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 Gluteus Maximus Muscle is the largest and the outermost of the gluteal muscles. It stretches from the sacrum and coccyx, parts of the spinal column, down to the femur. The other gluteal muscles include the gluteus minimus and medius. They each have a role in the normal function of the hips and legs. They are prone to tightness resulting in soreness, aches, and pain around the hips and in and around the buttocks.
The Gluteal/Rear End Muscles
There are three rear-end muscles:
The Gluteus Maximus extends the hip and rotates the thigh outwards, straightens the legs when moving, and provides strength.
Gluteus Minimus
Gluteus Medius
The minimus and medius are underneath the Maximus and stabilize the hip when:
Walking
Jumping
Other physical activities
There is another group of diagonal muscles under the gluteus minimus that attaches to the femur. The uppermost is the piriformis that is attached to the sacrum. The sciatic nerve and major arteries run below it.
Tightness and Irritation
The primary function of the muscles is to open the hips and push the legs out. Sitting for long periods shortens the gluteal muscles causing them to become tight, limiting normal hip function. The gluteal muscles are susceptible to tightness brought on from overuse and lack of development/strength. This can develop into tender/tight muscle bands that interfere with the normal function of the muscles. To get an example of what is happening imagine flexing and contracting one of the bicep muscles 6-10 hours a day. It would be extremely sore, tight, and tender.
Sports and Physically Active
Athletes and individuals that are physically active can also have tight gluteal muscles. This can cause post-game/exercise muscle soreness. Intense activities force the gluteal muscles to work overtime to support the back and knees. Sports that require a lot of leg muscle activation include:
Running
Soccer
Football
Crossfit
Dancing
Weight training
Awkward Walking Gait
Individuals that move with an unusual gait are vulnerable to straining the muscles. What happens is the muscles become stiff from the awkward positions/postures. This places additional strain on the back and hip muscles and worsens their overall posture. The hip muscles are also attached to the pelvis, and when the muscles begin to tighten they can pull on the gluteal muscles. Irritation of the sacroiliac joint can also place pressure on the piriformis, causing spasms that affect the gluteal muscles. Piriformis muscle spasms can also place pressure on the sciatic nerve, causing sciatica.
Diagnosis and Treatment
An examination will be necessary to diagnose whether the soreness or pain is due to muscle inflammation or other cause. Sciatica symptoms and problems at the hip level that involves the gluteus minimus and medius can be felt in the leg. The examination includes seeing and feeling muscle reactions, responses, contractions through a series of motion exercises and movements that involve different muscles. Common treatment includes:
Range of motion exercises
Strengthening exercises like bridging and resistance bands
Deep tissue massages
Heat and cold packs
Physical therapy
Electric muscle stimulation
Tightness in the glutes can be managed with chiropractic treatment. This includes:
Soft tissue work
Spinal joint manipulation
Lifestyle adjustments
Stretching
Diet
Health coaching
Simple exercises can help engage and strengthen the muscles. These include:
Individuals that sit for long periods of time, don’t get enough physical activity, and have an unhealthy diet can experience insulin resistance. This happens when insulin is not able to transport excess blood sugar out of the blood and into the muscles. A study found that women who sat for eight hours a day had an increased chance of developing diabetes. Diabetics can be inclined to have more fat within the body, specifically visceral fat. This further encourages insulin resistance. Diabetics also experience rapid loss of muscle mass as they age, intensifying symptoms and further affecting body composition.
References
Cochrane, Darryl J et al. “Does short-term gluteal activation enhance muscle performance?.” Research in sports medicine (Print) vol. 25,2 (2017): 156-165. doi:10.1080/15438627.2017.1282358
Coratella, Giuseppe et al. “The Activation of Gluteal, Thigh, and Lower Back Muscles in Different Squat Variations Performed by Competitive Bodybuilders: Implications for Resistance Training.” International journal of environmental research and public health vol. 18,2 772. 18 Jan. 2021, doi:10.3390/ijerph18020772
Distefano, Lindsay J et al. “Gluteal muscle activation during common therapeutic exercises.” The Journal of orthopedic and sports physical therapy vol. 39,7 (2009): 532-40. doi:10.2519/jospt.2009.2796
Kalyani, Rita Rastogi et al. “Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases.” The lancet. Diabetes & endocrinology vol. 2,10 (2014): 819-29. doi:10.1016/S2213-8587(14)70034-8
Selkowitz, David M et al. “Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes.” The Journal of orthopedic and sports physical therapy vol. 43,2 (2013): 54-64. doi:10.2519/jospt.2013.4116
Rain generally comes with a drop in barometric pressure. A low-pressure system you may have heard from the local weather forecast. Lower pressure outside can cause tissues inside the body to swell and irritate sensitive nerves. For those who have sciatic nerve pain, rainy, hot, humid weather can cause the nerve tissues to expand causing increased compression, inflammation, and pain.
Rainy Weather
For anyone who is prone to inflammation, there are ways to cope with rainy weather-related symptoms, including:
Stay inside air-conditioned areas where the humidity level is lower.
Use a dehumidifier to keep the indoor air at 40-60% relative humidity for comfort.
Utilize vent fans in the kitchen and in laundry areas and after baths/showers in bathrooms.
Easy Physical Activity
Easing the pain can also be done through:
At work, school, home adjust the seat to work for you. Individuals with sciatic nerve pain already know how to make adjustments to chairs and other places for sitting.
If you’re heading out to a baseball or soccer game, you may want to use a comfortable sideline seat that provides cushion and support. If attending a pro game, check online or call to see if you can bring a therapeutic seat cushion.
Going on a trip whether road or flight, seats might not be comfortable or supportive. Tips that can help maintain comfort to mitigate the pain, include:
Adjust the seat for proper posture to maintain spinal curvature
Use lumbar support
Maintaining a workout routine is key leading up to your trip. If the body is inactive for a period of time, the back muscles are more likely to spasm when having to sit in tight quarters.
Don’t overpack. Carrying around heavy luggage increases the risk of straining the muscles.
Pack pain medication or anti-inflammatories on hand in case of a flare-up.
Inflammation
Target inflammation with ice therapy
Using topical heat or a heating pad can get the blood circulation flowing through the area
Wear compression garments over the affected areas to bring down swelling and promote blood and nerve circulation.
Chiropractic Rainy Day Relief
Chiropractors know the whole musculoskeletal system. Chiropractic massage therapy induces deep muscles relaxation and the release of endorphins/natural painkillers. A regular spa massage can release sore muscles and tension, chiropractic massage focuses on soothing and healing sciatica. Adjustments or spinal manipulations allow the disc/s rest back into position and relieve the pressure on the sciatic nerve. This will lessen the pain and generate nerve signal flow and mobility.
Spinal decompression relieves the compression of the nerves that are causing sciatica pain. This includes techniques to lengthen the spine and enhance the space between the vertebrae.
A chiropractor will recommend exercises to prevent nerve aggravation and help release the pressure that comes from the inflamed and tight muscles.
Exercises include stretching programs that can be done at home to release pressure on the nerve and ease irritations.
Body Composition
About Fat
Fat, also known as adipose tissue, contributes to overall body weight. This is also the type that individuals want to get rid of when talking about weight loss. Two different kinds of fat:
Subcutaneous fat is the fat that is beneath the skin.
Visceral fat lies deep in the abdominal cavity and surrounds the organs.
Having a certain amount of fat tissue is necessary for a healthy body.
The body stores unused energy from food as fat. This is to provide a reliable source of fuel when the body needs it.
Fat tissue acts as insulation to keep the body warm and as a cushion to protect the vital organs.
The problem/issue is excess body fat. This is what leads to higher body weight and altered hormone release that can make the excess weight condition worse.
References
National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.
Zwart, J A et al. “Warm and cold sensory thresholds in patients with unilateral sciatica: C fibers are more severely affected than A-delta fibers.” Acta neurologica Scandinavica vol. 97,1 (1998): 41-5. doi:10.1111/j.1600-0404.1998.tb00607.x
Zwart, John-Anker, and Trond Sand. “Repeatability of dermatomal warm and cold sensory thresholds in patients with sciatica.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 11,5 (2002): 441-6. doi:10.1007/s005860100333
The sciatic nerve is the largest in the body and is created by five nerve roots that come together and exit the lower spine. It goes through the buttocks on either side and down the thighs all the way to the heels and soles of the feet. The sciatic nerve connects the spinal cord to the muscles of the thigh, leg, and foot. Any type of pain and/or neurological symptom/s that comes from the sciatic nerve is known as sciatica. The symptoms can be felt along the nerve’s path. This could be the:
When the nerve is compressed, neurological symptoms can accompany the pain. These include:
Thigh muscle weakness
If the thigh muscles are affected, weakness can be felt when bending or flexing the knee.
Leg and foot muscle weakness
Weakness can be felt while attempting to bend the knee or pointing the foot/toes upward/downward. This can lead to foot drop, which makes lifting the front part of the foot when walking difficult. Difficulty can also present when getting up from a sitting position or walking on the tiptoes.
Numbness
Loss of sensation can happen when the nerve impulses/transmissions cannot pass all the way through. Common areas affected by numbness are the:
Side of the calf
Side of the heel
Bottom of the foot
Top of the foot
Paresthesia
This is an abnormal sensation felt on the skin. It is brought on by improper nerve transmission. This sensation can include:
Tingling
Tightness
Pins-and-needles
Crawling feeling along the back of the thigh and/or leg
The Sciatic Nerve Gets Affected
The sciatic nerve can become:
Irritated
Compressed
Inflamed
This lumbar/low back radiculopathy means that the pain originates in and around the lumbar and/or sacral/sacrum nerve roots.
Compression
Physical forces could affect the nerve following common conditions:
Disc Herniation
A disc in the lower back can bulge or herniate. This causes irritation that can lead to compression of a nerve root.
Stenosis
Stenosis means the opening where the sciatic nerve exit into the buttocks begins to get narrow in size. This creates a clog with the other nerve roots that compresses or irritates the sciatic nerve. Degenerative changes in the spine like the thickening of the facet joint capsules and/or ligaments can also compress the sciatic nerve.
Instability
Instability of a vertebral segment happens when one vertebra slips over the one below it, known as spondylolisthesis. There are also vertebral defects like spondylolysis which is a complete dislocation of one or more vertebrae. This can directly compress the sciatic nerve roots.
Inflammatory Response
The body’s own chemicals can irritate the nerve causing inflammation. These chemical irritants include:
Hyaluronic acid
Fibronectin protein fragments leak out of degenerated or herniated discs onto and around the sciatic nerve roots.
There are times when degenerated discs can cause nerve tissues to grow into a disc. The tissue penetrates the outer and inner layers of the disc, causing inflammation and pain.
Some studies have shown how an immune system response can contribute to sciatic pain when there is exposure to the disc material from herniated disc/s.
Glycosphingolipids which are fats, and neurofilaments which are protein polymers. They are secreted by the immune system and have been found to have high levels in individuals with sciatica. It is believed they are released in reaction to the nerve roots and exposed disc material. This can lead to inflammation of the sciatic nerve.
Body Composition
The physical characteristics of an individual can also affect the sciatic nerve. Research has shown an increased risk of sciatica in:
Overweight individuals
Obese individuals
Older individuals
Tall individuals
Work Injuries
Individuals with certain jobs can have an increased risk of developing sciatica. Examples include:
Semi-Truck operators
Machine operators
Construction workers
Hairstylists
Office workers
Athletes that lift weights
This comes from:
Sitting for long amounts of time
Poor posture
Constant bending forward or sideways
Regularly lifting the arms above shoulder level
All are risk factors.
Vitamin B12 deficiency
Adequate levels of vitamin B12 are important for nerve health. Vitamin B12 supports the myelin sheath that covers and protects the nerves. It is important in nerve function and in transmitting impulses. Sciatica can present from vitamin B12 deficiency. However, this is more common in individuals 60+.
Body Analysis
Alleviating Nerve Pain Through Clinical Nutrition
Clinical nutrition is a powerful tool to help alleviate sciatica. Many individuals can relieve their pain through diet adjustments. Here are a few diet tips to alleviate sciatic nerve pain through clinical nutrition:
Sometimes, sciatica can be triggered by constipation from an unhealthy diet
Oily fish like salmon and halibut are rich in omega 3 fatty acids
Fresh pineapples and berries are anti-inflammatories that support healing and boost the immune system
2-3 cups of green tea
Add turmeric, ginger, and garlic to meals
B-Vitamins are important to take in when going through sciatica and are found in green peas, spinach, navy beans, nuts, bananas
Foods that are rich in A-Vitamins like dairy products, dark leafy vegetables, orange-colored fruits, eggs, and oily fish
Foods rich in C-Vitamins, like citrus and tomatoes
K-Vitamins like broccoli and spinach
Drink plenty of water, between 6 to 8 glasses a day
Foods to Avoid
Nutritionists recommend cutting out meat products except for oily fish for the first two weeks.
Foods that contain sunflower oil, corn oil, sesame oil, margarine, and partially hydrogenated oil.
Stressor foods like caffeine, processed food, soda, refined sugars, and chocolate.
Alcohol
References
Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482431/.
Heuch I, Heuch I, Hagen K, Zwart JA. Association between body height and chronic low back pain: a follow-up in the Nord-Trøndelag Health Study [published correction appears in BMJ Open. 2015;5(10):e006983]. BMJ Open. 2015;5(6):e006983. Published 2015 Jun 15. doi:10.1136/bmjopen-2014-006983.
Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.
Quero L, Klawitter M, Schmaus A, et al. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signaling pathways. Arthritis Res Ther. 2013;15(4): R94. Published 2013 Aug 22. doi:10.1186/ar4274.
Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a Risk Factor for Sciatica: A Meta-Analysis. American Journal of Epidemiology. 2014;179(8):929-937. doi:10.1093/aje/kwu007.
Living with sciatica can be debilitating and exhausting. Find out how different individuals reduced their pain from this condition. Sciatica has different treatment options. It is often a matter of trial and error to find a treatment/therapy that works for the individual. These include:
Different individuals with sciatica share what works for them. Here are their stories.
Rudy Found Relief With Self Care
A bad fall left Rudy, a graphic designer, with a broken pelvis and broken foot. I was in the hospital for a few days, and when I came home, I noticed I was hobbling. I had developed sciatica. I was in a lot of pain but decided to try the treatment that had helped me manage chronic migraines. This was yoga. Specifically, it was hot yoga sessions that, despite the pain, worked. However, for others, he recommends not staying still. The body can’t stay stagnant with no movement.
Rudy follows a plant-based diet. Eating right has helped significantly. He starts the day with a green smoothie and sips one throughout the day. This reduces inflammation and pain. His stress would also contribute to the pain. Anything felt from a pain perspective becomes amplified when in a sad, frustrated, confused mood. Rudy’s advice is to get the body moving. And follow a plant-based anti-inflammation diet.
Medication and a Topical Pain Balm Work For Jose
Jose, 66, figured how his sciatica developed was when he decided to insulate the garage. I was bending, twisting, turning, and contouring my body every which way. A week after the job, I developed excruciating pain that got worse over the following weeks. I would jolt out of bed at 2-3 in the morning with severe pain. My doctor gave me steroids that didn’t do anything. I could barely sit down and had to go through a careful method of getting into a chair. I was prescribed Vicodin – hydrocodone/acetaminophen. I took them for a week and a half.
The pain went away, but it came right back as soon as I stopped taking the meds. The meds were only masking the pain. I decided only to use it when the pain was excruciating. This was because I was worried about addiction. I tried chiropractic, massage, acupuncture, cupping, and physical therapy. Unfortunately, I was not feeling any real relief. Then I went to a pain management doctor, who ordered an X-ray and an MRI.
The doctor informed me that my spine was in great shape. The pain management doctor gave me a piriformis injection and, later, an epidural steroid injection. There were still no positive results. My primary care doctor prescribed gabapentin. This is an anti-epilepsy medication that has been shown to help some cases of back pain. Most of the major pain is gone, and I’m pretty sure it’s from the gabapentin along with weekly deep massage sessions. I also use CBD cream with arnica. Movement is important; during the day, I make sure to stand up and walk around.
Epidural Injections Work For Isabel
Isabel has chronic pain. This comes from arthritis, migraines, and fibromyalgia. Sciatica developed as a result of these conditions. Soon she couldn’t get into the car or even empty the dishwasher without going through excruciating pain. Nerve ablation or physical therapy was ineffective at relieving the pain. Then my doctor suggested getting an epidural injection. This is not the same type of injection as when having a baby. It is not the same at all. The injection includes a steroid medication called a corticosteroid that is an anti-inflammatory, along with an anesthetic. I tried it and got some relief, but the pain came back. However, after a month and a half, I began to feel more relief. The pain is not completely gone. I do feel better, but there is still some pain. My doctor told me that patients are all different and require different amounts of medication and time to work.
Surgery Gave Pablo His Life Back
Pablo, 50, is no stranger to back pain or back surgery. After living with chronic back pain from a roll-over auto accident, Pablo underwent a laminectomy. A doctor removed a portion of the vertebra in 1998 and spinal fusion in 2004 that fused the discs from L5 to S1. Life was going well until I was laid off from my desk job. I started working at a warehouse doing light work, but I would still help lift moderate/heavy bags, boxes, etc. I just pushed through the pain, thinking it was a strain that would go away.
However, during the last six months, the pain was so bad I had to stop working. I needed a cane to get out of a chair. Friends and family told me I was walking like a 90-year-old. I also lost feeling in a couple of my toes. In 2021 I had another fusion and had a broken screw from my earlier fusion repaired. The surgery went well, and they said as long as I don’t do any heavy lifting, I should be alright. Although there is still pain, it is much less than it was before the surgery. My doctor recommended a new desk job and a physical therapy rehabilitation, stretching, and strengthening program.
Body Composition
Calories burned from 10,000 steps
Estimations of how many calories are burned from exercises like walking or running depends on how heavy an individual is. Heavier people use more energy to move than lighter people. Estimates revolve around 100 calories burned per mile for a 180-pound person. 10,000 steps comes to around roughly 5 miles. Assuming an individual weighs 180 pounds means 100 calories x 5 miles equals 500 calories. Over a week, it becomes 3,500 calories. However, lighter or heavier individuals will burn less or more calories while walking the same number of steps or distance.
The spinal cord is the information pathway that transmits signals from the brain to the rest of the body. The body’s limbs and organs cannot function properly without regular communication flowing through the spinal cord. Understanding how the sciatic nerve responds to the other parts of the body can clarify how a doctor of chiropractic heals sciatica. When severe pain presents normal communications are overridden for the sake of body and health preservation. The sciatic nerve is an important part of the spinal cord and requires a trained professional to aid in proper and effective healing.
Basics On Sciatica
Sciatica happens when the nerves are compressed/pinched in some form. Lower back conditions can be the cause of such compression. Sciatica can be reduced and healed. Conditions that can lead to sciatic pain include:
Herniated discs
Subluxations
Disc Degeneration
Spinal Stenosis
Lower back disc bulge
Piriformis syndrome
Symptoms
Sciatica often includes:
Sharp pain
Numbness
Burning
Tingling sensation
Individuals can also experience weakness down the leg.
Normal activities can become strained as individuals experience these symptoms. Pressure on the nerve can be decreased and healed with professional chiropractic care. The human spine consists of 31 pairs of nerves. Five of these pairs are in the lumbar/lower back region and five are right below that area in the sacral region. The sciatic nerve starts in the lower back. It goes down through the hips, buttocks, thighs, knees, calves, and ends in the foot.
Causes could be something as simple as sitting on a bulging wallet or sitting for extended lengths of time can result in a decreased blood flow to the area. Also, direct trauma to the gluteal muscles from automobile accidents, sports, and work injuries can lead to sciatic nerve issues and pain.
Treatment Options
Tests and examinations will be conducted to figure out the origin of the pain to develop a personalized treatment plan to expedite the healing process. Treatment can include:
Chiropractic treatment
Decreasing muscle tension
Core stabilization
Spinal decompression
Rehabilitation therapy
Chiropractic treatment is designed to help the body activate its own healing system. It is non-invasive and drug-free providing an organic alternative. Advanced cases of sciatica can result in muscle weakness or a loss of sensation in the legs, if not properly treated. Individual treatment plans vary depending on an individual’s specific needs.
Prevention
Prevention is important once the condition is healing to not cause flare-ups. Sciatica symptoms can return, especially if proper and continued care to the spine is not maintained. Preventative care and maintenance are essential for ensuring a healthy spine and body. These tips can help avoid back injuries that can lead to sciatica and help with reoccurrences:
Practice proper posture
Regular exercise/physical activity with safe movements
Bend at the knees, especially when lifting heavy objects
Follow specific instructions given by a chiropractor
Body Composition
Healthy Snacks
Eggs
Eggs make a great snack that will keep the body full and help to eat less. They are a great source of protein and fat and have a healthy variety of vitamins and minerals. Hard-boiled eggs are easy to make ahead of time and are portable.
Cheese
Cheese is a great snack for protein and fat. But it is important to watch the serving size if watching/limiting calories. Cottage cheese is highest in protein but cream cheese and cheese sticks are also good options. Cheese can be paired with a serving of fruit or vegetables like grape tomatoes, bell peppers, celery, apples, or pears.
Jerky
Jerky is convenient and portable and is a great way to pack in extra protein throughout the day. The best option is grass-fed. Remember that some jerky is high in sodium if limiting sodium.
Greek Yogurt
Natural Greek yogurt is a great option for a high-protein snack. However, many yogurts are high in sugar. Therefore choose yogurt with less than 10 grams of sugar per serving, or opt for plain yogurt to avoid the sugar altogether. The yogurt can be sweetened with honey, fresh fruit, or mixed into a smoothie.
Hummus and Guacamole Dips
Hummus is a great source of plant-based protein and is balanced with carbohydrates, fat, and fiber. It is the olive oil in the hummus that provides a healthy dose of heart-healthy polyunsaturated fats. Guacamole is a delicious source of healthy fats.Both dips are calorie-dense, therefore it is important to be aware of portion sizes. These can be paired with carrot sticks, bell peppers, or celery.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico
References
National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.
North American Spine Society. (2012.) “Clinical Guidelines for Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy.” www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LumbarDiscHerniation.pdf
Sciatica is a very common and painful issue. Keeping it in check can be difficult especially with various causes that can generate flare-ups. Individuals managing sciatica need to pay attention and be vigilant of the negative activities/movements that could cause symptoms to reappear. A few common causes include:
Excessively tight-fitting pants
Improperly lifting heavy objects
Poor posture
Weight gain
Not stretching out
Wearing the wrong shoes
Knowing what not to do is just as effective for helping sciatica flare-ups as knowing what is best.
Sciatica Causes
The sciatic nerve is the longest nerve. It comes out the spine through the pelvis, down the leg to the foot. There is one sciatic nerve on each side of the body, and either can become irritated, injured, and inflamed. However, it�s rare that both are irritated at the same time. The underlying causes can vary. Most of the time the cause is a herniated disc that presses against the nerve, causing the pain. Even though this happens in the lower back, an individual might only feel pain in the buttocks and the back of the leg. Other causes of sciatic nerve pain include:
What makes sciatica worse depends on the underlying cause. For most, this is a herniated or bulging disc that presses against the nerve. With this type of case, any increase in pressure on the discs can worsen the symptoms. Sitting down in fact puts more pressure on the spinal discs, worsening the pain. Lying down can also worsen symptoms. When the pain is peaking, lying down for a little while can help, but for too long can worsen symptoms. Standing with a neutral spine, and walking around a bit, can help with nerve pain relief and the healing process.
Improper/Poor Posture
Poor posture, especially the rounding of the lower back. This usually happens when sitting. The rounded low back becomes a bad habit that individuals think will help with the pain. This can cause a flare-up. The spine has a natural S-curve and the more an individual can maintain that natural curve, the better off they will be.
Weight Gain
Too much weight can cause flare-ups with added stress/pressure on the spine, especially the low back. Maintaining a healthy weight will help relieve the added pressure, however, many who experience sciatica have trouble exercising. This is where a physical therapist and chiropractor can assist an individual with customized exercise and diet programs to overcome this obstacle. Eating is a way that individuals deal with pain, anxiety, and depression. But weight gain and poor health can worsen sciatica. Individuals that are overweight tend to experience more inflammation throughout the body, making sciatica even worse.
Stretching
Not stretching, especially as the body gets older tightens the muscles, ligaments, and tendons. And stretching improperly can injure these areas. There are recommended and non-recommended stretches for individuals dealing/managing sciatica. Stretches that require bending the low back can place added pressure on the lumbar spine, causing sciatica flare-ups.
Lifting Heavy Things
Lifting and improperly lifting heavy objects can worsen sciatica. This has to do with the rounding of the low back. Any time the spine is taken out of its natural S-curve, there is undue pressure on the joints and discs. When lifting heavy objects in this position the problem is worsened. When possible avoid lifting anything heavy while dealing with sciatica. It�s healthy to stay active, but there is no need to do intense workouts at home or the gym, especially heavy lifting.
Tight Pants
Tight pants can contribute to sciatica. Whether shorts, jeans, or skirts, wearing overly-tight, form-fitting pants should be avoided until the sciatica is gone. And even after it is not recommended to wear overly tight-fitting clothing, as this can cause blood and nerve circulation problems.
Shoes
Like tight pants, the wrong shoes without adequate support can cause flare-ups. For example, high heels force weight distribution to the front of the feet. For the body to compensate, it�s normal to push the pelvis and hips forward. When the body is in this position for a long time it starts to place stress on the hamstrings, which will exacerbate sciatica. Shoes without adequate support place added stress on the feet, which gets transferred up the leg to the hamstrings. Customized shoe inserts designed especially for individuals with sciatica can help in preventing symptoms.
Improvement
Sciatica takes time to heal. Avoiding making it worse and taking all the steps to help it heal, can bring the body back to normal within 2 weeks. For most, it takes around 4 weeks for the pain to go away. This depends on various factors. For example, if sciatica develops during pregnancy, it could take longer to get rid of the pain. One sign that shows improvement is called centralization meaning the pain is moving out of the leg and into the spine. This is a good sign that the individual is on the right track.
Body Composition
Meal Planning
The convenience of food delivery is wonderful, but remember that frequently eating food prepared away from home increases the risk of weight gain and obesity. Restaurants tend to serve oversized portions and prepare meals with excessive calories, sodium, and sugar. The benefit of eating from home is that individuals have more control over the ingredients and cooking methods used to prepare the food. It helps to plan meals and snacks in advance to make sure they are balanced. Here are the types of foods that should be included in a balanced meal plan:
A variety of whole fruits
Non-starchy vegetables – leafy greens, red and orange veggies
Starchy vegetables – potatoes, green peas, legumes, winter squash
Grains, with the goal to make at least � from whole-grain sources
Low-fat or fat-free dairy milk, yogurt, cheese
Protein from various sources – lean meats, seafood, eggs, nuts & seeds, and soy products
Healthy cooking oils – olive oil or canola oil
Nuts and nut butter
Fresh or frozen fruits
Dried herbs and spices
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Back pain combined with sciatica is the number one cause of temporary disability all over the world. The spine is a complex interconnected system that supports the entire body. Being overweight does not help. Losing weight can help relieve sciatica and prevent future episodes. It can be done through chiropractic health coaching. According to research, overweight individuals have a higher risk of developing sciatica. The more weight the body carries the more stress is placed on the spine and joints, which can irritate/inflame the sciatic nerve.
Causes and Symptoms
To understand how sciatica is affected by the weight of the body one needs to understand how it works. A breakdown of the causes and symptoms.
The sciatic nerve runs from the lower spine, through the glutes, down the back of the thigh, and is attached under the foot.
The nerve becomes compressed or irritated where it exits the lower spine. This can be caused by a bulging or herniated disc, narrowing of the spinal canal, or bone spurs.
Symptoms include a sharp pain that spreads out from the low back and down the back of the leg. It also causes tingling, numbness, and weakness.
Indirect Cause Being Overweight
Being overweight can indirectly cause sciatica. When the body has to support added/extra weight it can cause problems. That extra weight also places tremendous stress on the joints, especially those in the spine. The lower back takes most of the force from this stress, which is how sciatica develops. The stress slowly pulls the spine out of alignment and compresses the discs between the vertebrae, which then compresses the sciatic nerve, causing pain and discomfort.
Sciatica and Weight Loss
Keep in mind that weight loss is not a cure for sciatica. Weight loss will surely help relieve sciatica pain but there are other issues at work that are combined with excess weight and are causing sciatica. Weight loss is only a step in the right direction. The most recommended and effective ways to lose weight and relieve sciatica pain is having a healthy diet, exercise, and chiropractic health coaching. Other things that can be done to relieve sciatic nerve pain include:
Regular exercise will help reduce the symptoms and strengthen the body’s core and leg muscles. There are a variety of things that make sciatica worse like:
Sitting too much
Sedentary lifestyle
Wearing shoes with no support
Lifting, bending, twisting, reaching, overuse
Exercise is the best antidote to sitting too much and living a sedentary. Exercising with sciatica does not mean a full gym routine but doing the right exercises that will not worsen the condition. The important thing is staying active. Avoiding exercise will only make sciatica worse. For example, yoga is great for sciatica and health in general. A 30-minute session of yoga 3 times a week combined with another form of exercise twice a week can produce optimal results.
Weight Training
Weight training will work with sciatica with certain adjustments and avoiding specific exercises that can cause pain and should be discussed with a doctor, chiropractor, physical therapist depending on the individual’s sciatic condition.
Form and Posture
Weight training form is essential. Practice slow repetitions with special attention to physical form. Proper posture, maintaining a neutral spine, and avoiding rounding the lower back will help avoid worsening sciatica, and prevent further injury/s.
Avoid Overhead and Straight Leg Exercises
Not until the sciatica pain reduces avoid overhead lifting exercises and straight leg exercises, as these can cause flare-ups. Also, avoid intensive abdominal exercises that require doing crunches.
Know The Limits
When sciatica is present, the body is in healing mode, the key is to not overdo it. This exercise is minimal, to help in the recovery process, and strengthen the muscles. Too much exercise can prolong the recovery.
Losing Belly Fat
Losing belly fat with sciatica is possible. But it will take a sustained effort that will be well worth it when sciatica. Losing the fat needs concentration on three things:
Nutrition
Eating whole nutritious foods with plenty of vegetables, and staying away from processed and sugary foods. This is where a health coach and nutritionist can offer the greatest recommendations and develop a customized diet/health plan.
Exercise
Weight training, yoga, cardio, or a combination of all is probably best. Whatever regimen is chosen the objective to stick with it.
Lifestyle adjustments
This includes improving posture, workstation set up, adjusting sitting routines, and limiting activities that cause back pain/sciatica.
Chiropractic Health Coaching
The full-body approach outlined is how chiropractic treats sciatica. Chiropractic can relieve the pain quickly with massage, spinal adjustments, and physical therapies. This is why chiropractic health coaching is ideal for those who have a hard time making nutrition, exercise, and lifestyle changes on their own. Numerous studies show that chiropractic promotes weight loss, reduced pain, improved posture, and increased well being. And it is done in a safe, non-invasive, medication-free way.
Body Composition
Eating Out A Significant Contributor For Weight Gain
When eating out, there is a tendency to consume excess empty calories and increase fat storage. This is why preparing food is so important. It gives the individual direct control over what is being consumed and allows trying out different dietary approaches to see which one works best for improving body composition and gut health. Even for those that don�t enjoy cooking, consult a chiropractic health coach to see what options are available.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
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