Sciatica refers to pain or dysfunction involving the sciatic nerve in the lower back and legs. Symptoms may include tingling or a burning sensation, weakness, numbness, and pain. The symptoms begin in the lower back and commonly travel down the back of the thighs, calf muscles, and even into the feet. People usually experience sciatica symptoms down one side but can experience it bilaterally. Symptoms are secondary and caused by other primary conditions such as a herniated disk in the lower back that is pressing on the sciatic nerve.
Sciatica pain is often caused by a temporary inflammation or overuse of the low back, which irritates the nerve. In these instances, pain will usually subside on its own as long as you take care of your back. Your doctor or chiropractor may recommend an over the counter anti-inflammatory, ice for the first 48 hours then heat, and gentle activity for a few weeks until the symptoms subside. Chiropractors recommend avoiding extremes-no bed rest and no heavy lifting.
Chronic sciatica is pain or dysfunction that lasts more than six months. Most often, chronic sciatica is due to a herniated or bulging disk in the lower back due to overuse or an injury. Other causes of sciatica may include tumors, Piriformis syndrome, or a trauma to the pelvis. If you experience fever, redness or swelling of the back, problems urinating, or severe pain, call your health care provider immediately.
When chronic sciatica is a result of a non-life threatening condition such as a herniated disk, doctors recommend the most conservative treatment first. Surgery can be effective but there are risks and higher costs associated with surgery as opposed to more conservative treatments such as injections, physical therapy, and chiropractic care.
A recent study on the effectiveness of chiropractic care for sciatica showed that chiropractic spinal manipulations were equally as effective as surgery (microdiskectomy) in treating sciatica. The study in "Journal of Manipulative and Physiological Therapeutics" reported "sixty percent of patients with sciatica who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention."1 Further, surgery for sciatica can cost up to $25,000 and involves the risks associated with invasive surgery. When compared to the average 21 chiropractic sessions at $100 ($2,100) to treat sciatica, this is a savings of $22,900.2
The researchers concluded that spinal manipulations performed by a chiropractor proved to be an effective and cost efficient treatment for sciatica. Patients with sciatica due to a herniated disk should consider treatment by a chiropractor before surgery. Chiropractic manipulations have proven to successfully relieve sciatica without the need for surgery in many instances. For patients that do need to proceed with surgery, the study found that patients who delayed surgical treatment and tried chiropractic care first experienced no negative effects.
Chiropractors are whole body practitioners and work within the body's natural healing abilities. If treated by a chiropractor for sciatica or a herniated disk, your rehabilitation may include any combination of physiotherapy treatments including spinal manipulations, heat and ice therapy, electric stimulation, ultrasound, massage, and rehabilitative exercises.
References
1. McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010 Oct;33(8):576-84.
2. Spinal Manipulation Proves Equally Beneficial as Surgery in Sciatica Treatment. Foundation for Chiropractic Progress. Press Release May 10, 2011. http://www.yes2chiropractic.com
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