Is Chiropractic Treatment Good for Sciatica?

I would be filthy rich if someone gave me a dollar for every person that comes into our office with low back pain that radiates down their leg (sciatica). Probably one of the most common reasons someone visits our office or any chiropractic clinic is for sciatica. Low back pain that shoots into the butt and down the leg, sometimes all the way to the foot can be the most debilitating pain a person will ever experience. “I’ve tried stretching, hot tub, ice, ibuprofen and some old muscle relaxers I had left over and nothing touches it” us a phrase that should be painted on the wall of all my treatment rooms. It’s almost as though every sciatica patient is given that scripted phrase. 

Yes, chiropractic treatment has been proven to be one of the most effective options for treating sciatica. And this isn’t coming from your local chiropractor alone. This has been proven by many medical studies. However, the most comprehensive assessment was done by “Spine” which looked at 51 different studies and compared the results.

“There is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe. Multimodal programs may be a promising option.” – The Spine Journal Volume 18, Issue 5, P866-879, May 01, 2018

What is Sciatica?

Pain stemmed by irritation of the sciatic nerve is commonly called “sciatica.” This nerve is the largest in the body and starts in the lumbar spine. Originating from the L4, L5, S1, S2, S3 spinal nerves the sciatic nerve traverses through the gluteal muscles and down the leg. It controls many of the muscles it passes by such as the glutes, hamstrings, and calf muscles. It is not uncommon to have weakness of these muscles in conjunction with sciatica pain. 

What Triggers Sciatica? 

Sciatica is one of the most frustrating conditions to treat as a health care provider. It can be caused by a number of different condition however the most common reason is impingement of one of the spinal nerves listed above. L5 nerve root is the most commonly affected nerve when assessing sciatica and is usually triggered by a lesion of pathology of the intervertebral disc between the last lumbar vertebra and the sacrum or tail bone. These discs can be damaged for a variety of reasons from heavy lifting, to pathologic conditions, to prolonged wear and tear. 

Are Chiropractors Good for Sciatica?

One of the most searched questions of Google is “are chiropractors good for sciatica?”  And like many of my other posts I will simply say it depends on the chiropractor.  Most chiropractors are quacks.  Yes I am a chiropractor and I just told you that most of my colleagues practice pseudoscience with unproven results that are often unreproducible.  I spend hours educating patients to avoid chiropractors with quick fix techniques and especially those who are resistant to the idea of medicine as an adjunct therapy for treating sciatica.  This condition can be extremely complex and if the patient is unresponsive to chiropractic treatment after 3-4 weeks then the patient must be referred for either advanced testing like MRI or to another provider.  I want to scream at the top of my lungs when a patient seeks me out for a second opinion because they have been treating with their family chiropractor for 3 months and there “sciatic pain just won’t seem to go away doc”.  These are the quacks I am talking about.  

How do Chiropractors Adjust Sciatica?

This question makes me chuckle as we typically don’t “adjust the sciatic nerve”, but this is another one of those highly searched questions on Google so here we go.  As we discussed above sciatica is caused by impingement of the sciatic nerve most often by a disc but sometimes by a vertebral misalignment or peripheral entrapment like a muscle spasm or soft tissue injury.  A chiropractor MUST PROPERLY ASSESS, TEST AND DIAGNOSE SCIATICA TO DETERMINE THE CAUSE OF THE SYMPTOMS BEFORE THEY EVER LAY A HAND ON YOU! This is a theme I see all too often in my office.  The patient has never been given a diagnosis and the chiropractor is over there cracking away on their spine when all too often that is the last thing the patient needs.  

Treatments like spinal decompression and light adjusting are the most effective treatment modalities for treating sciatica.  If diagnosed and treated properly a chiropractor is one of the safest and most effective options for treating sciatica

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