Sciatica; something many have heard of but few understand. The first thing you need to know about sciatica is that it is not a diagnosis. It’s a symptom. Just like a runny nose is not a diagnosis, but is a symptom of conditions such as colds, sinus infections or allergies. So you need to find out is what the cause of your sciatica is.The Symptom: Sciatica is the term used to describepressure on the sciatic nerve. The pain runs down the back side of the leg. Generally, the more pressure there is on the nerve, the further the pain goes down the leg. The sciatic nerve is formed from nerve roots starting from the lower spinal cord. It controls the sensation, muscles and blood vessels of the leg. Sciatic pain can range from a dull ache to sharp and stabbing. The pain is generally worse when going to stand, coughing, sneezing and bearing down. Back pain is also found with sciatica.Very often there are odd sensations, known as paresthesia, when the nerve is compressed. This includes pins and needles or numbness. As the sciatic nerve controls muscles, you can find muscle issues as well. With mild compression you get spasm or cramping. With increased pressure you will find weakness and incoordination to the point where the sufferer is unable to walk on their heels or toes. As the spinal nerves also control the pelvic organs, it is possible to get internal complaints such as bowel, bladder or reproductive symptoms.

If at any point you notice loss of control over your bowel or bladder or have numbness over the genitals, this requires immediate attention as there is extreme pressure on the tail end of the spinal cord, known as Cauda Equina Syndrome.

Causes: As already mentioned sciatica is merely a symptom. You can correct the sciatica if you know the cause:

1. Misalignment (Subluxation): The spinal nerves leave the spine through small openings known as foramen. Each foramen is formed by two vertebra, or spinal bones. When a spinal misalignment occurs, the opening is narrowed. With this, pressure will be placed on the nerve roots and lead to sciatica. Misalignments occur through a single large trauma or cumulatively though smaller traumas, including poor posture. Your chiropractor will be able to detect and correct a misalignment.

2. Degenerative disc disease (stenosis): If left untreated, spinal misalignments will lead to degenerative disc disease. The intervertebal disc is the soft compressive shock absorber found between the vertebrae. It is one of the boundaries to the foramen, providing height to the opening. Unlike most tissues of the body, the discs lack a significant blood supply. They receive their nutrition through movement. Movement pumps old fluid out of the disc and fresh fluid in. This process is known as imbibition. Bones that are misaligned lack movement and will lead to degenerative disc disease. As the disc degenerates it will lose height and the vertebrae will form bony spurs known as osteophytes, both of which will cause narrowing of the foramen. This narrowing is known as stenosis. With less opening for the spinal nerve there is increased likelihood of pressure being placed on the nerve root, leading to sciatica.

3. Disc herniation (slipped disc): With continued degeneration, disc herniation becomes more likely. At the centre of the disc is a fluid filed sac, called the nucleus pulposus. You can think of the nucleus as being like a water balloon. It absorbs compressive force, such as when you jump. Surrounding the nucleus are a layers of rings known as the annular rings, so named because they look like the annular rings of a tree. The annular rings contain the nucleus pulposus. When disc degeneration takes place, tears form in the annular rings. This provides a pathway for the nucleus to push to the outside edge of the disc, much like a water balloon pushing through the gaps between your fingers when you squeeze it. When the nucleus reaches the outer border of the disc it will bulge out. This is called a disc herniation, commonly referred to as a “slipped disc.”

4. Piriformis: After the spinal roots join to form the sciatic nerve, the nerve exits the pelvis between two muscles deep in the buttock. One of these muscles is known as the piriformis muscle. If particularly tight it can cause compression of the sciatic nerve. Oftentimes, the piriformis is pulled tight by a misalignment of the sacroiliac (SI) joint. On rare occasion, it is possible that the sciatic nerve actually passes through the piriformis muscle, making muscular compression of the nerve much more likely.

Treatment: Proper diagnosis of the cause of your sciatica can only be determined by a thorough assessment. Find yourself a good chiropractor. The assessment will include a thorough consultation where the doctor listens to you and finds out everything you can tell them about your present condition. A medical history, including old traumas, will also be taken at this point. There’s an old but true saying that the patient will tell you 80-90% of the diagnosis.

Following this, a physical examination will be conducted. This would include orthopaedic, neurologic and chiropractic testing. If necessary, the chiropractor may take x-rays.

After you assessment, your chiropractor will be able to identify the source of your sciatica. Only after knowing the cause of the sciatica can the problem be corrected. There may be more than one treatment method for the problem. Your chiropractor will choose the techniques based on their clinical opinion. With almost all cases of sciatica, a program of stability exercises is an absolute vital component to correction and prevention of future recurrences. It is likely that you will need regular chiropractic maintenance to ensure the best possible spinal and nervous system health.

Call SpineWise if you are experiencing Sciatica at 905-623-8388.