• Dr. Norris S. Golberg

Sciatica: a pain in the butt!

Sciatica can be one tough condition to deal with. Sciatica is a radiating pain typically starting in the glutes/buttocks and running down the back of the leg, typically past the knee and into the toes. It is sometimes but not always associated with low back pain. I've had it myself a few times so I can speak from first-hand experience, it hurts and is very distracting to your daily life!


Something to note is you can have radiating pain into other parts of your legs, which is a sign of possible irritation and pressure on the nerves in your lower spine. This is often confused for sciatica but is also known as neuropathy or radiculopathy. These conditions can be helped by my neurologically-based approach, but for today's blog, I'm going to keep it focused specifically on Sciatica.



The sciatic nerve forms from the lumbosacral plexus which is a network of nerves that come off your spinal cord in your lower spine and once exited between the joints they join to form the largest and longest nerve in the body the sciatic nerve. Sciatica is very common, approximately 3 million people in the US get it every year and it is 3x more common in men than women although still common in women.

Sciatic pain can be caused by a mechanism other than spinal misalignments, arthritis, and disc bulging or herniation. Some people are born with a fairly common anatomical variance where the sciatic nerve runs through the piriformis muscle, instead of under the muscle. The problem with this is the muscles will get tightened with chronic sitting as well as intensive exercises like deep squats, this can squeeze down on the nerve, creating sciatic like symptoms. The key difference is the pain typically will not travel below the knee. Many people have tight hamstrings and piriformis muscles so if this symptom sounds like your pain I'd start with these simple stretches. If the stretches help, keep at it daily until your sciatica goes away and keep on top of the stretches even after so it doesn't come back.


"An ounce of prevention is worth a pound of cure" ~ Benjamine Franklin


However, I find the more common cause of chronic or reoccurring sciatica is due to spinal misalignments and the long term effects of misalignments such as disc bulging and arthritis. The nerve roots are what branch off your spinal cord and run out between the vertebrae and travel throughout the body to control and coordinate all bodily functions. Don't forget the nervous system is the master and commander of every other organ system in the body, it is the top of the hierarchy physiologically!



What happens is with traumas such as slips and or fall sports injuries, or microtraumas like sitting at a desk all day putting excessive postural stress on the spine the joints become misaligned and fixated which results in a loss of range of motion, tight and achy muscles, sometimes spasms, and often nerve pain. This is what it looks like on an x-ray.

You can see the image on the left I have to outline the spine in red and the green is where that red line should be. After going a gentle and specific adjustment, with no twisting, popping, or cracking required I usually take another x-ray to make sure we are making legitimate structural changes. The x-ray on the right is the 'after." Their spine is not "perfect" but the realignment we did eliminate the sciatic and low back pain completely, even though they have arthritis and disc bulging. They also slept better after that of course and saw an immediate improvement in the quality of life.


Sciatica can be a real pain in the butt if you don't know how to effectively manage it. As I mentioned above if you or a loved one is struggling with sciatica they should try the stretches first. If those don't work I would recommend a functional neurological evaluation to see how your spinal nerves are functioning and if there is any irritation to them, this is how we evaluate all of our prospective new patents to make sure they are a good candidate for our type of chiropractic care. Especially in un-resolving cases where patients have tried massage, stretches, physical therapy acupuncture, we oftentimes find out greatest successes, simply because we are looking at the spine, your health, and your body through a totally different lense than other approaches, even other chiropractors.


Also, don't forget to do your Spinal Hygiene Exercises every day to keep those joints and discs healthy. You can grab the videos for free here. Or if you'd like to schedule a consultation to drop us a line here and we will get in touch with you as soon as possible.



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