Pain starting in the back or buttock and traveling down the leg has many causes. Chiropractors have long been relied upon for helping with neck and back pain. While sciatica falls under a treatable option for chiropractors, it is important to know what is causing the pain. Rarer causes of sciatica, like cancer, are contraindicated with chiropractic manipulation.
Sciatica Definition
The sciatic nerve is the longest and largest nerve in the body, according to MayoClinic.com. Sciatica is a generalized term used to describe pain going down the leg and is a symptom, not a disease. Figuring out what is causing the leg pain is an important first step.
Determining Diagnosis
A chiropractor should ask questions about the location and aggravating factors of pain to obtain an initial idea of the cause. Further confirmation of the diagnosis, according to MayoClinic.com, requires getting the range of motion of the low back, testing deep tendon reflexes of the lower extremities, touching the skin to look for signs of paresthesia--altered skin sensation--testing muscle strength and specific orthopedic tests that may aggravate the leg pain but will give further information to the practitioner.
Imaging
Even with a very thorough history and physical exam, it may still be difficult to figure out the initial pain generator or severity of it. Dr. Fishman, director of Manhattan Physical Medicine and Rehabilitation Center, states that more common causes of sciatica are disc herniation, shifting of the bones, called spondylolisthesis, arthritis and specific hypertonic muscles. Imaging like CT scans or MRIs are the best options for looking at soft tissues and figuring out what is going on. Different states may or may not allow a chiropractor to order the imaging, so co-treatment with a physician will be necessary. Conservative treatment can start without imaging, but will be needed if there isn't a positive response to treatment.
Adjustments
Chiropractors are trained to move and stretch joints in the body through the use of high velocity low amplitude adjustments, or HVLA, a fast shallow impulse to specific areas of the spine. The website Spine Universe states that when the body is out of alignment, inflammation and muscle spasm can develop, leading to further inflammation and pain. Adjusting the joints will allow the body to be in alignment and function better, thus allowing for the body to heal itself.
Physical Therapy Modalities
Spine Universe states that physical therapy modalities are mostly aimed at pain relief. The use of electrical current through a TENS or IFC machine causes the muscles to contract and relax. This contraction of the muscles will help pump out waste products and pump in nutrients to help the area heal. Ultrasound can also be used as a therapeutic procedure to increase circulation and help decrease pain.
Pregnancy
The Expectant Mother's Guide to Chicago states that sciatica is a common complaint during pregnancy. The growing uterus and the changing hormones can cause a shift in the spine, ligaments and muscles, which may cause pain in the back and down the legs. A chiropractor with diversified training can help ease discomfort in a pregnant woman with the use of regular adjustments, a drop table, pelvic blocking or a tool similar to a reflex hammer.
