Sciatica is brutal – no other way to describe it, I’ve seen grown men cry with the pain – it really does bring people to their knees. What’s worse is that loads of people suffer with it – but what is sciatica?

Well sciatica is a result of one of the nerves in the back being squeezed or irritated – the sciatic nerve runs right from your lower back right down to your toes. When this happens it sends pain into the leg, mostly commonly the back of the thigh and calf.

Sometimes people with sciatica feel pain - its like a toothache type pain most commonly – but severe, it can make you want to chop your own leg off it’s so bad. Sometimes people with sciatica feel pins and needles or numbness – sometimes it’s a mix of all three.

90% of the time sciatica is caused by a disc prolapses – sometimes people call this a slipped disc. The disc sits between the bones in the spine acting like a shock absorber – when the disc bulges out it presses onto the nerve.

Slipped Disc

If your suffering with sciatica some of this stuff might sound a little familiar by now, but it still doesn’t confirm for definite what is going wrong. There are a few tests that Chiropractors use to decide this is what’s happening.

The first are your reflexes – the reflexes are a test of your nerves. Tapping the patella tendon stretches the tendon and the muscle in the thigh that connects to it. A message then gets sent to the spinal cord that the muscle has been stretched. The spinal cord very quickly sends a message back to the muscle telling it to contract. The contraction of the muscle causes your lower leg to kick out.

Essentially this test works like a circuit tester.

The second test is a straight leg raise – with this test each is slowly lifted, the painful leg is done last, the normal leg should go up easily, the painful leg may only raise a few degrees before it causes pain into the back or into the leg. This test puts tension onto the sciatic nerve. As the leg lifts it will pull the sciatic nerve against the bulging disc causing pain.

Straight leg raise

To be thorough testing all the muscle strength and sensation is important too. When nerves become compressed the signals it carries can become distorted so sensations can become altered and muscles tension can change.

The GP’s normal approach to dealing with sciatica is to give painkillers, they tend to start with anti-inflammatories like ibuprofen or naproxen and combine it with Paracetamol – when that doesn’t work they tend to move onto codeine or occasionally medication like tramadol.
Also sciatica does cause a lot of pain so it tends to result in muscles spasming – some GP’s will top off the Paracetamol and ibuprofen with a muscle relaxant like diazepam.

With all these pills it can feel like your rattling and it still doesn’t get rid of the problem or cause. In extreme cases GP’s may prescribe morphiene – although its pretty rare because of the problems it can cause. Having a thorough consultation from your Chiropractor can aid in a diagnosis and plan of action

NICE Guideline - Sciatica (lumbar radiculopathy) – April 2015

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