By Dr. Tom Solecki
As a Chiropractor I see a multitude of conditions that patients present to me. One of these conditions happens to be sciatica. Sciatica is a condition that has many causes to its complexity. In involves the inflammation of the great sciatic nerve and presents acute or chronic pain down the back of the leg, starting from the buttock and extending into the feet. It can originate in the nerve roots such as in discopathy or facets syndrome or can be caused by the gluteal muscles tightening over the nerve. Gluteal muscle spasm is often secondary to sacroiliac joint dysfunction; which in turn can be secondary to short leg syndrome, sacroiliac sprain/ strain, lumbar sprain / strain and strain causing tightening of the entire lumbar erectae spinae musculature.
There is however, a rule of thumb when doing an investigation of this condition. It is to remember that the nerves are irritated by pressure by the gluteus medius muscle gradually causing spasm in order to protect the joint, which the body perceives as injured. The splinting spasms produce pressure on the sciatic nerve as it exits the pelvis, causing irritation. Additionally, the sciatic nerve may pass through the piriformis muscle, which if in spasm, pressures the nerve. Sciatica is rarely the result of just trauma. Although stretching of the nerve can result from the injury to the leg or vertebral trauma.
Onset is usually gradual as the nerve becomes inflamed. Ice usually brings immediate ,temporary relief. Sciatica usully causes splinting spasm of other muscles and may cause favoring of the opposite leg. Symptoms of sciatica usually cause burning down the track of the sciatic nerve from the buttocks down the posterior side of the leg. Spasm of the gluteal or piriformis muscles, burning pain increased by direct pressure to the nerve are also symptoms. Straightening of the leg often worsens the sciatic nerve irritation. It may cause knee buckling upon loading as well as long-standing pain, causing weakness.
In treating sciatica, we utilize a number of different procedures including joint manipulation/mobilization of the lumbar and pelvis region in order to increase function and, range of motion as well as to decrease pain and reduce irritation to the sciatic nerve. We utilize physical therapy, which consists of ice and moist heat and strengthening of the gluteal, abdominal and lumbar muscular regions. This will help increase function, and range of motion, as well as to decrease pain and stabilize the condition. Stretching and strength training exercises of the gluteal, abdominal, lumbar, hip flexors, and hamstrings will help with alleviating and stabilizing the condition. We approach sciatica, as well any other condition in our clinic by utilizing a variety of health disciplines to achieve optimal balance. Joint manipulation, physical therapy, and dietary considerations are utilized with sciatica in order to help achieve proper stabilization. Encompassing vitamins B1, B12, D, E, and C will reduce inflammation and help supply important nutrients to the sciatic nerve. A diet high in complex carbohydrates, moderate protein and low fat as well as an increase in foods containing vitamin B improves the overall condition as well as a healthy lifestyle. Avoiding foods like fatty red meats, alcohol, spicy foods, fatty foods, salty foods, caffeine and sugar wiil promote a quicker recovery.
If you or someone you know suffers from sciatica, they may be able to benefit from Chiropractic care.