Chiropractic care for sciatica: what do they do?

Chiropractors are a non-invasive, non-drug, conservative form of medical care. In fact, it is generally accepted that this type of care should be done before performing any invasive procedure, such as back surgery. Chiropractic care has been well documented in its success for conservative medical care. Sciatic pain is right up a chiropractor’s alley. Chiropractors are legendary in treating patients with back problems. They routinely diagnose (test) and successfully treat back and leg pain. Whether you have a pinched nerve, muscle, ligament, or tendon that may be causing your pain, a chiropractor will take the proper time to examine your back and leg pain to determine the exact source of your sciatic pain. Essentially, chiropractors help your body heal itself.

It is important to understand that sciatica is not an actual diagnosis but an underlying symptom of your problem. A chiropractor will start by evaluating the five known culprits (culprit parties) of the sciatica symptom. These five culprits include:

• Herniated disc problems

• Spinal stenosis (narrowing)

• Facet joint problems

• Nerve entrapment

• Presence of tumors, infection or metabolic complications

A chiropractor needs to determine if your pain is caused by a herniated or ruptured disc. This condition in medical terms is known as sciatic neuritis. Neuritis means that the nervous system is involved (neuro = nerves and itis = inflammation). The diagnosis (evaluation) and treatment program will be for “disc injury”.

If you don’t have neuritis, the chiropractor will look for spinal stenosis. Spinal stenosis is another common cause of sciatica, which is a narrowing of the spine that can lead to nerve inflammation. If this is your diagnosis for your leg pain, then you will be treated specifically for that.

So far, he doesn’t have a herniated disc or spinal stenosis, so the chiropractor will look for symptoms in the lumbar facets. Your facet joints come in pairs at the back of each spinal vertebra. These facet joints join the vertebrae above with the one below to form a functional joint that allows movement of the spine. This is not that different from the knee joints, just that you have many of them up and down the spine between each of the spinal bones. This allows you to slightly bend your spine up, down and to the sides, as well as rotate. Think of all the movements your spine can make when you work a hula-hoop. It’s amazing. So, facet joint syndrome refers to pain that occurs in the facet joints. These joints are filled with synovial fluid just like your spinal discs. Your discs act as shock absorbers between your vertebrae and the joint allows your vertebrae to move in several different directions. If this is your problem, the chiropractor has a therapy that works on this particular problem.

Don’t have any of the above? Now the chiropractor will look for nerve entrapment syndrome. What it is about is mechanical imbalances in the spine and hip with damaged (but not herniated) discs with movement restrictions of the facet joints. This can lead to muscle strain that can lead to entrapment of the sciatic nerve. The muscles involved here are the piriformis muscles. Chiropractors will perform muscle therapy on these muscles to loosen them up and restore balance to the spinal joints and release pressure on the sciatic nerve.

If none of the above are diagnosed, your chiropractor will refer you to another doctor to determine if you have any tumors, infections, or metabolic problems.

Therefore, a chiropractor’s goal is to diagnose (find out what you have) and treat you for that specific problem conservatively (non-invasively, without surgery). This involves active hands-on care to return full motion to the spine by treating disc, joint and muscle problems. Spinal manipulations may include thrusting techniques, non-thrusting techniques, instrument-assisted therapies such as Graston’s technique for muscle problems, trigger point therapy, stretching and resistance techniques, electrical stimulation, ultrasound, and alignments. The goal of the chiropractor is to return normal function to the back. The chiropractor’s job doesn’t end there. Too, the chiropractor knows that prevention of back problems is important and will tell you how to keep your back healthy.