What is Sciatica?
Sciatica is a condition that causes pain, weakness, numbness, or tingling that runs along the sciatic nerve, the largest nerve in the body. This nerve starts in the lower back, extends through the hips and buttocks, and travels down each leg. Sciatica usually affects just one side of the body, and the pain can range from mild to intense, making it different for each person [1, 2, 3].
Causes of Sciatica
Sciatica can be caused by various issues, both in the spine and elsewhere in the body. The most common culprit is a herniated or bulging disc in the lower back, which can press on the sciatic nerve. Other spinal problems like narrowing of the spine (lumbar spinal stenosis), worn-out discs (degenerative disc disease), or a slipped vertebra (spondylolisthesis) can also lead to sciatica. Additionally, muscle spasms or inflammation in the lower back or pelvis can irritate the nerve roots, causing pain and other symptoms [4, 5, 6].
Although less common, sciatica can also be caused by issues outside the spine. One example is piriformis syndrome, where a muscle in the hip called the piriformis can put pressure on the sciatic nerve if it becomes tight or spasms. Other causes include injuries, complications after surgery, certain gynecologic problems, or infections like shingles. People with certain body structures or a tendency to get muscle spasms may also be more likely to experience sciatica [5, 7].
In rare cases, sciatica can be caused by tumours, infections, or inflammatory conditions affecting the sciatic nerve. In very unusual instances, distended veins in the spine (epidural veins) or veins in the buttocks (gluteal veins) can put pressure on the nerve, leading to sciatica [8, 9, 10].
Chiropractors
Chiropractors are licensed professionals with advanced training who use hands-on techniques to relieve pain and inflammation by adjusting different parts of your body [11]. These experts specialise in treating aches and pains through manual adjustments or small instruments [12].
Chiropractic care is based on the idea that the body can heal itself naturally. By aligning the spine and other parts of the body, chiropractors aim to improve the nervous system's function and overall health [13]. They perform spinal adjustments and other manipulations to correct misalignments, reduce pain, and support the body's natural healing process [14].
Chiropractors treat a variety of issues related to muscles, tendons, ligaments, bones, cartilage, and the nervous system [12]. They use adjustments and techniques like spinal manipulation to help reduce pain and inflammation [11].
Chiropractic care can address a wide range of health conditions for people of all ages, focusing on the musculoskeletal and nervous systems. Many people turn to chiropractors for relief from low back pain, neck pain, and headaches. It can also be helpful for joint pain in areas like the knees, hips, and elbows [11, 14].
Chiropractors can also treat other issues like constipation, infant colic, and acid reflux. Pregnant women might visit a chiropractor as they near delivery, especially if the chiropractor is trained in the Webster technique. This method helps realign the pelvis, which can encourage the baby to get into the right position for birth [12].
However, note that chiropractors are often criticized that their methods lack scientific credibility. Also, not all chiropractors adhere to evidence-based practices, which can lead to potential risks.
Can chiropractors make sciatica worse?
Chiropractic care is often sought by individuals suffering from sciatica, a condition characterised by pain radiating along the path of the sciatic nerve. This is because chiropractic treatments can potentially provide long-term pain management and relief, especially for those who have not found success with traditional solutions such as medication and physical therapy.
It's important to note that the effectiveness of chiropractic care can vary greatly depending on the individual's specific condition and the techniques used by the chiropractor. Chiropractic manipulation, if not performed correctly or in certain conditions, could potentially exacerbate sciatica symptoms.
Therefore, it's crucial to consult with a healthcare provider before starting any new treatment regimen for sciatica.
Treatment for sciatica?
Medications: To manage sciatica, doctors typically recommend medications like NSAIDs (which help with pain and inflammation), muscle relaxants, and sometimes anticonvulsants for nerve pain [4]. If NSAIDs don’t provide enough relief, oral steroids may be prescribed to help reduce inflammation [4]. In certain cases, epidural steroid injections can also be used to relieve pressure on the affected nerve and reduce inflammation [15].
Physical therapy: Physical therapy is key for managing sciatica. It includes exercises to strengthen your core, gentle stretches for your back and hamstrings, and activities like walking, swimming, or water therapy [4]. Spinal adjustments and deep tissue massage can also help ease the pain [4].
Other Alternatives: Alternative treatments like acupuncture, massage, and chiropractic adjustments have also been found to help relieve pain [16, 2]. These therapies can improve spinal alignment, boost blood circulation, and help relax muscles.
Surgery: In severe cases of sciatica, where other treatments haven't worked after about 3 months, surgery may be recommended [2]. Surgery can help fix issues like herniated discs, epidural hematomas, abscesses, or tumors that are pressing on the nerve [4].
The right treatment depends on how severe the pain is and what's causing the nerve compression. So, it's important to talk to a healthcare professional to figure out the best plan for you.