The age old “diagnosis” of sciatica
As a chiropractor I see many patients coming in telling me they have been diagnosed with sciatica from their GP or good ol’ Dr Google. This however is great to know your area of pain but unfortunately not a full diagnosis. Sciatica is simply an irritation of your sciatic nerve which branches from your lower back through your hips and buttocks and down each leg. Other symptoms include pain, numbness, and tingling in the back of the thigh, calf and foot. The real art of the diagnosis is finding out where the sciatic nerve is being aggravated. Here we will look into 2 of the most common reasons I see people who have sciatica:
The first reason for sciatic nerve pain is disc herniation. These are the little cushion pads between your vertebrae, this can be caused by trauma, repetitive lifting and twisting, poor posture or congenital defects, plus many more. With this diagnosis the leg pain can sometimes be greater than your actual back pain. Pain is described as sharp, shooting, or electrical type pain which runs down the back of the leg, quite often all the way to the foot.
Secondly, I see a lot of patients with piriformis syndrome. We call this ‘pseudo-sciatica’ since true sciatica comes from irritation to the nerve in the back, but patients often feel the same symptoms. So, let’s get to looking at what and why this pain is being caused. The piriformis is a small muscle that lies deep into your buttock. This muscle attaches to your sacrum (back of the pelvis) and attaches towards your thigh bone. This muscle helps with rotating the hip and turning the leg and foot outwards. The sciatic nerve runs under this muscle and if you imagine it being squeezed when you get a lot of tension within this muscle, that is what then causes the pain. This condition is usually aggravated by prolonged sitting, standing or is common in runners.
Now what can you do if you think you have sciatica. The first would be to get a proper diagnosis so you can understand the best course of treatment for yourself. This can usually be done through manual orthopaedic testing from our Chiropractor, Sarah, but an MRI maybe suggested if this feels relevant to the individual case. Piriformis is best treated through stretches/ exercises and manual therapy delivered by either a chiropractor or sports massage therapist. Lifestyle changes are also usually needed to help with the reoccurrence of this condition. Disc herniation is usually the trickier of the 2 to treat. Treatment varies a lot on the degree of herniation but if we say on average those that haven’t got a huge degree of herniation are usually treated well with manual therapy, manipulation, dry needling, and exercises. Disc herniation in 90% of patients have resolution of symptoms within 3 months of onset, so unfortunately there is no “quick fix” for this one!
Back pain in any form can be debilitating and its best to always get it looked at sooner rather than later. So why wait, if your sat here reading this and yourself or somebody you know is suffering then book an appointment today!! Let’s work together to get you on the road to recovery.