Chiropractic Treatment of Sciatica:  A Safe, Non-Surgical Approach

by Dr. Bryan W. Barry ◊ Oct 15, 2010

Doctors of Chiropractic Medicine regularly treat sciatica.  Sciatica is characterized by pain that originates in the low back or buttock that travels into one or both legs.  Sciatic nerve pain varies in intensity and frequency:  minimal, moderate, and severe, as well as occasional, intermittent, frequent, or constant.  Pain is described as dull, achy, sharp, toothache-like, pins and needles, or similar to electric shocks.  Other symptoms associated with sciatica include burning, numbness, and tingling sensations.  Sciatica is also called radiating or referred pain, neuropathy, or neuralgia.  A misconception is that sciatica is a disorder – however, sciatica is really a symptom of a disorder.

Caused by Nerve Compression, Sciatica is generally caused by compression of the sciatic nerve.  Disorders known to cause sciatic nerve pain include lumbar spine subluxations (misaligned vertebral segments), herniated or bulging discs (slipped discs), pregnancy and childbirth, tumors, and non-spinal disorders, such as diabetes, constipation, or sitting on one’s back pocket wallet.

One common cause of sciatica is Piriformis Syndrome.  Piriformis syndrome is named after the piriformis muscle that is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation.  The sciatic nerve runs beneath the piriformis muscle.  This muscle is susceptible to injury from a slip and fall, hip arthritis, a difference in leg length, sitting, or driving for prolonged period of time.  Such situations can cause cramping and spasms to develop in the piriformis muscle, thereby pinching the sciatic nerve and causing inflammation and pain.  Sciatic nerve compression may result in the loss of feeling (sensory loss), paralysis of a single limb or group of muscles (monoplegia), and insomnia.

Proper Diagnosis
Since there are many disorders that cause sciatica, the chiropractor’s first step is to determine what is causing the patient’s sciatica.  Forming a diagnosis involves a thoughtful review of the patient’s medical history, as well as a physical and neurological examination.  Diagnostic testing may include an x-ray, MRI, CT scan, thermography, and/or electrodiagnostic tests (nerve conduction velocity, electromyography).  These examinations and tests help to detect possible causes of the nerve compression, as well as contraindications to spinal adjustments and other chiropractic therapies.

Treatment Approach
The purpose of chiropractic treatment is to help the body’s potential to heal itself.  It is based on the scientific principle that restricted spinal movement leads to pain and reduced function and performance.  Chiropractic care is non-invasive (non-surgical) and drug-free. The type of chiropractic therapy provided depends on the cause of the patient’s sciatica.  A sciatica treatment plan may include several different treatments such as ice/heat therapies, ultrasound, electrotherapies, such as interferential current or TENS- transcutaneous electrical nerve stimulation, acupuncture, stretching and spinal adjustments – sometimes called spinal manipulation.  Therapies may be administered together for safe and fast effective relief of sciatic nerve pain.

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