Determining if sciatica pain and symptoms are showing improvement can be as simple as the pain significantly reduced, or it could be a bit more complex, depending on the severity of the condition. Chiropractic treatment keeps track of the location and movement of the pain as a reliable indicator that complete relief is getting closer. When the pain retreats up the leg, it is a sign of improvement even with back and buttock aches/pain that feel like it is worsening.

Various Symptoms

The most common symptoms include:

• Tingling
• Numbness
• Sharp pain
• Dull pain
• Radiating/spreading pain
• A feeling like insects crawling or water trickling down the leg
• Changing sensations in the buttock, back, leg, or foot

Does It Get Worse Before Getting Better?

Sciatica can get worse before it gets better. This is known as centralization, where the pain moves or retreats back towards the midline of the spine after repeated movements or guided/chiropractic positioning and adjusting. It can be misleading, making the individual think the sciatica is worsening or something has caused a sciatica flare-up. However, healing is taking place. The area to pay attention to is the furthest location away from the low back. It is different for individuals. It could be the:

• Foot
• Calf
• Back of the thigh

No matter where the pain is, pay attention to that particular area. If it feels like the sciatica is getting worse, take a moment to determine where the pain is presenting. If the pain has retreated and there is no pain in the foot, calf, or leg, the sciatica is improving. The retreating pain going up the spine increases the pain in the back and buttocks. This means there is an improvement.

Sciatica Getting Worse

How to tell if it is getting worse? An increase in pain could indicate that it is getting worse. But, the key is to pay attention to the location and movement of the pain. When it gets worse, the pain is advancing; for example, if there was pain only in the back and buttock yesterday, and today the pain radiates down the back of the leg into the calf, then the sciatica is getting worse.

Length of Time Sciatic Nerve Pain Lasts

For most individuals, sciatic nerve pain lasts from two to six weeks.

• The acute pain lasts around 1 to 2 weeks, with lingering discomfort as the condition heals
• Some factors can cause sciatica to remain longer or increase the chances of returning. This includes:
• Tight hamstrings
• Weight gain
• Pregnancy
• Poor posture
• Improper lifting

Sciatica that lasts more than six weeks is considered chronic. Medical intervention should be sought out if it lasts this long. Non-invasive treatment like chiropractic or physical therapy is recommended to help speed the healing process and reduce pain.

Permanent Cure

Most sciatica cases are caused by a spinal disc disorder in the lower back. Around 85% of sciatica cases are disc-related. There is a chance that sciatica can return. It only takes a small amount of work for most individuals to keep sciatica at bay. Staying healthy and flexible are two ways to prevent sciatica from returning. This can be done through:

• Healthy diet
• Maintain a healthy weight
• Staying active with 2½ hours of physical activity/exercise a week
• Maintain proper posture
• Regular stretching
• Quitting smoking

If overweight, it is highly recommended to lose weight. One study showed that obesity increased the risk of hospitalization by 36%. Other factors that increase the potential for sciatica are frequent intense physical activity levels in sports, exercise, DIY projects, etc.

Chiropractic Improvement

Whether dealing with sciatica during pregnancy, tight hamstrings, or piriformis syndrome, chiropractic can help. A chiropractor can bring relief through:

• Ice therapy to reduce swelling
• Heat therapy to increase blood circulation
• Ultrasound
• Transcutaneous electrical nerve stimulation
• Massage

Once the pain is manageable, the chiropractor will get to the root cause. They will utilize:

• Spinal manipulation to relieve pressure
• Soft tissue therapy
• Stretches to release tight muscles
• Strengthening exercises
• Physical therapy
• Nutrition/health coaching
• Lifestyle adjustments

Surgery is rarely needed and only as a last resort. Chiropractic care will generate improvement and educate the individual on what to do to prevent sciatica from flaring up.

---

Body Composition Improvement

---

Essential Fat vs. Storage Fat

There is essential fat in the body. It has a significant role in overall health and is essential for survival. Essential fat is present in the:

• Organs
• Bone marrow
• Nerve cells
• Brain

Essential fat helps with:

• Maintaining sufficient energy reserves that function as a metabolic fuel
• Conserves body heat and functions as an insulator
• Protects the internal organs and joints, acting as a soft cushion
• Reproduction as adipose tissue/fat cells and fertility are linked

Non-essential/storage fat is adipose tissue that accumulates as an energy reserve. Storage fat affects body shape and appearance.

References

National Institutes of Health. (2019.) Sciatica. medlineplus.gov/sciatica.html.

North American Spine Society. (2012.) Clinical Guidelines for Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy. www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LumbarDiscHerniation.pdf

StatPearls [Internet]. (2020) Anatomy, Sciatic Nerve. www.ncbi.nlm.nih.gov/books/NBK482431/

StatPearls [Internet]. (2020) Sciatica. www.ncbi.nlm.nih.gov/books/NBK507908/