sciatica back painHave you ever had a white hot poker stabbing you in the butt cheek that travels down your leg?  If you haven’t, chances are that you have heard a friend, coworker or family describe the sensation. This is a very typical description of the pain felt when experiencing sciatica.  So, what on earth could cause this kind of pain?
To understand sciatica let’s talk a little about the main structure that is involved, the sciatic nerve.  The sciatic nerve is the largest bundle of nerves extending from the spinal cord in the human body.  It is a combination of five very large nerves all wrapped up together and they travel from the lower back through the buttocks and down the back of the leg.  Along the way the nerve has to pass through several openings and between a few muscles.  As the nerve travels down the buttocks and leg, it branches out and innervates many of the muscles and tissues. The sciatic nerve also transmits pain and sensory signals from these areas.
What are the characteristic of sciatica?

  • Constant pain in only one side of the buttock or leg but rarely can occur in both legs
  • Pain can travel down to different spots in the buttocks, leg or calf depending on the individual nerve being compressed
  • Pain varies from mild ache to a sharp, burning sensation, or even an electric shock
  • Pain that is worse when sitting
  • Burning or tingling down the leg
  • Sharp pain that may make it difficult to stand up or to walk

A number of different problems cause sciatica, but all of them essentially cause compression or irritation to the sciatic nerve.  In some cases a protruding or herniated intervertebral disc can place pressure on nerves when the disc is squashed.  Over time the squishy material that makes up the disc can become thinner and tougher, this is known as degenerative disc disease, and it too can cause irritation to the nerves by decreasing the space for the nerve to exit the spine.  Another cause can be due to narrowing, also known as stenosis, of the opening that the nerve travels through can cause the problem.  A common culprit of sciatica is actually a muscle known as the piriformis muscle.  This little muscle is found in the buttock and can entrap the sciatic nerve.  This condition is known as piriformis syndrome.  Pain can be felt from the lower back and can even travel down the leg.
So what is actually happening to the nerve?  Think about the sciatic nerve as a highway running through a large city.  There are many on and off ramps along with a lot of traffic moving in both directions.  Imagine that the highway is designed well and traffic flows properly without any problems.  What happens on a busy highway when the road starts to fall apart and construction closes down half of the lanes?  You have what is called a bottleneck.  This bottleneck backs up traffic and causes irritation to the drivers; possibly even a little road rage or an accident.  The road itself is obviously in the need of repair and crews have to respond to fix the problems.  Now think of a nerve being pinched and signals that are traveling back and forth are being altered.  The irritation manifests as pain and the altered signals show up as tingling or numbness.  The repair crew can also cause inflammation to the area while trying to fix the problem.  Now you should have a better understanding of how sciatica and nerve pain in general are caused.
The good news is that, yes once again, this is a condition that can be alleviated with chiropractic care and some physical therapy.  My job as a chiropractor is to take the pressure off of the nerve and increase the ability of that nerve to function.  I do this by adjusting the bones in the lower back and pelvis.  Physical therapy is used to stretch and strengthen the structures around the affected area to prevent future relapse.  When a disc herniation or in the case of disc degeneration, I will recommend spinal decompression therapy, which helps to decompress the lower back and take pressure off the nerve.  In some cases conservative care is not enough, and a referral to the appropriate facility is considered.  Common medical treatments include pain injections, anti-inflammatory medications, and the possibility of surgery.
Adam Gingras, DC

Senara Health and Healing Center, located in Peoria, Illinois, offers a multidimensional approach to chiropractic and wellness care. Using the latest advancements in spinal and holistic health, they advance their mantra, Live Life Well, to their guests. Established as Kramer Chiropractic in 2002, the facility moved and expanded it’s services in late 2011 to Senara Health and Healing Center & Spa.