by Long Van, D.C.
Sciatica is a lower back pain that radiates to the lower extremities due to the irritation of the sciatic nerve.
The sciatic nerve is formed by the lower back nerves coming together. “The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb.”1 It is composed of the lumbar nerves and sacral nerves that connect and travel under the piriformis muscles located behind the buttock.
Sciatica not only causes pain but also burning sensation, numbness, or tingling sensation radiating from the lower back and upper buttock down the back of the thigh to the back of the leg.
Common symptoms of sciatica include2:
1. Pain in the lower back, rear or leg, and/or hip
2. Constant pain on one side of the rear
3. Shooting pain that makes it difficult to stand up
4. Burning or tingling down the leg
5. Weakness or numbness on the leg or foot making it difficult to move
Sciatica should be understood through its root causes, as treatment should revolve around the root cause as well as alleviating the most intense symptom and/or pain.
The following conditions can cause the disease:
1. Lumbar spinal stenosis (compressed nerves in the lower back)
2. Disc herniation (the spilling out of the soft inner material of the disc, squeezing the adjacent nerve roots)
3. Degenerative disc disease (natural age-related wear-and-tear of discs that act as cushions between the vertebrae)
4. Spondylolisthesis (the slipping of one of the lower vertebrae onto the bone directly under it)
5. Pregnancy (from back strains due to weight gain and change in center of gravity)
Various treatment options for sciatica may be obtained from chiropractic doctors, physical therapists, and medical doctors. It may be treated in various ways, including:
1. Bed rest
2. Hot/cold compresses
3. Yoga & other exercises that strengthen and stretch the lower back
4. Physical Therapy
6. Massage therapy
7. Spinal manipulation*
8. Topical preparations
9. Non-steroidal pain relievers
10. Epidural steroid injection
According to the Journal of Manipulative and Physiological Therapeutics, a study in 2010 showed that “60% of patients with sciatica who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention.3” The study further concluded that patients with the disease should consider spinal manipulation first before surgery, if at all needed.
Although not all causes of sciatica are preventable, lifestyle-related causes should be changed in order for you to reduce the risk of having the disease. The following steps are suggested4:
1. Stop smoking, which enables disc degeneration
2. Conduct exercises the strengthen your abdomen and back
3. Use good posture in all your physical activities
4. Avoid sitting for long periods of time
5. When lifting heavy loads, lift with your back straight, bringing yourself up with your hips and legs
1. Jagga Allura, M.D. Board Certified Neurologist, last accessed 8/28/2018
2. “Pain Management and Sciatica,” Reviewed by Melinda Ratini, DO, MS, WebMD Medical Reference; last accessed 8/28/2018
3. “Manipulation or microdiskectomy for sciatica: A prospective randomized clinical study.” By McMorland G1, Suter E, Casha S, du Plessis SJ, and Hurlbert RJ., Journal of Manipulative Physiological Therapeutics, 2010 Oct., U.S. National Library of Medicine National Institutes of Health Resources; last accessed 8/28/2018
4. “Sciatica: Prevention,” Cleveland Clinic Foundation; last accessed 9/1/2018
1. “Pain Management and Sciatica,” Reviewed by Melinda Ratini, DO, MS, WebMD Medical Reference; last accessed 8/28/2018
2. “Sciatica,” Cleveland Clinic Foundation; last accessed 9/1/2018
3. “Sciatica” by William C. Shiel Jr., MD, FACP, FACR, Edited by Melissa Conrad Stöppler, MD; last accessed 8/28/2018
4. “Sciatica Causes,” Spine Health; last accessed 9/2/2018
5. “Sciatica Treatment,” Spine Health; last accessed 9/2/2018
6. “11 Effective Solutions for Sciatica Pain,” Prevention.com; last accessed 9/2/2018