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Lower Back Pain or Sciatica

Pain Sometimes Radiates down the legs

Sciatica is pain that originates in the low back or buttock that travels down the back of one or both legs. Sciatic nerve pain varies in intensity and frequency: minimal, moderate, severe, and occasional, intermittent, frequent, or constant.

Sciatic pain can be described as dull, achy, sharp, toothache-like, pins and needles, or electric shock-like shooting leg pain. Other sciatica sensations may include burning, numbness, and tingling. Sciatica is also called radiating or referred pain, neuropathy, or neuralgia.

A misconception is that sciatica is a disorder—sciatica is really a symptom of a disorder.

Sciatica Is Caused by Nerve Compression

Sciatica is generally caused by sciatic nerve compression. Spinal disorders known to cause sciatic nerve pain include lumbar spine subluxations (misaligned vertebral body/ies), herniated or bulging discs (slipped discs), pregnancy and childbirth, spinal tumors, and non-spinal disorders such as diabetes, constipation, or sitting on one’s back-pocket wallet.

One common cause of sciatica is piriformis syndrome. Piriformis syndrome is named after the piriformis muscle. The piriformis muscle is near the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. This muscle is susceptible to injury from a slip and fall, hip arthritis, or a difference in leg length. Such situations can cause piriformis muscle cramping and spasm to develop, pinching the sciatic nerve and causing inflammation and pain.

Sciatic nerve compression may result in the loss of feeling (sensory loss), paralysis of a single limb or group of muscles (monoplegia), and insomnia.


Proper Diagnosis of Sciatica Is Essential

Since there are many disorders that cause sciatica, the chiropractor’s first step is to determine what is causing sciatica. Forming a diagnosis involves a thoughtful review of the patient’s medical history, and a physical and neurological examination.

Diagnostic testing may include an X-ray, MRI, CT scan and/or electrodiagnostic tests (electromyography/EMG and nerve conduction velocity/NCV). These tests help to detect possible reasons to avoid spinal adjustments and other chiropractic therapies.

Chiropractic Treatment of Sciatica Symptoms

The purpose of chiropractic treatment is to help the body’s potential to heal itself. It is based on the scientific principle that restricted spinal movement leads to pain and reduced function and performance. Chiropractic care is non-invasive (non-surgical) and drug-free.

The type of chiropractic therapy provided depends on the cause of the patient’s sciatica. A sciatica treatment plan may include several different treatments such as therapeutic exercises and/ activities, ice/cold therapies, ultrasound, electrical-muscle stimulation, and spinal adjustments (spinal manipulation).

Adjustments (spinal manipulation). At the core of chiropractic care are spinal adjustments. Manipulation can free restricted movement of the spine and help restore misaligned vertebral bodies (subluxation) to their proper position in the spinal column. Spinal adjustment can help reduce nerve irritability responsible for inflammation, muscle spasm, pain, and other symptoms related to sciatica. Adjustments should not be painful. Spinal manipulation is safe and effective when done correctly, on people who don’t have major preexisting health problems.

Chiropractic Limitations in Treating Sciatica

Sciatica can be caused by other disorders beyond the scope of chiropractic practice. If the doctor of chiropractic determines the patient’s disorder requires treatment by another type of doctor, then the patient is referred to another specialty. In some cases, the referring chiropractor may continue to treat the patient and co-manage the patient’s care with the other specialist.

Other Treatments for Sciatica

If chiropractic treatment isn’t the right choice for your sciatica or it hasn’t helped, there are other treatments that can be used alongside it or as an alternative.

Some other treatments that may help relieve sciatica pain include:

Building Up Core Strength

Low-impact exercises can help strengthen the muscles in the core and back. This improves the spine’s support and may help alleviate sciatica pain. It’s important to start slowly, in order to avoid causing injury or making symptoms worse.

Gentle Stretching

Tight muscles in the hips and hamstrings can put pressure on the lower back. A program of regular, gentle stretching may bring significant improvement to a patient’s sciatica pain.


Yoga can help improve strength, flexibility, and posture. A small 2013 study showed that Bhujangasana (Cobra Pose) and Salabhasana (Locust Pose) might help improve sciatic symptoms. That said, yoga likely works best as a varied practice with many different positions and flows. It’s important that a patient works with a qualified practitioner who takes the patient’s pain under consideration.

Getting a Massage

Regular massage from a trained therapist can help to loosen tight muscles and improve blood circulation, which might help with pain relief.

Trying Acupuncture

Acupuncture can be an effective method for controlling sciatica pain. It can be used as a safe alternative to surgery, chiropractic, or medications.