How Chiropractic Care Can Help Your Sciatica!

By: Dr. Ivana Monserrate, DC

Sciatica is not a condition – it is a symptom, therefore, there is always an underlying problem and cause of the sciatic nerve being compressed. Sciatica is a term to describe the sensation of sharp, dull, achy, numb or tingling pain into the buttock, leg or foot. Causes of sciatica include, but not limited to, a bulging or herniated disc, scar tissue, bone spurs, pregnancy or tightness of the piriformis muscle. Because the sciatic nerve is the widest and longest nerve in the body, the effects, when compressed, can be debilitating. Fortunately, Chiropractic care has a long history of success in treating sciatica. Not only does Chiropractic provide a conservative, non-surgical and drug-free option for cure but it also targets and addresses the root cause of the sciatica symptoms. 

When going to a Chiropractor they first will determine the cause by taking a medical history and doing a physical and neurological examination. If needed, a Chiropractor can order any additional tests including x-ray or MRI to help further confirm diagnosis. Differentiating the cause of the sciatica helps delegate the proper treatment protocol. For instance, if the cause is the piriformis muscle being tight, the treatment may consist of piriformis stretching and strengthening of the area. On the other hand, if the cause is from the lumbar discs, relief may be achieved more from traction of the lumbar spine, massage or manual therapy of the lumbar musculature, and possible chiropractic manipulation. 

As mentioned before, one cause of sciatica can be a tight piriformis muscle, otherwise named as Piriformis Syndrome. The piriformis muscle is a small muscle that lies deep in the buttock, connecting from the sacrum or tailbone to the hip. It helps turn the thigh outward. The sciatic nerve either travels under or through this piriformis muscle, which explains why it can get compressed by tightness of the muscle. 

How does the piriformis get tight anyway? In 90% of the population, the sciatic nerve passes directly through the piriformis muscle.  In the remaining population it may travel above or under the muscle. The piriformis can get tight from sitting in the same position for periods at a time, running/walking, falling on the buttocks, misalignment of the pelvic bones or exercising without stretching. For those who walk with their feet outward may be at risk for Piriformis Syndrome. When diagnosing Piriformis syndrome the patient will have tenderness, pain and possible weakness when the piriformis muscle is touched. It is possible for the patient to also experience the sciatica pain increase when the piriformis is touched. This point of tenderness will help a Chiropractor differentiate between sciatica coming from the piriformis muscle or another source like the low back. 

How does a Chiropractor cure Piriformis Syndrome? Once diagnosed, the chiropractor will determine the proper treatment protocol. The protocol may include stretching, massage or myofasical release techniques such as Active Release Technique (A.R.T) to the piriformis muscle.  Because the piriformis muscle attaches to the pelvic bones, joint mobilization may also be found necessary. Lastly, rehabilitative stretches may be given for the patient to complete at home to continue decreasing the tightness and compression on the sciatic nerve. Common stretches given may include a figure 4 or pigeon stretch. 

Another cause for patients experiencing sciatica could be from a lumbar disc bulge or herniation. In this case, the patient will experience pain and tenderness in the low back mostly. The sciatica symptom can extend into the buttock, back of thigh, calf and foot. Usually when the cause of the sciatica is a lumbar disc, a patient may not get as great of relief with massage or A.R.T of the piriformis as they would with A.R.T of the lumbar musculature. Patients may also have increased pain and sciatica symptoms when coughing, sneezing or sitting on the toilet as well as decreased range of motion of the low back. In some cases, the chiropractor may find it necessary to order an x-ray, MRI or other imaging studies to help confirm diagnosis.     

Overall, with the appropriate treatment protocol and correct diagnosis of the cause of sciatica, Chiropractic care has proven success in resolving the issue. By taking breaks from sitting, stretching of the gluteal area and proper lifting or posture techniques, sciatica can be prevented. Lastly, every patient is different and depending on severity and other factors helps determines progress and length of recovery. 

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