Sciatica: symptoms, diagnosis & treatment

Sciatica is a type of low back and leg pain resulting from irritation or compression of the sciatic nerve, a large nerve extending from the lower back down the back of each leg.

What are the symptoms of sciatica?

Common symptoms of sciatica include:

• Pain in the buttock or leg that is worse when sitting
• Burning or tingling down the leg often into calf, ankle and/or foot
• Weakness, numbness, or difficulty moving the leg or foot
• A constant pain on one side of the buttock
• A shooting pain that makes it difficult to stand up or move in any direction

Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the buttock, back of the thigh and down through the leg. The pain often extends to the foot or toes.

For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse.

Seek immediate medical attention if you experience loss of bladder or bowel control, numbness around the anus or perineum.

 

What causes sciatica?

Sciatica is caused by irritation or compression of the sciatic nerve.

 

Causes of sciatica include:

• Lateral foraminal narrowing (due to a disc bulge, osteopytic bone, disease process)
• Entrapment of sciatic nerve by piriformis muscle
• Lumbar spinal stenosis (narrowing of the spinal canal in the lumbar spine)
• Spondylolisthesis (a condition in which one vertebra slips forward over another one)
• Pregnancy (most often this is not true sciatica but referred pain from mechanical irritation of the lumbar spine or sacro-iliac joints)

 

Your chiropractor is trained to diagnose and distinguish the various causes of your back and leg pain.  Not all low back and leg pain is sciatica. Most often these symptoms are due to lumbar facet joint irritation and/or sacro-iliac joint dysfunction. The latter causes have a much better prognosis than true sciatica.

 

Sciatica diagnosis

In diagnosing sciatica, a chiropractor will take your medical history and perform an examination of the back, hips, and legs in order to test for strength, flexibility, sensation, and reflexes.

 

Other tests may include:

 

• X-rays (This type of imaging with show us the bony structure, and allow us to see any “wear & tear” and misalignment issues. It will not show us the discs or other soft tissues)
• MRI scans (This is usually the best imaging modality for determining if, where and to what extent the sciatic nerve is compromised
• CT scans

 

Sciatica treatment

Treatment for sciatica focuses on relieving pressure and inflammation. Typical sciatica treatments include:

• Chiropractic Treatment: This type of highly skilled manipulation treatment helps to relieve current sciatic pain and prevent further episodes of sciatica.
• Medical treatments: Anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, or oral steroids, to relieve inflammation.
• Epidural steroid injections. Steroids, with their strong anti-inflammatory effects, are delivered at the origin of the inflamed sciatic nerve roots.
• Surgery. Surgery may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.