Dealing with Sciatica

Sciatica is a term used to describe pain or numbness along the backside of the leg caused by irritation of the sciatic nerve. This blog post will discuss what causes sciatica and a few ways it can be treated. 

While the term sciatica describes where the pain or numbness is, it doesn’t give a reason for why the sciatic nerve is irritated. Traditionally, disc herniations were thought to be the reason for sciatica. The disc herniation would cause inflammation in the low back which would irritate the sciatic nerve leading to pain and numbness. If this was always the case, then surgical removal of the herniation would be the treatment of choice. 

However, removal of the disc herniation has not been completely successful in long term resolution of sciatica. In fact, a recent review of 13,883 patients with sciatica found that some patients with sciatica will still experience mild to moderate pain and disability 5 years after having surgery. 

Since pain can persist even after the disc herniation has been removed and the fact that many individuals have relief from conservative treatment, the mechanism of sciatica may not always be a disc herniation. While no treatment strategy that has been proven to be better than an other for sciatica, the goal is to find a treatment strategy that provides you with relief. 

Home treatment options that may help can include foam rolling, nerve flossing, and glute strengthening exercises. 

Glute Foam Rolling

Nerve Flossing

Glute Strengthening

If home treatment options are not effective, other conservative treatment options include manual therapy, spinal manipulation, NSAIDs, and muscle relaxers. Manual therapy and spinal manipulation both provide a mechanical stimulus that can provide pain relief and restore proper biomechanics in the lumbo-pelvic-hip complex.

Even though there is no superior treatment strategy for sciatica, you have to find what works for you. Starting with the most conservative options allows you to find the treatment that gives you the most benefit with the least amount of risk. If your sciatica responds well to acupuncture, chiropractic, or physical therapy, then that is the treatment you should do. The treatment of sciatica can be difficult, but there are many treatment options that can help you.