by American Chiropractic Association

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of lowback and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report:

• A pins-and-needles sensation, most often in the toes or foot

• Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

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Pain relievers

Recent research has demonstrated that some nonsteroidal anti-inflammatory drugs may actually slow the healing process by restricting the body’s natural healing mechanisms, so they should be used sparingly.

Joint manipulation

Recent research has shown us that, in some cases, joint manipulation can be helpful with pain reduction and more rapid recovery. Your doctor of chiropractic will determine if this procedure will be helpful in your case.

A Word about Prevention

In many cases, sports injuries can be prevented. Proper conditioning and warm-up and cool-down procedures, as well as appropriate safety equipment, can substantially reduce injuries. Understanding proper techniques can also go a long way toward preventing injuries.
Sufficient water intake is also an important preventive measure.

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Generally no more than 48 hours of rest and/or immobilization is needed, depending on the severity of the injury. In most cases, the sooner the person becomes active after an injury, the more rapid is the recovery. In fact, long-term immobilization can sometimes be harmful to recovery. Your doctor of chiropractic will guide this process, as too early a return to activity, choosing the wrong type of activity, or excessive activity can be detrimental.

Ice or heat
Ice or heat can be helpful with pain reduction and tissue healing.

Compression of the area may reduce the amount of swelling from the injury. Your doctor of chiropractic will determine if this will be beneficial in your case.

Elevation of the injured arm or leg above the level of the heart is thought to be helpful in reducing swelling.

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Diagnosis and Treatment

Sports injuries are most often diagnosed from the history of the activity that brought on the pain, along with a physical examination. In some cases, x-rays are necessary to rule out a fracture. Magnetic resonance imaging (MRI) and diagnostic ultrasound are also used in finding soft-tissue injuries, like tendinitis and sprains.
Fractures require the application of some stabilizing device, such as a cast, after the bone is put back into position. Rarely, surgical intervention is required. There is a relatively standard treatment protocol for most of the other overuse types of injuries. This protocol involves the following:

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Stress Fractures

Some athletes may experience a stress fracture, also called a fatigue fracture. This type of fracture occurs when an abnormal amount of stress is placed on a normal bone. This might occur in a runner who rapidly increases the amount of mileage while training for a race. Stress fractures also occur in people who begin running as a form of exercise but overdo it from the start, rather than gradually progress to longer distances.
One final common injury is worth mentioning, and that is shin splints. This overuse injury is caused by microfractures on the front surface of the tibia (shin bone). This is most often seen in runners, although other athletes can also be affected.

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In those who are training too much, overuse of a particular joint or joints in the body can result in pain and dysfunction. These injuries are called “overuse syndromes.” A common overuse injury is tendinosis, also called tendinitis. In this condition, the tendon becomes inflamed from repetitive use. In the shoulder, the rotator cuff (a complex of muscles that stabilizes and moves the shoulder) becomes inflamed, resulting in rotator cuff tendinitis. Tennis elbow is another form of tendinitis that occurs along the outside of the elbow, most commonly in tennis players. In golfer’s elbow, the tendons on the inside of the elbow are affected.

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Strains and Sprains

Although bones can sometimes be fractured with acute sports injuries, the most commonly injured structures are the muscles, tendons, and ligaments. Tendons attach muscles to bones, and ligaments attach one bone to another.
An acute twisting or overextension of a joint can lead to tears of muscles and tendons, called “strains,” and tears of ligaments result in “sprains.” These tears range from mild to severe. In mild injuries, just a few fibers are torn or stretched. Severe injuries, where there is a tear through the full thickness of the structure, are most often considered unstable injuries and frequently require surgical intervention. The intervertebral disc, a ligament between the vertebrae of the spine that works as a shock absorber, can also be torn, resulting in a disc bulge and/or herniation.
Ankle sprains most often involve tears of one or more of the ligaments along the outside of the ankle. Knee ligaments, including the larger external supportive ligaments and the smaller internal stabilizing ligaments, can also be torn. The cartilage on the back of the patella (knee-cap) can also become eroded from overuse, leading to a condition termed chondromalacia patella.

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