Sciatica pain: why it happens, where it happens, how it is treated and who do you need to see
Why sciatica pain?
The sciatic nerve is made up of a bundle of nerves that branch off your spinal cord and is considered to be the longest and thickest nerve in your body. When this nerve becomes irritated or injured it can cause pain that can be described as burning or similar to an electric shock; this pain can sometimes move down your leg. In some cases, sciatica can cause a feeling of pins and needles like numbness down your leg
The pain from sciatica is very common, in fact approximately 40% of the population will experience sciatic pain at least once in their lifetime.
What causes sciatica pain?
The sciatic nerve becomes irritated and painful when pressure is put upon it. This can be the result of herniated discs in the spine, degenerative disc disease (DDD), stenosis (which is a narrowing of the space where the spinal cord travels, this is often caused by arthritis), osteoarthritis, pregnancy or subluxations/misalignments in your spine.
Risk factors that can contribute to developing sciatica include a history of injury, being overweight, and poor core strength.
Just to elaborate on core strength and why this impacts sciatic pain. Your abdominal muscles are what help to support your back, having a weak core can be a risk factor for not only developing sciatica, but chronic low back pain as well.
There was a study done in New Zealand in the past that looked at how the core muscles were able to activate prior to activity in a population of healthy athletes. What the study found was that misalignments in the spine caused the brain to miss cues to engage the core; this lack of engagement caused “injury similar to whiplash” to occur in the lower back. The study did find that in correcting those misalignments with a chiropractic adjustment, the muscles were able to engage as they should with different movements.
How is sciatic treated? Who do you need to see?
Well, that answer depends on what your goal is, managing the symptom (pain) or treating the cause.
In my former career as an emergency room nurse, it was my experience that low back pain (including sciatica) was a common reason that people sought treatment.
I can tell you in my over seven years of emergency room experience, the “treatment” was always medication; often a pain killer and a muscle relaxer, as the opioid epidemic became more apparent the treatment shifted more towards anti-inflammatory medication like Motrin, Aleve, Naproxen-things that you can purchase over the counter. While that did help (sometimes), the help was temporary and never addressed the root cause.
The other path to treatment is to seek to correct the cause, this is where chiropractic comes in. Chiropractors are trained to assess your spine and find areas that aren’t moving properly. This improper movement can not only cause impairment between the communication between the body and brain through the network of nerves in our body, but it can also cause wear and tear on our joints.
Misalignments in our spine often don’t cause pain in and of themselves, but the poor movement that they lead to often cause not only pain, but over time can contribute to arthritis and further injury in other parts of the body. (example being, over time chronic hip pain can eventually cause you knee pain).
Can sciatica be cured?
Good news is the pain from sciatica often resolves on its own. I do however want to reiterate, if left untreated by a chiropractor, the root cause still remains, pain relief is simply the result of your body finding a way to adapt to whatever caused the pain in the first place, until that root cause is addressed the pain often will return, sometimes worse than it initially did.
Important things to know!
Because the sciatica is caused by irritation to a nerve, leaving this untreated can lead to more severe issues. A condition called “drop foot” is the result of damage to the nerve. The nerves that branch off of our spinal cord travel to reach muscles (amongst other structures in our body). These nerves supply the signals that cause the muscle to contract and release.
If damage is sustained to the sciatic nerve, it can cause the nerves that supply the muscles of our leg and foot to not function as they should. Drop foot leads to difficulty lifting the front part of your foot and can cause difficulties in walking and other activities of daily living.
Another, more urgent condition is called Cauda Equina Syndrome. The cauda equina is a bundle of nerves and nerve roots at the end of the spinal cord that resembles a horse's tail (fun fact: cauda equina is actually Latin for horses tail). Symptoms of cauda equina syndrome include muscle weakness in the legs, urinary and/or fecal incontinence and saddle paresthesia. (Imagine sitting on a saddle, saddle paresthesia is numbness/tingling in the areas that would be touching the saddle).
Cauda equina syndrome is a 911 emergency as it is an indication of severe nerve damage.
So, to summarize. Sciatica is a common condition that most everyone will experience at least once in their lifetime. Taking proactive steps such as regular chiropractic care can help prevent it as well as provide pain relief.
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