I've been treating sciatic nerve problems for the past twenty-three years and have seen more cases during the past five years than in previous years.

Possibly this is a result of our overall trend toward sedentary jobs, gradual increase in body weight, or tendency to be less active.  As these trends continue and our population ages, cases of sciatica are likely to increase.

Sciatica (pronounced sy-at-ih-cuh) is a condition that results when the sciatic nerve is irritated, pinched, damaged or otherwise impaired.  The sciatic nerve is actually a large bundle of nerves that branch off the spinal cord just above the base of the spine and proceed to the toes.

Because the sciatic nerve originates from the lower end of the spinal cord, a misalignment, injury, sprain, degeneration or other condition that affects the spinal joints can cause sciatica.  For example, if you slip, fall, strain or otherwise injure the lower back, the resulting dysfunction or misalignment of the lower back joints can cause sciatica.

Likewise, the sciatic nerve can become pinched by gradually increasing pressure from degenerative processes that affect the spine such as arthritis, stenosis, bone spurs, disc damage and other conditions.

Although many doctors tend to think of spinal causes for sciatica, in many patients the problem is coming from the muscles of the buttock area rather than the spine.  This confusion is the root of some cases of misdiagnosis. 

The sciatic nerve passes between the muscles of the buttock and hip areas, known as piriformis and gluteal muscles, and can be pinched or irritated by those muscles.  Under normal conditions, the muscles are pliable and flexible enough to avoid compression of the nerve.  However, when these muscles become injured or over-contracted the nerve can become caught between the actual muscles and a pinched nerve is the result.

Like any pinched nerve, sciatica can cause a wide range of symptoms.  The nerve transmits neurological signals to and from the legs.  This includes sensory nerves that transmit sensations of touch, pain, pressure, temperature, position sense and other sensory information.

The sciatic nerve also transmits impulses to the muscles to cause contraction and relaxation.

As a result, if you have irritation, compression or injury to the sciatic nerve, your symptoms could possibly include, pain, burning sensation, numbness, tingling, weakness, muscle spasm, or trouble with balance and coordination. 

Because the causes of sciatica vary widely, the success of various treatments varies as well.  If the treatment is matched well with the cause it is likely to be successful.  If a treatment has not been successful, it may be that a second opinion is warranted and a different treatment should be considered.

Conservative treatment for sciatica can include chiropractic spinal manipulation, physical therapy, massage therapy, and acupuncture.  Chiropractic spinal manipulation improves the overall function of spinal joints and addresses misalignment issues, spinal joint issues, and spinal muscle function.  Even cases that involve arthritis, spinal degeneration, stenosis and disc injury are likely to respond well to appropriate chiropractic spinal manipulation.

It may seem surprising that functional restoration accomplished through chiropractic spinal manipulation would help patients with spinal arthritis, stenosis, degeneration or other problems.  In many cases, although these diagnoses are accurate, the actual symptoms the patient is experiencing are the result of functional problems such as joints that have become fixated, stuck, or misaligned.  Fortunately, if the spinal joint function can be restored through chiropractic spinal manipulation, the symptoms often improve.

Rehab therapy can be helpful for many cases of sciatica.  By stretching or strengthening the affected muscles, or applying therapeutic modalities, it may be possible to reduce the pressure on the nerve.  I often recommend rehab for patients recovering from sciatica.

Acupuncture and massage can be helpful for some cases of sciatica as well. 


The newest, most advanced non-surgical treatment available for sciatica resulting from spinal degeneration or herniated discs is Spinal Disc Decompression.  Ths special table targets the injured area and seperates the vertebrae, taking pressure off the pinched sciatic nerve.  The treatment itself is surprisingly comfortable and has proven to be highly effective, even on cases where surgery has been recommended.

Although spinal surgery may sometimes be the only option for severe degenerative conditions, all appropriate conservative approaches should be considered first.

The first important step in addressing sciatica is doing a thorough evaluation to determine the actual cause of the symptoms.  Most cases of sciatica can be treated successfully.

Dr. Mark Kestner