Sciatica

Symptoms by body part:

Sacro-Iliac (Upper-Buttocks)
Acute Pain
Gluteal (Buttocks)
shooting, or electrical type pain or burning

Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own.

How does it occur?

Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower spine and runs down the back of the leg. There are two nerves that comprise the sciatic nerve, known as the Tibial and Peroneal nerves.  They are made up of the L4-S3 nerve roots.  Thus, an injury to any of those levels could contribute to dysfunction.  Sciatic nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg, the sole of the foot and along the outer edge. 

Often, biomechanical shifting of the sacrum, pelvis, coxofemoral and lumbar spine causes added pressure on the sciatic nerve as it travels between the Piriformis muscle and Superior Gemellus muscle.  Due to the attachment of those muscles, any shifting of the aforementioned bone, muscle and joint structures will cause further compression of the sciatic nerve. 

Symptoms:

  • Pain in the lower back
  • Buttock pain on one side
  • Hip pain on one side
  • Pain down one leg and into the foot
  • Tingling/numbness/burning down one leg and into the foot
  • Worsens when straightening leg
  • Decreased ROM when flexing forward, bending to the side, or extending backwards
  • Stiffness in foot or leg
  • Increased pain when sitting for longer periods of time

How is it treated

It depends on the cause of the sciatic pain.  There can be disc involvement, resulting in pressure on the nerves as they exit the spine, or can simply be caused by misalignment or rotation of the vertebrae, pelvis and hip structures causing muscle tension and thus compression on the nerve itself.  Both are common and treatable.  There are instances where a disc herniation is causing the sciatic pain and may result in surgery when not correctable with conservative care.  Often, an X-ray or MRI will be ordered to determine the involvement of lumbar disc and pelvic structures. 

Treatment consists of chiropractic manipulations, physical rehabilitation, disc decompression, ventricular muscle stimulation, cold laser therapy, neurological rehabilitation and active therapeutic/myofascial release.