5 Causes of Sciatica

First, let us define what sciatica actually is and is not. Sciatica is, very specifically, pain along the sciatic nerve stemming from irritation of that nerve. The sciatic nerve is formed from a conglomeration of spinal nerves in the low back which binds together into one sheath. This nerve runs under the piriformis muscle in the pelvic area, then runs in between the two parts of the biceps femoris, also known as the hamstrings. It has become common to call any pain in the leg which is suspected to come from the back, sciatica. However, sciatica is a nerve pain which is the same feeling you get when you hit your “funny bone.” Most leg pain, and consequently what most people call sciatica, is actually referred pain. That is a different post. To be a true diagnosis of sciatica, it must be nerve pain that stems from the lumbar spine and runs into the buttock and/or down the backside and middle of the thigh. Now that we have that out of the way, let’s talk about what causes it!

  1. Disc Injury. Disc injuries are the most common back ailment. When a disc bulges or herniates, it can occupy the space where the spinal nerves exit from the vertebral column. If a disc bulges too far it can push against the nerve root causing pain to travel down the sciatic nerve and beyond. Sometimes, the bulge will hit the nerve and then pull back enough so that the sciatic pain is not constant. If the disc is in constant contact with the nerve, one can experience pain, numbness and tingling, weakness, and other symptoms. Chiropractic can help, but these can take a long time to heal and consistency makes the difference. Traction, rehabilitation exercises, physical therapy, and stretching can also help if done properly. If it comes to it, cortisone injections and surgery may be last resort options.
  2. Inflammation. With injury comes inflammation. Though the disc is the most common injury, there are several other structures in the area of the nerves that make the sciatic nerve that can be injured. Inflammation is toxic and can cause its own set of issues. Nerves are especially sensitive to inflammation. Icing, NSAIDs like ibuprofen, Chiropractic, and steroids can all help reduce inflammation. When the inflammation is in check, the back and sciatic pain will diminish. When the area with the sciatic nerve or nerve root is inflamed. The symptoms will remain constant.
  3. Sacro-Iliac (SI) Joint Dysfunction. The sciatic nerve crosses the SI Joint just after it forms the large nerve. If the pelvis shifts or is not working properly, it can irritate the Sciatic Nerve through direct pressure, inflammation, or by causing muscle tightness or spasms from the imbalance. Adjusting the SI joint will help reduce inflammation and muscle guarding, as well as move it away from contact with the nerve if that is the case. Chiropractic is by far the best thing for this case but a clever physical therapist can help, too. Exercise, stretching, and icing may help but can irritate it, as well.
  4. Piriformis Syndrome. This diagnosis has become pretty popular. I find that it is misdiagnosed more often than not. The piriformis is a little pear-shaped muscle (hence the name, piri means pear), that spans the SI joint. The Sciatic Nerve runs underneath it in most individuals. If this muscle tightens, it can compress the sciatic nerve and cause sciatica. The piriformis can tighten for various reasons including any of the above-mentioned maladies. Usually, I find the piriformis is a secondary issue. Sometimes, however, it can take on a life of its own after the other condition has resolved. If it is, truly, piriformis syndrome, the best thing to do is have a specialist perform a muscle release on it. Active release, myofascial release, Bowen, Rolfing, massage, etc. can all help if done right. Be aware that if it only helps for a little while, then there is probably another issue that is still causing the muscle to tighten or guard.
  5. Direct Contact. Because the Sciatic Nerve runs through the buttock and down the back of the leg, the way one sits can cause sciatica. The most common cause is a wallet in the back pocket. Additionally, a seat that curves upward along its lip can put pressure on the legs and irritate the nerve. Unfortunately, I have seen this most often in vehicles.  The solution for these is obvious. The trick is to figure it out before it causes problems more difficult to remedy.

There you have it. Probably not a comprehensive list but definitely the most common causes. Sciatica is actually rarer than it seems. When you have it, however, it is very painful and can be difficult to treat. If you are experiencing sciatica or any type of pain or other symptoms down the leg, chiropractic can help. And, like all conditions, being prompt and consistent makes for better and quicker healing.

Stellar Article Review!

I read this great article review by Dan Murphy, one of the leading chiropractic researchers. If you have the chance, click on this link for his review. If everyone read and understood what this article is about, my office and every other chiropractor in the world would be flooded with patients. Here are just a few bullet points from the article if you don’t want to read the whole article review. I added a few notes in orange to help clarify some things:

1) Curvatures of the spine adversely affect the sympathetic nervous system.

2) The sympathetic nervous system controls the blood supply to the viscera, and
is therefore related to all manner of visceral diseases and pathology, and
specifically, “the ordinary diseases of adult life.” (Visceral means organ)

3) Visceral diseases and pathology can be traced back to the segmental levels of
sympathetic involvement with nearly 100% correlation. (For example: Nerves that are irritated in the low back cause bowel and reproductive organ dysfunction, mid back=heartburn, neck=thyroid, etc.)

4) Prolonged abnormal spinal posture stretches the sympathetic nervous system,
firing the sympathetics, causing reduced blood supply to visceral organs, and
resulting in visceral pathology. (Irritation causes decreased blood flow to organs which causes problems)

5) Abnormal spinal curvatures precede organic visceral diseases. (Sit up Straight!)

6) The author perfectly describes pelvic-lumbar subluxations, fibrosis, reduced
motion, and sympathetic nerve interference adversely influencing blood flow and
resulting in visceral pathology. (Read my previous article to find out about subluxation)

7) Spinal disease precedes old age and to cause old age.

8) Stiff distorted spines cause sympathetic irritation, vascular spasm, arterial
hardening, and old age follows. (Motion is Life, get up and do something physical!)

9) A person is as old as his spine.

10) Postural distortions causing sympathetic dysfunction can be treated with
fulcrum-assisted reversal of the postural distortion. [Incredible] (Adjustments work!)

11) This author references both osteopathic and chiropractic literature in his
bibliography.

What is Health?

What is health? I ask this question all the time both to others and to myself. When I remind myself of the answer on a daily basis, I have real purpose to my work.

The definition of health used to be the absence of disease. That is a pretty narrow definition and, to my way of thinking, isn’t really possible. I think everyone has something that causes dis-ease and therefore, by definition has a disease. For that reason I think we have evolved as a society into a broader more dynamic view of health.

Health can be good or bad. It is a spectrum, if you will. Everyone alive has health to some degree. It is kind of like the old saying “If I didn’t have bad luck, I would have no luck at all.” Some people have bad health and others have good health.

To me, good health means that all aspects of the body function as they should. This includes functioning with other parts of the body. Proper function and even synergy of the body relies on good communication. Good communication is in large part dependent on a properly functioning nervous system.

The nervous system consists of the brain, the spinal cord, the cranial nerves, the nerve roots, and all the nerves with their bundles that come off of the nerve roots. The most common area of the nervous system to have a problem is the nerve root.

When vertebra in the back is dysfunctional it irritates the nerve root which alters communication to the organs and other parts of the body that nerve root innervates and leads to disease. Chiropractic helps relieve the irritation of the nerve. Simple as that!