Sciatic Nerve Pain 

 June 18, 2010

By  Dr. John Vilkelis

I recently posted a blog about low back pain entitled Low Back Pain: Serious or Not. Low back pain and sciatica are not always present at the same time and therefore with encouragement from some of my followers I decided to write a post about sciatica.
Sciatica – pain, tingling, or numbness produced by an irritation of the nerve roots of the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. Branches of the sciatic nerve extend through the buttocks and down the back of each leg to the ankle and foot according to WebMD. This in turn can cause pain, tingling, numbness, burning and muscular weakness in the buttocks, legs and feet.


While WebMD lumps all sciatica into one group in its article Wikipedia smartly points out, “Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain.” In other words there are numerous causative factors that can bring about very classic sciatic symptoms. The nerve roots can be impinged by a bulging of a lumbar disc (the cartilage between the bones in your spine), a bony impingement in the sacroiliac joint (the joint between the sacrum & pelvis), a muscle spasm in the piriformis or gluteus medius muscles or a subluxation.
There are numerous treatment options if you have sciatic pain. You could have physical therapy, steroid injections from an orthopedist or neurologist, massage therapy or you could see a doctor of chiropractic. I think everyone knows which practitioner is my first choice; yes you guessed it, a chiropractor. The reason I would send you to a chiropractor first is this, if you have a subluxation causing your sciatic pain then no other practitioner is trained to find it and fix it. If subluxation is not causing your pain then the chiropractor is trained to recognize this and refer you to the appropriate alternative practitioner.
Now just for a bit of perspective I would submit this study. A study performed in Norway showed how effective chiropractic is in treating sciatica. After the treatment, 40 patients (91%) returned to work full-time within an average of 21.1 days. Two patients returned at reduced work levels: one at 80% and another at 50%. “The positive effects of cooperation between orthopedic surgeons and chiropractors may be measured in the reduced duration of sick leaves.” The study refers to Norwegian public health records that show that the average patient with sciatica is disabled for 72 days; in this study, the time to return-to-work was just 21 days—a 70% reduction. If you want to read a little more on this study you can find it on my website under sciatica.
There are a few things you can do on your own for those who feel they need to help themselves. First; ICE. There is inflammation in the joint and the nerve is inflamed so icing will reduce the swelling so it will hurt less and the ice numbs so it will hurt less. I recommend icing your low back for 20 minutes of every hour that is reasonably possible. Second; give your back a rest. Don’t go to the gym a squat 300 lbs if you have sciatic pain. Helping a friend move will make it worse. Get the picture?? Finally, some gentle stretching can help some sciatic pain suffers.

In closing I want to point out that if you have sciatic pain that is getting worse or if it’s not going away with some of the self help then you need to seek professional help. The longer you wait the harder it will be to fix it.

Let me know what you think of this article. Please share your experience, we’d love to hear about it.

Dr. John Vilkelis

Dr. Vilkelis has been in private practice for over 27 years. He has a reputation for truly caring for his patients and goes the extra mile to make sure people get the help they need. He accepts patients of all ages and is eager to help you get well and stay healthy. Give him a call today at (914) 618-4330.

Dr. John G. Vilkelis

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  1. Excellent submission on sciatica, I agree with many if not most points. I would like to add that as a medical massage therapist the majority of my low-back-pain clients have symptomless sciatica. Upon palpation I may find the piriformis muscle spasming or, more often, adhesions and inflammation in the connective tissue in that area. Connective tissue therapy usually corrects this within one session, depending on the root cause of adhesions. Daily, gentle, horizontal stretching of the gluteus area is one of the best prevention methods. Horizontal stretching, because the muscles underneath the glutes run horizontally. And as you noted, the first person to check with is the chiropractor to rule out subluxation, and I would add that the second person to check with is the massage therapist, for there is no medical test that will identify connective tissue adhesions or the oft accompanying low-grade inflammation.

  2. I think I would go along with checking with your massage therapist next. I often recommend my sciatica patients in particular also seek out care from their massage therapist to work out any connective tissue problems. Thanks for that informative comment, Paula.

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