Lower back pain plagues many people throughout their life. I consistently see patients that complain of sciatic pain, pain radiating down the leg, usually in the posterior part of the leg that either stops at the knee or travels all the way to the foot. These are 3 main causes of sciatic nerve pain aka sciatica. The most important task I have as a chiropractor is to determine which functional issue is causing the pain and address the proper cause.
Your symptoms are the first window in helping to determine where the pain is coming from. After a thorough history of the patients symptoms and prior injuries we start the examination.
The first cause of sciatic pain can be Sacro-Iliac joint dysfunction. The SI joint is the joint between the ilium (hip bone) and the Sacrum (lower triangular bone in the spine). This joint is very large and has a lot of soft tissue. I see SI joint dysfunction every day in the clinic. The patient usually presents with back pain favoring 1 side, and possible radiating pain that rarely goes past the knee. If the SI joint is the culprit of the patients sciatic pain chiropractic manipulation as well as anti-inflammatory modalities such as electrical stimulation can take care of the problem.
The second cause of sciatic pain can be Piriformis syndrome. The piriformis is a muscle that attaches on the front (anterior) side of the sacrum and inserts at the greater trochanter of the femur. Studies show that in 84% of the population the sciatic nerve pierces through the belly of this muscle to make it's way down the leg. During examination piriformis tightness is assessed, and if in fact it is tight on the side of radiating pain we have found the cause of your sciatic pain. The radiating pain from piriformis syndrome can travel all the way to the foot. Proper alignment of the SI joint along with post isometric stretching of the piriformis will help. Piriformis syndrome may take many visits as this muscle really likes to stay tight, aka it has stubborn muscle memory. Acupuncture has been shown to also help the piriformis relax.
The third cause of sciatic pain is lumbar disc bulge. The nerve is impinged at the intervertebral foramen which usually causes back pain and radiating pain and numbness all the way to the foot. If a lumbar spine disc bulge is suspected and the pain is very severe an MRI is usually ordered to get extreme detail to determine exactly what is happening in the lumbar spine. There are alternative treatments for lumbar disc bulge. Decompression therapy is my go to treatment for lumbar disc bulges. This therapy gently pulls the lumbar spine apart so that the disc has space to move back to its normal position. Correcting any misalignment in the lower back and SI joints is also necessary.
Enduring lower back and sciatic pain is no fun. Proper diagnosis of the cause of the pain is the first step to get you on the proper treatment path to correct the cause. After symptoms have decreased I strongly encourage my patients to start a core stabilization routine. The stronger the core and lower back the less likely the pain will reoccur.
If you are experiencing sciatic pain please give my office a call at 913-825-2550. I am the Overland Park Chiropractor to get you back on track!