Sciatica is pain accompanied by numbness, tingling, and occasionally weakness along the sciatic nerve. The sciatic nerve is the thickest in the body and is formed from nerve roots exiting the spine and extending into the buttocks and down the back of the legs to the toes. Common causes of sciatica, along with non-surgical treatment options, are presented by a chiropractor and a physical therapist.

 

Causes of Sciatica and Non-Surgical Care

Compressed Lumbar Disc, also called lumbar radiculopathy

Probably one of the most common causes of sciatica that I treat. About 90% of patients respond positively to alternative/conservative treatment. I use x-rays to guide where the nerve is compressed and where the best manipulation areas are for me to adjust. Spinal manipulation is a very safe procedure and, in most cases, will heal without surgery.

Dr. Alex Jimenez, D.C., and a practicing physical therapist  “Combined with chiropractic treatment and massage, we may use a topical steroid combined with electric stimulation or ultrasound to adjust/release the area where the nerve is compressed.”

Lumbar traction is also used to reduce the disc herniation size and combine this with customized exercises for the patient. Extending back and flexing exercises are also incorporated into the treatment plan, and each is made specific to the patient. Patients may experience muscle spasms or joint stiffness, which is also relieved by massage therapy and joint mobilizations. Patients could also be trained on Kinesio tape application to relieve pressure and relax muscles.

 

 

Remember that strengthening the core is the key to reducing the risk of injury worsening and getting new ones.

Lumbar Spinal Stenosis

This condition can be difficult to treat because of the mechanical compression on the nerves. The cause is often a combination of osteoarthritis, disc bulging, and spinal holes that have narrowed, called neuroforamen. Physical therapy consists of traction, stretching, exercises, and chiropractic to lessen pain and inflammation.

Spondylolisthesis

This condition can be caused by trauma or degeneration of the spine. Conservative care is highly beneficial. Extending the spine can worsen symptoms; therefore, flexion-based exercises are what we recommend. Therapeutic exercises are utilized for abdominal strengthening and core stabilization. We get the patient to increase hip extension to reduce stress on the lumbar spine.  Manual therapies can also control inflammation and alleviate muscle tightness or spasms.

Piriformis Syndrome

Piriformis syndrome also responds positively to conservative treatment. We look for the main cause when we see piriformis syndrome. This type of injury happens when a patient has a job or plays a sport where they shorten and overuse the muscle.

We create a custom treatment/exercise program based on what is found structurally. Most of the time, the piriformis muscle gets over-used because the hips are weak, so strengthening the hips and the core is key. Sciatic nerve mobilization can also help increase sciatic nerve mobility. This can be achieved with instrument-assisted soft tissue mobilization/Graston technique and deep tissue massage to get optimal results.

Pregnancy

Sciatic symptoms often present in pregnant women, making the pregnancy miserable. We aim to reduce symptoms and restore normal function with gentle exercise, massage, and hot/cold therapy.  The pelvic girdle is what we focus on, along with core stabilization and Kinesio tape application to stabilize the girdle because of ligamentous laxity or loosening of the hips.

Trauma

Any trauma that hits the gluteal area can become inflamed and spasm and bind around the sciatic nerve. We focus on relieving pain and inflammation with manual therapies and gentle exercises. These are based on what is found from the examination and how intense/extensive the trauma was.

Light spinal mobilization and massage have been proven to activate the body’s natural painkillers to alleviate and release tight muscles. More rigorous exercises are brought into the treatment plan as the patient strengthens. These will strengthen their core and return them to regular activities, jobs, and sports.

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Get Rid of Sciatica Non-Surgically

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