If you have low back pain and hip pain with numbness, or tingling down the back of your leg, sciatica could be the cause.
The pain can be excruciating, and you would probably do anything to make it go away when the pain is at its worst.
Fortunately, the best treatment for sciatica is as close as your chiropractor’s office. Surgery is not usually needed.
Before we get into treatment, let’s look at how sciatica happens.
What is the Sciatic Nerve?
The sciatic nerve is your body’s largest nerve. It forms from the nerve “roots” of the lower back. The sciatic nerve runs down your buttock. It then goes down your thigh and calf, and all the way to your toes.
Irritation of either of the sciatic nerve’s roots causes sciatica. A common source of irritation is pressure against the sensitive sciatic nerve, which is usually from a disc herniation.
Your symptoms will depend on which nerve root is affected. Pain on the back of your leg, back of the calf, down to the side and bottom of your foot will result if one nerve root is irritated.
Pain will be felt elsewhere, however, if a nerve root one level up on the spine is irritated. Your pain and numbness will then run down the side of your thigh. It will reach into the front of the shin and into the top of the foot.
More pressure on the nerve means pain farther down the leg. In some cases, the nerve is compressed, a more serious problem. Compression of the nerve can cause weakness.
In the past, doctors urged surgery right away for weakness with sciatica. Today, weakness is treated without surgery. In fact, the best treatment for sciatica does not call for invasive measures in most cases.
Role of Herniated Disc in Sciatica
Have you been told you have a herniated disc? A herniated disc is a common cause of pressure on nerve roots.
Discs provide cushioning between the small bones in your spine, called vertebrae. If a disc cracks or tears, however, it can push against the nerve root. Fluid leaking from the disc can also irritate the nerve root.
Most Common Symptoms of Sciatica
Symptoms vary from person to person. Constant pain is common, but you may have pain that comes and goes. Other symptoms include:
- Pain in the lower back and buttock, which can be severe
- Shooting pain from the back to the hip, leg and to the toes
- Morning pain
- Extreme pain
- Increased pain with coughing, sneezing, laughing and straining at the stool
- Pain turning or rolling in bed
- Sharp pain that makes it hard to stand or walk
- Pain that gets worse when you sit down
- A pins-and-needles feeling
- Weakness or numbness in the leg and foot
The best treatment for sciatica relieves these symptoms by reducing the pressure not only on the nerve root but also on the discs. As a result, you can enjoy a more active life.
Home care may ease your pain somewhat before you see a doctor. Use ice packs with a new injury or with any pain levels above five out of ten. When your condition improves and pain levels are below five, you can use heat.
How Does the Medical Model Treat Sciatica?
Several sciatica treatments are available. Chiropractic care and traditional medical treatment take different approaches, however. Learning about both help you choose the best treatment for sciatica.
Here’s is what to expect at the various doctors with a case of sciatica:
Medical Doctor or Physician Assistant
Your medical doctor (MD) or physician assistant (PA) will give you medication, anti-inflammatories, muscle relaxants, steroids and opioids or pain pills. Medication is a short-term solution to get the inflammation down and decrease pain. However, the medication does not heal or get the pressure off the disc or the nerve. Furthermore, many medications have unwanted and potentially significant side effects:
- Anti-inflammatories – side effects include GI bleeding, liver problems and kidney failure, to name a few
- Muscle relaxants – not effective for back pain and will make you drowsy (some patients like to use them as a sleep aid)
- Steroids – numerous horrible side effects with long term use, such as weak bones, spinal fractures, blood sugar problems, anger, irritability and many more (should only be used for short term treatment, if at all)
- Opioids or pain pills – highly addictive and cause thousands of overdose deaths every year (should only be used for short term treatment, if at all)
Your MD or PA may also order X-rays, an MRI and refer you to physical therapy. X-rays are appropriate and should be performed especially if there is night pain and symptoms in the leg.
In the absence of “red flag signs,” your doctor should not order an MRI immediately. Reasons to recommend an MRI include the presence of “red flag signs” and if the patient’s condition doesn’t improve after 2-6 weeks of care.
Physical therapy is for exercise. However, many sciatic patients are not ready for exercise, especially in the acute phase. Studies show that chiropractic care with the Cox Technic is more effective than physical therapy for patients with leg pain. Sciatic patients should start their care with the provider that gives them the best chance for recovery.
Pain Management Doctor
Your doctor may then send you to the pain management doctor. This doctor will try different oral medications and, if that doesn’t work, will schedule an ESI or Epidural Steroid Injection or a “shot in your spine.”
During the shot, a steroid is injected into and near the disc herniation and irritated nerve with the hopes that the steroid will decrease inflammation in and around the disc-nerve area. Notice we did not say the shot heals the disc and nerve. It does not. All it does is reduce inflammation.
Studies show the long-term success rate of a shot is 15%. Shots should not be used as the only treatment because even if it does help, the relief will not last. Some people get relief right away from this treatment and others experience relief after a few days. However, some patients don’t get any relief at all and some experience worse pain than they did before the injection!
At Algonquin Chiropractic Center, we work with a couple of excellent pain doctors in the Algonquin area. We will order a shot for patients that did not improve significantly after a few weeks of chiropractic care with the hopes the shot will get the inflammation down. If it works, it will make our treatments more effective and give you the long-lasting relief you want and deserve.
Orthopedic Surgeon
We also work with excellent local, orthopedic surgeons. We have criteria for when we refer patients to these professionals. For example, if the patient has weakness or something called cauda equina syndrome associated with their sciatica we will order an orthopedic consultation.
However, most of our sciatica patients never need to see an orthopedic surgeon. Studies show only 1-5% of people ever need back surgery. A Work-Comp study out of Washington showed that if you start your care with an orthopedic surgeon, you will have a 43% chance of having surgery. Conversely, if you start your care with a chiropractic physician, your chance of back surgery is only 1.5%!
What doctor you see first matters! Wouldn’t you want to start care with a conservative doctor that won’t perform surgery but will refer you to a surgeon if you need it?
Are you looking for a better way? Keep reading.
How Does Chiropractic Care Treat Sciatica?
The best doctor for sciatica might be a chiropractor. Chiropractic care is the best way to treat sciatica for several reasons. Unlike traditional medicine, treatments that do not use pain medication, injections or surgery are utilized.
Chiropractic care succeeds where other types of care fall short. An array of techniques help ease your pain and other symptoms.
Cox Technic Adjustment
One gentle adjustment method to treat sciatica is the Cox Technic. The painless procedure decompresses spinal nerves, easing disc pressure.
Research in the European Spine Journal compared physical therapy with the Cox Technic. Researchers reported that the Cox Technic produced “significantly greater relief from pain.” Those with leg pain and numbness “did significantly better with it.” Also, it “provided more relief than physical therapy.” One year later, patients had “significantly lower pain scores than subjects who received physical therapy.”
Topics in Clinical Chiropractic reported that 91% of 1,000 patients treated with the Cox Technic found the relief they were looking for within 90 days.
Gentle Exercise
When you’re recovering from an injury, your inclination might be to remain in bed until you feel better, but for many conditions, including sciatica, movement is a key part of the healing process without which they’ll worsen. Bed rest is NOT good for any back pain, especially sciatica. What patients find is they feel better when they are moving and active and worse when they sit, lay or are inactive. Motion and movement are helpful, so keep moving as much as you can within your pain tolerance.
If you’re lying in bed in the morning, you can perform a few simple exercises to alleviate pain before you get up. Knee-to-chest stretches, the cat-camel exercise and the figure-4 stretch can all help.
Light Stretching
Light stretches are the perfect way to start your day to decrease pain and increase mobility. Again, the idea is to get some of that spinal disc fluid moving.
When doing these exercises, or any exercise for sciatica, remember that stretching shouldn’t aggravate pain. If a stretch or exercise increases leg pain, stop immediately. Leg pain is a sign that you’re irritating the sciatic nerve. If the exercise causes some mild low back pain, you can slowly work thru it; however, if it gets worse or sharp, you have to stop.
If you do low back exercises and have an increase in pain for more than 3 hours, you did too much. Cut back 25-50% during your next exercise session. If you have increased pain for 1-2 hours, keep the same level of exercise you are at. You should be able to perform the same set of exercises without pain in a few days.
Home Remedies
In addition to stretching and exercising, non-addictive topical analgesics as well as cold therapy are among the best pain relievers for sciatica. There are many effective over-the-counter topical analgesics, though our favorite happens to be BioFreeze.
As with many injuries, a good, old ice pack is an effective way to relieve sciatic pain. For convenience’s sake, you can strap an ice pack (or a bag of frozen peas) around your back with a bandage or towel. Wear your uniquely fashionable cummerbund for 15 minutes, then leave it off for 1-2 hours before reapplying it.
Strategic Body Positioning
There are precautions you can take during sedentary activities to relieve and prevent sciatica.
Most of us sleep for eight hours a day, so that activity is a good place to start. If you’re a back sleeper, place a pillow under your knees. This will relieve pressure on nerves by increasing space among your spinal discs.
If you’re a side sleeper, curl into a fetal position and leave a thick pillow between your knees and ankles. This will offer sufficient pelvic alignment to avoid cramps in the morning. As you carefully rise from bed each morning, you’ll notice a difference in how your back feels. If you cannot get comfortable in bed, try sleeping on a recliner.
Car rides, especially longer ones, can be challenging with sciatica. Here are a few things you can try to reduce the pain:
- Move the seat an inch closer to flex the knees and take pressure off the lower back.
- Place a small pillow or rolled up towel between the seat and the small of your lower back.
- Adjust the position of the back of your seat to make it more upright or leaned back.
- Slide an ice pack between your low back and car seat
- If your pain is not acute, try the seat warmers for heat.
- Try the cat-camel exercise while seated in the car.
- Stop to get out, walk around and stretch as often as possible.
If you are driving, take great care and make sure you are comfortable with the suggestions above.
Spinal Manipulation
Employing spinal manipulation, chiropractors relieve pain by moving spinal joints more than those joints would move during daily life. Practitioners thrust against spinal joints with varying degrees of pressure. They usually do this with their hands, but sometimes they do it with an instrument or device.
While other medical professionals can practice spinal manipulation, this technique is one of many in a chiropractor’s repertoire. Studies show that 94% of ALL spinal manipulation is performed by chiropractors.
Rehabilitation
The important difference between rehabilitation and physical therapy more generally is that the former is much more active, prioritizing your critical need to restore function and relieve pain.
We can guide you through specific exercises and stretches that’ll allow you to return to work or sports. No two injuries are the same, so we tailor rehabilitation regimens to each patient.
Not only can we use rehabilitation to treat your symptoms, but we can make you physically strong enough to return to activities you’ve enjoyed. Our goal is to make you BETTER than you were before your injury!
Orthotics
We also have treatments you can wear. Before their 20th birthday, 80% of people develop foot problems that can lead to back pain. By improving gait and posture, our orthotics can be another tool we use to treat your sciatica.
We create orthotics from scratch, literally molding them around patients’ feet. Our effective orthotics reduce shock, improve propulsion and provide support for all three arches of the foot.
Wearing orthotics for a single month, our patients enjoy improvements in balance, coordination, and posture as well as a 35% reduction in back pain.
Whole-Body Standing Vibration
Sometimes, the simplest solutions are most effective. Whole-body vibration therapy is achievable with a machine that vibrates a platform. The patient stands on this platform to do their exercises for spinal stabilization, posture and balance. These vibrations force muscles to contract and relax dozens of times per second. Studies show you can improve strength, posture and balance 3-4 times FASTER than traditional rehab.
How to Get Started
Your initial chiropractic visits begin with completing some simple paperwork, followed by a consultation with the doctor, where the doctor will listen to you. If Dr Galante thinks he can help you, the consult will be followed by a detailed examination including a postural exam, range of motion testing, orthopedic tests, sensory testing, reflexes and muscle strength.
Then, the doctor may order X-rays and any necessary diagnostic testing to pinpoint your diagnosis. MRIs are performed frequently but usually are not necessary.
If, after a consultation, examination and reviewing your imaging, the doctor thinks chiropractic care can’t help you, we’ll refer you to someone who can. We work with numerous medical doctors, orthopedic surgeons, neurologist, pain management doctors, physical therapists and podiatrists.
Support for Chiropractic Care
The chiropractic approach is popular. Consumer Reports surveyed 3,562 back-pain sufferers. More than 80% said they were satisfied with their chiropractic care.
Mayo Clinic’s website states that “Chiropractic adjustment is safe when it’s performed by someone trained and licensed to deliver chiropractic care.”
Safety is a top concern for professional athletes and celebrities. Tiger Woods, Jerry Rice, Jonathan Toews, Sidney Crosby, Sylvester Stallone, Ted Danson, Demi Moore, David Spade and many, many others choose chiropractic care.
Is chiropractic care the best treatment for sciatica nerve pain? Faster relief, longer-lasting relief, and a high level of patient satisfaction are reasons to consider chiropractic care.
Choose the Best Treatment for Sciatica!
As the sciatic nerve is among the biggest in the human body, sciatica is a painful condition that affects many people, but there are solutions that require neither invasive surgery nor addictive medication. The various causes of sciatica call for various solutions and a diverse plan that incorporates as many of those solutions as possible.
Chiropractic care offers faster, longer-lasting relief with a high level of safety. See for yourself why so many people turn to Algonquin Chiropractic Center in Algonquin, IL. Stop suffering, start living! Call (847) 854-2000 or email us at docgalante@aol.com.
This blog was originally published in May 2019 and updated in May 2023.
