Sciatica is a term used to describe pain anywhere along the sciatic nerve. The sciatic nerve forms from the nerve roots of the lower lumbar vertebrae and the sacrum. The nerve roots that exit between L4/L5, L5/S1 and S1/S2 later form the larger branch known as the sciatic nerve. Sciatic pain can present anywhere in the low back, the glute, down the back of the leg and into the bottom of the foot. Sciatica may occur along the entire distribution of the nerve or in certain areas. For example, sciatic pain may only be present in the calf of one leg and/or in the glute of one side rather than traveling from the glute to the calf. It doesn’t always follow the entire nerve pathway.

While sciatica can be excruciating or a dull nagging pain that doesn’t let up, sciatica is technically not a medical condition or a disease. Sciatica is a word used to describe the symptom of sciatic pain.  It is the effects of another condition.

There are several different reasons that sciatic pain can occur and below are a few:

1. Piriformis Syndrome

Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed by the piriformis muscle causing sciatic pain, numbness, and/or tingling. Usually Piriformis Syndrome is made worse with sitting, squatting, and/or walking and there may also be a history of a former low back or hip injury, or a blunt trauma to the piriformis area.

It is also important to note that the piriformis muscles and its relation to the sciatic nerve has variations, which can be a risk factor.  The most common variation is when the sciatic nerve travels below the piriformis muscle, but there are about 10% of people that have the variation where the sciatic nerve pierces right through the piriformis muscles. About 2% of people have a variation where part of the sciatic nerve is above the piriformis muscle and the other part is below the piriformis muscle. The less common variations can increase the susceptibility of Piriformis Syndrome.

Treatment of Piriformis syndrome depends on how the syndrome started but generally include chiropractic adjustments that address the sacrum, sacroiliac joints, hips, knees, or feet. Massage therapy will help to improve the blood flow and spasm in the muscle. Light stretching and heat can help to release the muscle spasm as well as adding supplements of bromelian and turmeric for their anti-inflammatory qualities.

2. Lumbar Disc Herniation

A lumbar disc herniation is when a tear and/or rupture occurs in fibrocartilagenous material that surrounds the intervertebral disc. This most commonly occurs at the levels of L4- S1, which are the nerve roots of the sciatic nerve. This can create pain in the leg that travels past the knee.

Usually there is a history of overloading the low back, a fall or trauma, a lifting and twisting movement, poor posture and/or poor core strength. Disc herniations are secondary to disc degeneration and usually are occurring silently until a certain movement or trauma pushes the disc past its limits to were it puts definite pressure on the nerve tissue.

Treatment of a disc herniation is crucial for pain management and the ability to get back to normal activities of daily life. The sooner someone with a herniation is up and moving, the better their prognosis. In the acute phase of care it is important to quickly centralize the disc, decrease inflammation, and reduce pain. Ice, rest, and walking are usually the first plans of action. Chiropractic adjustments, traction, blocking, and flexion-distraction will work towards centralizing the disc herniation, correcting the joint misalignments, and decreasing inflammation.

Depending on the severity of the disc herniation, they can take several weeks and months to heal. If left untreated, it can take years to heal.

3. Vertebral Subluxation

A vertebral subluxation is a misalignment that puts pressure on the central nervous system. If a subluxation is occurring in the lower lumbars, sacrum, and/or sacro-iliac joints, then that dysfunction can add unwanted compression to the sciatic nerve. Chiropractors are the only professionals that treat subluxations and Dr. Sarah K. Wharton will adjust the area of subluxation in order to restore function to the area and decrease that pressure on the sciatic nerve.

Let’s face it…sciatica sucks and it can truly put a damper in your work, your personality, your mood…your whole life. Understanding that it is something that can be healed with the help of Cypress Chiropractic can get you back to normal sooner than later.

Thanks for reading Cypress Chiropractic’s holistic health blog. Cypress Chiropractic is located downtown Charleston, SC and serves the greater Charleston area. Hopefully this was informative to you and your health journey. If you have any questions or concerns about your sciatic nerve, book your appointment online today!

The information in this sciatica blog is mainly from my clinical experience and the book, Orthopedic Conditions by Dr. Nikita A. Vizniak.