Sciatica is one of the most “Stubborn” conditions which we see at the clinic – we say stubborn because it’s notoriously difficult to treat and has a nasty habit of going away, only to reappear shortly after. This week, let’s learn a bit more about that pesky sciatica.
So what is sciatica anyway?
Sciatica isn’t actually a condition in and of itself – rather it’s a term which we use to describe the kind of pain it causes. Sciatic pain is quite unique too – it travels down the back of your leg from the lower back or buttock, often as far as the foot. Fundamentally, it’s caused by irritation of the sciatic nerve, and is often accompanied by back pain – many sciatica patients find that the leg pain is worse than the back pain, or is at least more bothersome, as it can make getting around difficult.
The distinct pain which comes with Sciatica is the most common symptom – and it’s one which you’ll (unfortunately!) know if you encounter it! This isn’t the only symptom of sciatica, however, and in some cases, spotting other signs early can give you an opportunity to seek treatment before any serious pain sets in.
As mentioned above, back pain, especially lower back pain often accompanies and frequently precedes sciatica – this is especially the case where subluxation, a condition in which the spinal vertebra become misaligned is the cause. More broadly, sciatic symptoms can include:
- Pain on one (and only one) side of the body
- Burning, pins and needles, or sharp sensations in the leg, foot or hip
- Numbness in the leg
- Hip pain, which may spread to and also affect the lower back
- Pain that intensifies when sitting, standing, or especially sneezing
- Weakness in the affected leg, or back
- Numbness in the upper thigh
- Tightness in calf or back of the thigh
As you might have noticed, sciatica shares symptoms with other conditions – like arthritis or soft tissue injury to the leg itself. For this reason, it’s helpful if you can keep a record of any sciatic symptoms you experience and this can help a spinal professional, like a chiropractor, to diagnose the issue and rule out other conditions. This is also helpful if you visit your GP, as it can help them to rule out other conditions more quickly.
Sciatica is also fairly unusual in that it can vary a great deal in its severity – some people experience sciatic pain so bad they can barely walk, others struggle with a low-grade nagging pain which may affect them more psychologically the physically. Sciatica is also fickle in its comings and goings – for some people, sciatica resolves on its own within a few weeks, while others can be stuck with the pain for months on end.
How to treat Sciatica
There are three main options for treating sciatica – wait, and hope it subsides on its own, medicate to mask the pain (while it hopefully resolves) or try to address the underlying issue with some form of manual therapy.
Wait and see…
Sciatica is one of the few conditions where there may be real value in waiting a week or two to see if the condition subsides – if you haven’t suffered from sciatica before there’s an argument to be made that the issue may be just a passing one for you, hence seeking treatment may not be worth the time and money. There’s a judgment to be made about whether you want to stay in pain for a few weeks, but here, short term usage of painkillers while you see if the condition goes away on its own could be worth a go. If you’re still in pain after a few weeks, it’s time for something more active.
If you’re still in pain after some time, or if the pain is so bothersome you can’t function day today even with over the counter medicines, you might want to visit your GP and seek some prescription medication to help with the pain. While your GP hopefully can help you with this, some research has shown that even stronger painkillers may not be especially effective for sciatic pain – a 2017 study that followed 207 patients with sciatic pain eventually reported that the medication prescribed, pregabalin, did not actually reduce the intensity of the patient’s leg pain. In any case, medication is unlikely to resolve the underlying issue causing the sciatic pain – and after a period of time, it’s likely that your GP will recommend some form of manual therapy – through the NHS it’s most likely to be physiotherapy.
Probably the best approach for treating sciatica are manual therapies – these include physiotherapy, chiropractic, massage, sports therapy and perhaps acupuncture. Chiropractic is especially well recognised for its ability to treat sciatic pain, but any of these approaches can likely be of significant help. Manual therapies seek, in one way or another, to reduce the pressure on the sciatic nerve which is actually causing the issue. Indeed, research suggests that manual therapy, in combination with some home exercises and stretches may be the most effective way to treat sciatica of all. A 2014 paper reported greater improvements in most patient-rated outcomes, including pain and disability, after 12 weeks of dual chiropractic and home exercise care. Patients treated with a dual approach report significantly reduced pain, use of medication, disability and most importantly showed high satisfaction with their treatment.
Is Sciatica getting you down, we can help!
No matter where you are with your sciatica struggle, Complete Chiropractic is ideally positioned to help you recover. We’re not just a Chiropractor – instead, we offer Chiropractic, massage and sports therapy at our clinic every day, so we’re able to quickly find the right approach for most people. If you’ve just developed sciatica you don’t need to suffer with it – come in for a consultation, take advantage of our new patient special and beat the pain sooner! If you’ve been waiting to see if the pain goes away and so far it hasn’t – it might be time to pop in and see how we can help.
 New England J Med 2017; 376:1111-1120
 Bronfort et al. Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation. Ann Intern Med. 2014 Sep 16;161(6):381-91. doi: 10.7326/M14-0006