HELPFUL INFORMATION

Unravelling Sciatica: A real pain in the backside…

Sciatica – you’ve probably heard of it… and you probably know someone who has experienced it or you’ve experienced it yourself. For those of you who have truly experienced sciatica, you know just how much of a pain in the backside it can be!

Considering so many of us are aware of the word ‘sciatica’ and considering it is commonly misunderstood, this blog aims to break it down to help you understand what it is, what else it could be, what you can do to help and why you might consider seeking help from a chiropractor.

So what is sciatica? 

Sciatic pain is caused by direct irritation of the sciatic nerve. 

Firstly, let’s run through the anatomy of the sciatic nerve to help you understand where the nerve starts and finishes. The sciatic nerve starts in your lower back from your lumbar vertebrae number four to your tailbone (L4-S3 nerve roots). 

Interestingly, it is the largest nerve in your body. It travels into the glutes, down the back of the leg and into the back of the knee. This is the area of pain that it’s felt and can be described as a burning sensation accompanied by numbness deep in the buttocks.

A model of the Sciatic Nerve which issues with can lead to sciatica

What we commonly see in practice is people experiencing a sensation of not being able to release a deep, dull ache in their buttocks and will use their spiky ball to release it, but they end up with bruises instead of relief – does this sound like you? Well read on to find out more…

As we mentioned earlier, sciatica pain is due to a direct irritation to the nerve. Some things that can cause irritation to this nerve include:

  • Herniated lumbosacral discs
  • Nerve root impingements
  • Spinal stenosis
  • Arthritis
  • Swelling of associated discs, muscles & ligaments
  • Spondylolisthesis (slipped vertebrae)
  • and other rare conditions including: epidural abscess, epidural hematomas & tumours.

A good place to start is by working out whether you TRULY have sciatica

Although many people claim to have sciatica, there are a few differentiating factors that truly make it sciatica. What we notice with sciatic pain is it’s made REALLY worse with:

  • Lumbar spine flexion, i.e., bending forward, knees straight, and trying to touch your toes.
  • Twisting & bending
  • Coughing and sneezing
  • Trying to pass a bowel movement
  • Going over a speed bump in the car

So if it’s not sciatica, what else could it be?

There are other conditions that can present as sciatica, and these other conditions can include:

  • Piriformis Syndrome
  • Muscle spasms
  • Joint restrictions
  • Weak glutes or hamstrings
  • Referred pain from other surrounding structures

The best way to differentiate sciatica is to have a healthcare practitioner, such as a chiropractor, assess and diagnose you correctly.

How can a Chiropractor help me?

Firstly, it’s important to recognise that chiropractors are university qualified primary healthcare practitioners, meaning they are well equipped with the knowledge and tools to either rule in or rule out sciatica. 

Chiropractors have a thorough understanding of the spine and now know that sciatica is a condition of the spine, making them well versed in the diagnosis, management and treatment of sciatica. Chiropractors have specific techniques they can use to help proper spinal alignment and soft tissue skills to help alleviate any pressure on the sciatic nerve. Chiropractors can also refer for imaging, including X-rays & MRI, should they be warranted. 

Read more about our Chiropractors here

So what can you do to help?

Firstly, differentiating it and confirming whether it is true sciatica is the best start. A qualified health care professional like a chiropractor can help you do this. 

Other things you can do include:

  • Use of hot or cold packs for comfort and to decrease inflammation
  • Stay moving, within comfort levels 
  • Rest where appropriate but avoid complete bed rest (side note – the disc needs blood supply to help it heal & gentle movement allows this to happen)
  • Try to avoid prolonged sitting or standing
  • Practise good, erect posture
  • Gently stretch and mobilise the lower back and pelvis
  • Get into a rehab pool for short periods of time, max 20-30 minutes
  • Consult with your GP for assistance with pain relief (should you require it)
  • Book in to see a chiropractor

It is important to understand if your symptoms have been around for longer than 4-6 weeks, it is highly recommended you seek consultation with a healthcare professional.

So where to from here?…

Unless there’s an acute compression of the spinal nerves or something more serious, most sciatica cases are best managed conservatively with the use of modalities such as chiropractic care, remedial massage and strength based programs like clinical pilates. 

Lucky for you, we have all these services available here at Chiropractic On Winston. 

So, what are you waiting for? Give us a call or book an appointment today so we can get to the bottom of that pain in the butt! 

References

Davis D, Maini K, Taqi M, et al. Sciatica. [Updated 2024 Jan 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/