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Sciatica is described as a series of intense and painful symptoms in one or both legs along the course of the sciatic nerve. The pain is generally felt at the back of the leg and runs from the buttocks down the back of the thigh into the calf and foot. The pain may begin suddenly or start gradually, and is typically distinguished by a sharp, shooting, or electric shock-like in quality. Movement of the lower extremities often worsens the symptoms. Pain may be uniformly spread along the leg, but there are certain areas where pain may be more intense. Also,� pain is frequently associated with numbness and/or tingling sensations along the sciatic nerve.

Sciatica can result from any health issue that causes pressure or irritation of the nerve roots that compromise the sciatic nerve. This pressure may result from a variety of injuries and/or aggravated conditions, such as a ruptured intervertebral disc, narrowing of the bony spinal canal, medically referred to as spinal stenosis, or infrequently from infection or tumor. The sciatic nerve is the longest and largest nerve in the body; it measures three-quarters of an inch in diameter and it originates from the sacral plexus; a network of nerves found in the low back, or the lumbosacral spine. The lumbosacral spine refers to the lumbar spine and the sacrum combined. The sciatic nerve and its associated nerves allow movement and enable feeling, known as motor and sensory functions, in the thigh, knee, calf, ankle, foot, and toes.

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About the Sciatic Nerve

The sciatic nerve begins in your low back, which is known as the lumbar spine. The nerve roots are in the L4 and L5 vertebrae (the ‘L’ means lumbar, as well as the numbers indicate the degree of the vertebra found along the spine). The sciatic nerve also travels throughout your pelvic area, or the sacrum. In most individuals, the sciatic nerve runs beneath the piriformis muscle, which functions by moving your thigh from side to side. From there, the sciatic nerve descends through the buttocks and the back of your thighs. Behind your knee, smaller nerves branch out from the sciatic nerve and journey down to your toes.

Your sciatic nerve is a part of an intricate arrangement of the human body’s nervous system. The nervous system is responsible for transmitting pain and feelings, as well as other sensations, to other parts of the body. Therefore, when an injury and/or a condition presses on a nerve, you are going to feel it, and many of the times it won’t feel great. With sciatica, a health issue on your low back, such as a herniated disc, for instance, permeates the sciatic nerve, which then transmits pain down your legs.

The sciatic nerve exits the sacrum in the pelvic area of the body through a nerve passageway called the sciatic foramen. At the top part of the sciatic nerve, two branches form; the articular and muscular branches. The articular branch goes to the hip joint. The muscular branch serves the leg flexor muscles, which are the muscles that enable movement. Other complicated nerve structures are also involved, both the peroneal nerves and the tibial nerves. The peroneal nerves originate from the nerve roots in the fourth and fifth vertebrae of the lumbar spine (L4-L5) and first and second levels of the sacrum (S1-2). When the peroneal nerves leave the pelvis, they move down the front and side of the leg and along the outer side of the knee to the foot.

The tibial nerves originate from the nerve roots in L4-5 and S1-3. The tibial nerves move in the front of the knee and then back into the foot, through the heel, sole and toes. In case your sciatic nerve is compressed or irritated, it can cause pain along these pathways; this is how sciatic pain can “spread” or radiate to some of the other parts of the body.

Common Questions and Answers of Sciatica

What is causing my pain? Your sciatic nerve pain, or sciatica, may be commonly caused by but not limited to a bulging disc or a herniated disc, degenerative disc disease, piriformis syndrome, pregnancy, spinal stenosis, a spinal tumor or other spinal illness, spondylolisthesis, or due to trauma from a injury. Any one of those conditions, among others, can put pressure on the sciatic nerve or related nerve roots in your low back. That stress is what causes your pain and other symptoms.

Will I need surgery? Most patients with lumbar radiculopathy respond positively to non-surgical treatments, such as chiropractic care, therefore, spine surgery for sciatica symptoms is seldom needed to treat it. However, there are situations when you might want to check with your healthcare professional about considering spinal surgery, particularly if:

You have bowel or bladder dysfunction. This is rare, but it might happen with spinal cord compression.
You have spinal stenosis, and your doctor believes that surgery is your best way to take care of it.
You are having other neurologic dysfunctions, such as intense or severe leg weakness.
Your symptoms become severe and/or non-invasive treatments are no longer effective.

What types of surgery are used for lumbar radiculopathy? Two frequent spinal surgeries for sciatica are:

Discectomy or microdiscectomy: In both these procedures, the surgeon removes part or all of a herniated disc that is pushing in your sciatic nerve and causing the symptoms. The distinction between the processes is that a microdiscectomy is a minimally invasive operation. The surgeon uses microscopic magnification to operate through a really small incision with very tiny instruments. Because the surgery is minimally invasive, you should recover more quickly from a microdiscectomy.
Laminectomy or laminotomy: These processes both involve a part of the spine known as the lamina, a bony plate that protects the spinal canal and spinal cord. A laminectomy involves the removal of the whole lamina; a laminotomy removes only a section of the lamina. These processes can produce more space for the nerves, therefore reducing the likelihood of the nerves being compressed or pinched.

Can I utilize over-the-counter drugs and/or medications to deal with my pain? Over-the-counter non-steroidal anti-inflammatory drugs, or NSAIDs, can help reduce swelling and inflammation while relieving your pain. You and your doctor have plenty to choose from. You may use acetaminophen (eg, Tylenol), ibuprofen (eg, Advil), or naproxen (eg, Aleve). However, the use of drugs and/or medications only temporarily relieves the symptoms of sciatica without treating the source of the pain. Make sure to talk to a healthcare professional regarding the utilization of these and continue to seek the most appropriate treatment for your sciatic nerve pain, such as chiropractic care.

How Chiropractic Can Help Treat Sciatica

Sciatica is a frequent issue for a lot of people that is identified by pain that begins in the lower back or buttocks, then radiates into one or both legs. It may vary in terms of frequency and severity, but it may often be constant.

The pain from sciatica can often be severe, and in addition, it can be very sharp. It may be associated with tingling sensations, burning, or numbness and weakness. What people may not realize is that it’s a collection of symptoms, an indication that something isn’t right, rather than a single type of injury and/or condition itself. The problem which leads to pain is generally a misalignment, or subluxation, of the lumbar spine. The sciatic nerve begins in the lower back and extends to the lower leg. That is why the pain may often be felt everywhere along the sciatic nerve.

A chiropractor commonly treats patients with symptoms of sciatica. Spinal adjustments and manual manipulations will aim to realign the spine, taking the pressure from the sciatic nerve and often bringing immediate relief. When the stress is off, the body can begin to heal itself. While spinal adjustments and manual manipulations are probably most frequently used, other treatments may be provided, particularly if common chiropractic care may not be advisable. Other treatment modalities might include using ultrasound, a TENS, or transcutaneous electrical nerve stimulation, device, or ice therapy. Ultrasound warms the region and increases circulation, which can lessen the swelling and muscular tension. A TENS device brings relief using a minor electric current to relax muscle spasms and also to increase endorphins. Furthermore, physical therapy, massage and or a series of stretches and/or exercises, may also help improve sciatica.

Dr. Alex Jimenez’s Insight

Chiropractic care is a popular, alternative treatment option commonly utilized to help treat symptoms of sciatica. Sciatica is characterized as a collection of symptoms, rather than a single injury or condition. A chiropractor can help diagnose the source of a patient’s sciatic nerve pain, or sciatica, in order to properly determine the best treatment for their specific health issue. Spinal adjustments and manual manipulations can be utilized to help carefully correct the alignment of the spine, restoring the natural integrity of the spine and allowing the body to heal itself, without the need for drugs and medications or surgery.

In certain individuals, sciatica may fix itself, possibly happening just once or a few times throughout their lifetime. But, it’s important to remember that if an injury and/or aggravated condition is not treated effectively, symptoms may worsen. A chiropractor can help provide relief from your sciatic nerve pain. Physical activity will most likely be recommended to strengthen the muscles in the back to help prevent sciatica as well as to speed up the recovery process. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

Curated by Dr. Alex Jimenez

Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.