Sciatica refers to pain from the lower back which travels down the buttock and leg. It is usually one sided but can affect both legs. There can be a deep ache, shooting pains, burning, numbness or pins and needles.
The sciatic nerve is made up of a number of nerves that join together and consist of branches from L4, L5, S1, S2 and S3. So five spinal levels make up the sciatic nerve.
This means irritation or pressure to the nerves at one or more levels can contribute to sciatica.
The irritation can be from disc inflammation or protrusion but may also be from facet joint inflammation or even sacroiliac joint lesions. Less commonly it can be due to spasm of the piriformis muscle in the buttock.
Firstly, a detailed history can give clues as to what is causing the irritation. Secondly, a thorough exam can narrow down the pain source. Targeted orthopaedic tests can be performed for discs, facet joints and sacroiliac joints. These 3 are the main culprits in descending order with the discs being the most common pain source in the under 50 age group. After 50 years it swings a little more to facet joints.
Imaging is not always necessary however if sciatica does not improve after conservative care and if there is weakness in the muscles of the lower limb, then we may consider an MRI.
Solutions for sciatica will depend on what is irritating the nerve. Conservative chiropractic care may help with sciatica, but you may need a referral to a medical practitioner in more stubborn cases. If disc inflammation irritates a nerve, you may need a cortisone injection to settle the area down, and likewise for an inflamed facet joint. These do not necessary heal the problem, but can help with the pain whilst the body does the healing
At Farrelly Chiropractic we have managed thousands of cases of sciatica and are experts in the diagnosis and care of sciatica. Our treatment may consist of gentle manipulation and adjustments, flexion distraction, nerve gliding, active release technique, massage and exercises.