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postheadericon Sciatica: The Causes, Symptoms and Treatment

Here’s a trivia question for you. What is the longest nerve in your body? Take a wild guess…Yes, the sciatic nerve. This nerve runs from your spinal cord through your hips and buttocks as well as down the back of each leg. It can also pierce the piriformis muscle, a major muscle that starts at the bottom of your spine and stretches across your buttock to your hip.

The sciatic nerve controls the muscles in your lower legs and provides feeling to the thighs, legs and feet. The term “sciatica” refers to the inflammatory pain that travels along this nerve to the above mentioned areas.  In a recent article, we spoke about Cervical Radiculopathy. Sciatica really refers to Lumbar Radiculopathy.

The pain a person feels from sciatica is usually a sign that there is another, much larger problem. Sciatica can be quite painful, but it generally dissipates within a couple of months.  When the pain radiates from a central location, such as the spine, to an outlying area like the legs, it is usually an indication that the nerve supply is at least partially the problem. This is why seeking chiropractic care to resolve this issue makes so much sense.

Causes of Sciatica

Sciatica can develop if a nerve root is compressed in your lower (lumbar) spine. This is usually the result of a herniated disc. These discs consist of two parts, an outer annulus fibrosus and the inner nucleus pulposus. Think of a jelly donut where the annulus fibrosus creates a shell around the nucleus pulposus and helps to distribute pressure evenly across the whole disc. The nucleus pulposus is a mucoprotein gel with the consistency of jelly. It absorbs the impact of your body’s daily activities and keeps your vertebrae separated. 

If the outer shell of a disc tears , the nucleus propulsus can bulge or “herniate”.  The gel contained within then begins to seep out and press on a nerve root. This would cause pain in your back, legs or both. If the damaged disc is in the lower part of your back, numbness, tingling or weakness could be experienced in the buttock, leg or foot.

While a herniated disk is a common cause of sciatica, there are other conditions that could put pressure on the sciatic nerve, including:

Trauma - Any fall or blow to the spine can injure your lumbar area (there are five nerve roots that originate from the lumbar spine) or sacral nerve roots (five nerve roots originate from the sacral vertebrae).
Sciatic Nerve Injury – The sciatic nerve itself could be affected by a tumor or injury.
Lumbar Spinal Stenosis – Spinal Stenosis is the narrowing of one or more areas in your spine, usually in your upper or lower back. If this occurs in the lower spine, the lumbar and sacral nerve roots may be affected.
Piriformis Syndrome - The piriformis muscle is located at your lower spine and connects to each thighbone (femur). Piriformis syndrome is when the muscle tightens or spasms. This puts pressure on the sciatic nerve. This often happens when the sacrum is out of alignment or if you have Spinal Stenosis.
Spondylolisthesis – This often occurs due to degenerative disk disease. It is when one vertebra slips over another. It could pinch the sciatic nerve where it exits the spine.  The vertebra can slip backwards (retro) or forward (antero).

Symptoms of Sciatica

As stated above, pain that travels from your lumbar spine through your buttock and down the back of your leg is the classic sign of sciatica. Pain could be felt almost anywhere along the nerve pathway, but it most commonly follows a path from the lower back to the buttock and back of the thigh and calf. The pain you experience can be a mild ache or a sharp, burning sensation and anything in between. It could also feel like a jolt or electric shock. Other Sciatica symptoms include:

Numbness or Muscle Weakness – This could be experienced along the nerve pathway in the leg or foot. You could experience pain in one part of the leg and numbness in another.
Tingling or a Pins-and-Needles Feeling – Usually in the toes or part of the foot.
Loss of Bladder or Bowel Control – If either of these symptoms is experienced, please seek medical help immediately.

A Doctor of Chiropractic will use the following to help diagnose Sciatica and locate which lumbar nerves are affected:

Medical History
Chiropractic Physical Exam
Basic Muscle Tests. These basic tests check your muscle strength and reflexes.
Spinal X-ray. An X-ray of the lumbar spine can help pinpoint the cause of sciatica if encroachment is easily seen or by measuring the spinal canal from the top of the lumbar vertebrae (L1) to the bottom (L5 or L6 in some cases where individuals have an additional lumbar vertebra).
Magnetic Resonance Imaging (MRI). This is probably the most sensitive test for assessing the size of the spinal canal and thus the visualization of spinal stenosis.
Computerized Tomography (CT) Scan. When CT is used to image the spine, the doctor could order the exam with or without a contrast dye. If the dye is used, it is injected into the spinal canal before the X-rays are taken. This dye circulates around the spinal cord and nerves and will appear white on the scan. This will help to clearly delineate the size of the spinal canal.


Sciatic pain can usually be relieved through a combination of stretches, massage of the piriformis muscle and most importantly – chiropractic care. In cases where a disc herniation presses on the nerve, Spinal Decompression Therapy could be an alternative to surgical intervention.  Spinal Decompression Therapy is a natural choice for treatment because it gently stretches the spinal segments apart, giving the nerve more room during both passive and active movements. This will then allow healthy nerve information to flow between all segments of the spine in regards to both sensation and motor activity. This addresses the issues of numbness, tingling, muscle weakness and pain.

If you have suffered from such pain or weakness without any treatment success, or have been told that surgery is necessary, you owe it to yourself to find a Doctor of Chiropractic properly trained in Spinal Decompression Therapy. This non-invasive technique may be the very thing that gets you back on your feet and into a more active lifestyle.

If you have questions or need further information about this topic, please go to for more information about Spinal Decompression Therapy and the conditions it can address.  If you wish to contact Dr. Lynn Kerew directly, please visit her website at or email her at