg down into the foot.
Compression or irritation to any nerve roots can present with symptoms in the hip, thigh, calf, and foot.
Sciatica foot and ankle symptoms can accompany numbness and muscle weakness.
Sciatic nerve irritation mostly causes symptoms on the outside of the foot but can spread to other areas.
Nerve Roots
One or more of the lower spine’s sciatic nerve roots are being compressed or pinched. The foot symptoms location depends on which nerve root is affected.
If the S1 root is affected, symptoms will radiate to the sole and side of the foot.
If L5 is affected, symptoms will radiate to the top of the foot and the big toe.
If the L4 root is affected, symptoms can radiate to the medial or inside the ankle area.
Chiropractic Care and Relief
Foot Massage
A foot massage can be helpful.
A massage therapist finds points around the ankles that are tender.
Tenderness indicates a lymphatic blockage or muscle tension that needs to be worked out.
They will apply varying pressures to massage the muscles and get the circulation flowing.
The therapist will loosen the tarsal and metatarsal bones to loosen the muscles and nerves.
Moving the bones resupplies the joints, forces out inflammatory metabolic waste, opens the space for the nerves, and allows improved lymphatic drainage and blood flow to expedite healing.
A chiropractor will perform and train the individual on targeted stretches to the Achilles tendon and plantar fascia.
They will stretch, release, and open the ankle and sciatic nerve.
Injections
A cortisone injection where the nerve is affected can help in certain cases.
Injections of a corticosteroid, an anti-inflammatory medicine, can offer relief for up to three months and are given under local anesthesia.
The medicine reduces the inflammation and swelling around the nerve roots.
Foot Orthotics
Custom foot orthotics can help support a postural foot or ankle problem.
Overpronation is when the ankles collapse inward, which creates an imbalance of leg lengths that affects the hips, pelvis, and spine.
Orthotics can help provide symptom relief.
Nutrition
Part of a treatment plan will include an anti-inflammatory and antioxidant nutritional plan.
A professional nutritionist will make recommendations based on the individual’s case.
Magnesium-rich foods are generally recommended for sciatica as this nutrient aids the body in releasing muscle contractions.
99 percent of the body’s magnesium is stored in the bones, muscles, and soft tissues, with only 1 percent concentrated in the blood.
Foods rich in magnesium include:
Avocado
Bananas
Apricots
Dried pumpkin seeds
Dairy
Dark chocolate
Dried figs
Black beans
Brown rice
Fish
Spinach
Swiss chard
Yogurt
Benefits of Custom Foot Orthotics
References
Davis, David, et al. “Sciatica.” StatPearls, StatPearls Publishing, 6 May 2022.
Ge, Phillip S et al. “Iatrogenic pseudoaneurysm of the superior gluteal artery presenting as pelvic mass with foot drop and sciatica: case report and review of the literature.” Vascular and endovascular surgery vol. 44,1 (2010): 64-8. doi:10.1177/1538574409351990
Hughes, Michael S et al. “Post-traumatic catamenial sciatica.” Orthopedics vol. 31,4 (2008): 400. doi:10.3928/01477447-20080401-15
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