What causes Sciatica?

Sciatica is inflammation of the sciatic nerve that will typically cause pain along the course the nerve travels and around the tissues that it controls. The sciatic nerve is one of the largest nerves of the body and originates from the low back while also controlling many of the muscles in your legs. Therefore, people with sciatica often experience low back and/or leg pain. The sciatic nerve originates from nerve roots, which travel through an opening between two adjacent vertebrae called an intervertebral foramen (or IVF). The IVF is an important location because this is an area where the nerve root could become entrapped from increased pressure and cause sciatic nerve pain. 

Nerve pain typically is caused because of two reasons: pressure or tension. We already went over the IVF as a potential location for pressure. Another common area is the pressure caused by a disc bulge. If the disc is bulging, there could be pressure on the nerve root, resulting in sciatic-type nerve pain. Luckily, discs are mobile and herniations do not have to be painful. The goal for treatment of a disc herniation should be to get pressure off the nerve root, which can be done by finding out if there is a specific movement that alleviates the low back or leg pain. Chiropractors are movement specialists, so if you are experiencing sciatica related symptoms, a chiropractor should be one of your first choices for seeking care.

Tension is another potential cause of nerve pain and the sciatic nerve commonly experiences tension issues. Think of a nerve as a rubber band. A rubber band has its relaxed length, but its length can also increase when it is stretched.  A nerve responds in a similar manner, but when a nerve has too much tension, it can become inflamed and cause pain.  If you came in for an evaluation at our office, the doctor would likely be testing different movements to see what causes tension and what alleviates tension.

So now that we know how nerves can cause pain, what about imaging? Most patients expect to receive an x-ray or an MRI when they see a doctor for low back pain, but most of the time those imaging tools are not needed. As we went over previously, we know that we need to evaluate movement in order to figure out the cause of sciatica. Both x-rays and MRI’s are static images, meaning that no movement is involved.   This does not mean those imaging tools are unnecessary, it just means that we cannot rely on them alone to determine the cause of the sciatic nerve pain. If a patient is not responding to treatment, that’s when an x-ray or MRI can be a valuable tool for understanding the cause of the pain. If you are experiencing sciatica-like symptoms, make sure to visit your local chiropractor and schedule an appointment.  If we are local to your area, our office would be more than happy to help you!