Sciatica

​Sciatica refers to lower back pain that develops from compression or irritation of the sciatic nerve. The sciatic nerve is the largest nerve in the body and travels from the lower back and down the back of each leg. When compressed or irritated the sciatic nerve can cause pain that will radiate from its origin in the lumbar spine (lower back), through the buttocks, down the back of the leg and possibly into the feet and toes. 

The sensation of sciatica varies among patients, however, it is usually felt in one leg and is described as tingling and/or burning or prickling. The intensity of pain can also vary with some patients experiencing debilitating pain while others experience irritating pain. Sciatic pain may be aggravated by postures or activities that increase lumbar intervertebral disc pressure or cause further compression or irritation of the nerve. Many patients find sitting, bending forward, walking, and driving to be aggravating factors.

The four most common causes of sciatica that we regularly see in our practice are:

Lumbar Disc Herniation

A herniated disc occurs when the inner portion of the disc known as the “nucleus pulposus” herniates or travels through the disc wall known as the “annulus”. The herniation of lumbar (lower back) intervertebral discs can compress the spinal nerve root causing sciatic pain down the leg. 

Sacroiliac Joint Dysfunction

The Sacroiliac joint or commonly called the “SI joint” is located at the base of the spine. When there is a dysfunction of the SI joint it can irritate the L5 spinal nerve that sits on top of it causing sciatic-type pain.

Piriformis Syndrome

After the sciatic nerve leaves the lower back it travels under a deep muscle in the buttocks called the Piriformis. If the Piriformis spasms it can compress the sciatic nerve and cause sciatica-type pain.  When sciatica-type pain is caused by the impingement of the sciatic nerve by the Piriformis muscle this condition is called Piriformis syndrome and is not considered true sciatica.

Disc Degeneration

When one or more of the lumbar intervertebral discs begins to degenerate due to ageing or injury, proteins from inside the disc can be released and irritate the adjacent spinal nerves resulting in sciatic pain.

When dealing with sciatica rest should be the first treatment approach. However, if there is no reduction in pain with rest alone, acupuncture is an excellent alternative. 

There is moderate to high quality evidence suggesting a positive effect of Acupuncture for sciatica. 

At Poke Acupuncture we have a very systematic sciatica treatment approach. Therapy begins with a thorough western orthopedic assessment of the spine and sciatic nerve, then the hips for muscular imbalances, the posterior chain (muscles on the backside of the body) for tension and trigger points, followed by an alignment check of the pelvis. Specific therapies will be chosen depending on your needs and assessment findings. Some of the therapies that will be utilized may include: acupuncture, dry needling, electro- acupuncture, massage therapy, cupping therapy, kinesio taping, herbal liniments, and corrective exercises. 

To book a treatment session or a free 15 minute assessment Click Here

Ryan Samuels - Registered Acupuncturist & Chinese Herbalist 

 

Reference 

Dutton, Mark, Dutton’s Orthopaedic Examination, Evaluation and Intervention (McGraw-Hill Companies, 3rd ed, 2012)

McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). © Australian Acupuncture and Chinese Medicine Association Ltd, 2017: http://www.acupuncture.org.au.

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