Sciatica & Leg Pain

1.  What is Sciatica? 
Sciatica is a term used to describe nerve pain in the leg that is caused by a problem in the lower back. The sciatic nerve is formed by smaller nerves known as nerve roots that enter and exit the spinal cord in the lower back. Irritation of these nerve roots can cause pain in the buttock, thigh, calf, and foot.

2.  What are the symptoms of sciatica?
As well as pain travelling down the leg, people with sciatica can experience burning pain, electric shock type sensations, and pins and needles travelling down the leg. More unusual symptoms include a sensation of coldness and running water, and numbness or muscle weakness in the leg.  

3.  What causes sciatica?
A common cause is herniation of a spinal disc causing compression of the sciatic nerve. Spinal discs are tough oval-shaped structures made of many layers of fibrocartilage that separate the vertebrae of the spine. Located at the center of the disc is the nucleus which is composed of a jelly-like material.  

Spinal discs attach strongly to the vertebra and therefore there is no such thing as a ‘slipped’ disc.  However, over time and with repetitive loading such as bending and lifting, numerous clefts can form between the layers of the disc that will allow the material in the center to migrate toward the outer edge, creating a bulge in the disc (the herniation) that can subsequently irritate or compress a spinal nerve root. 

The good news is that some disc herniations shrink over time allowing nerve roots to heal and recover.   Importantly, not all disc herniations will compress or irritate the nerve roots. Many people of all ages have disc herniations but do not experience any pain. In some cases, nerve roots are irritated by inflammation without any compression, and this can be just as painful.  

Sciatica can also be influenced by other factors such as reduced sleep, stress, and emotional well-being.  

4.  Who gets sciatica and how long does it last? 
Sciatica affects people of all ages, but it is experienced most often by people in their forties and fifties.    

5.  How painful is sciatica? 
Sciatica symptoms range from mild to severe and can vary from day to day. Symptoms can be intense, unpredictable, and very distressing. This can be scary, but sciatica is rarely a worrisome diagnosis.  

Symptoms can be all-consuming so that it may be tough to focus on other daily activities. In addition to seeking chiropractic treatment, try to engage in things that bring back value to your life. This might include going for a walk, playing with your children, having coffee with a friend, or going to work. This may be difficult at times, but it can help with coping and emotional well-being.    

6.  Is leg pain always caused by sciatica? 
Current research reports that only a small percentage (8-10%) of leg pain is known to be caused by sciatica. Pain from sensitive muscles and joints of the back and hips is the cause of leg pain in most cases.    

7.  Do I need an MRI or CT scan to diagnose sciatica? 
Scans are usually not required to diagnose sciatica. Sciatica is a clinical diagnosis based on a medical history and physical examination. In many cases scans do not influence the diagnosis or treatment plan.  

For a small group of people with sciatica, scans are appropriate as part of surgical planning or when considering an epidural nerve injection.  Scans are also required when the pain may be due to a serious medical condition. Thankfully, these conditions are rare.    

8.  Sitting and sleeping with sciatica 
People with sciatica often find that sitting, sleeping, or driving positions are painful. Maintaining these body postures is not harmful, but during times of intense pain it can be helpful to move regularly and to find more comfortable positions.    

9.  Exercising with sciatica 
When the pain of sciatica persists, it is common for the spinal nerves to be sensitive to movement. While it can be sensible to rest in the early stages of pain or during a flare-up, exercising and being active in a gradual and progressive way is safe and helpful. For many people this helps to reduce nerve inflammation and to maintain function.  

There is no best exercise for people with sciatica, so choose activities that you enjoy such as walking, swimming, yoga, strength training, etc.      

10.  How is sciatica treated?
At Gelley Chiropractic, we will conduct a thorough assessment to determine if your leg pain is related to sciatica.  Sciatica is treated and managed effectively with chiropractic care that includes spinal manipulations (adjustments) and soft tissue therapy, exercise and activity, and lifestyle advice. We will also work with you to develop a plan for a tolerable level of daily exercise and activity as you progress through treatment.   

Referral for pain medication may be helpful. In a small group of patients, an epidural nerve injection or spine surgery may be discussed. At Gelley Chiropractic, we can arrange a referral for these procedures if they are required.