Sciatica Treatment – A Ramsey, NJ Chiropractor’s Perspective

How We Treat Sciatica in Ramsey, NJ

When it comes to sciatica, it’s important to find the root cause, not just the daily aggravators. Our protocol consists of:

Comprehensive Consultation and Exam

We’re going to sit down with you to dig into your history, as many clues about your sciatica come from that discussion. It’s a two-way conversation, as we’re listening intently but providing feedback along the way. During the exam portion, we’ll check things like your low back’s range of motion and lower body muscle strength and perform several orthopedic and neurological tests to see where you are compared to normal. This helps us identify exactly how your sciatica is affecting your overall health.

Computerized Posture Analysis

Your neutral standing posture is one of our most important tools to analyze where your sciatica is coming from. We take pictures of you from front and side, and by placing digital reference points on your pictures we can see in seconds where your body is under the most stress from poor posture. Most people are amazed as to what they really look like!

Digital X-Rays

We use the most up-to-date technology both when taking and analyzing X-rays to know exactly what we are dealing with before we start care. One of the most important areas we’ll look at is your lower back. There are three main things we are looking for in your low back X-rays: degeneration, disc spacing, and how far your alignment is from normal alignment.

In the low back specifically, we look to see how far your rib cage is from your hips, both from the front and from the side. We know the normal angles and positions of the bones, and we match your X-rays up to those normals to evaluate the strength of your spine.

Once we have evaluated all of the information, we then choose from several therapies, depending upon your condition:

Specific Chiropractic Adjustments

At its core, the spine wants to be neutral. When bones are out of their normal position (sometimes one in a section of your spine, sometimes several), the result is a gradually weakening posture and pressure on the nerves between the bones. By reducing the misalignments in those areas, the spine gets more freedom of motion, allowing its function to improve. We find that improving this alignment with chiropractic adjustments can be significant in reducing the frequency and intensity of sciatica.

Custom Therapeutic Exercise Plan

Trying to recover from sciatica can’t fully occur if there is muscle weakness or imbalance. If your muscles have been fighting a bad posture for many years (maybe even exaggerated by long hours at a computer, driving, or sitting), getting them strong is a priority.

We often find people with sciatica present with limited range of motion in the low back. Therefore, we start by increasing flexibility. Once your range has improved, we then can focus on building your strength. It takes consistency, so we give you a customized exercise plan for both in-office and at home to make sure you’re able to keep aggravating episodes to a minimum, both in frequency and intensity.

Lumbar Spinal Decompression

There are occasions where sciatica may be caused by a bulging or herniated disc in your low back, putting direct pressure on highly sensitive nerves. In these cases, spinal decompression is a highly effective therapy that gently pulls your hips away from your lower ribs. This allows the muscles in your low back to relax while relieving the disc pressure on your nerves.

As with exercise, consistency of decompression is important to change muscle patterns that have been set in for a long time. But the results, in conjunction with spinal adjustments and your customized exercises, can be significant.

Electrical Muscle Stimulation

In the initial stages of care, we are looking to reduce muscle spasms and tension along the pathway of the sciatic nerve. Electrical muscle stimulation is used to accelerate that process, allowing you to feel better and alleviate the low back and/or buttock stiffness often associated with sciatica. Most people say e-stim feels like a light massage and often comment how much looser they feel when it’s done.

Posture Rehabilitation

If your sciatica improves but your posture is still poor, the likelihood of having relapses is high. Putting in a plan to create and stabilize good, strong posture is your key to having the longest-lasting results. We’ll utilize various forms of therapy to put your posture in the “mirror image” – essentially, the exact opposite posture that you currently have. (Let’s face it – that posture isn’t helping you, or you wouldn’t have sciatica!)

By performing mirror image exercises and traction, your body will gradually learn what “correct” posture is. Each time, in-office and at home, your body goes into the mirror image, it’s another signal to the brain, your bones, and your muscles to dump the old, bad patterns and create new, stronger patterns. This may be the most overlooked aspect of low back pain; there’s no way a weak posture can help you get better.

Acupuncture

Acupuncture can help remove negative energy and restore positive energy throughout your body. By focusing on specific points and zones in your body, endorphins (the “feel-good” hormones) get released, and that triggers a positive response throughout the body.

Acupuncture has been used for both acute and chronic sciatica and can be very beneficial, either on its own or in conjunction with chiropractic and postural rehabilitation.

Supplements and Other At-Home Remedies

Depending on the cause of your sciatica, certain nutritional supplements may be worthwhile. However, each case is different, which means your nutritional recommendations may be quite different than someone else you know with sciatica. We’ll often recommend certain topical gels or ointments to relieve muscle tension and reduce pain. Some of our recommendations can even be purchased in your local grocery store or health food store.

Lifestyle Changes

Given that we’re working for 8-10 hours a day and sleeping 6-8 hours, whatever posture you’re in had better be right for that amount of time! It’s important that you know how to sleep, how to bend and lift, and how to sit at your computer. It’s just as important to know what not to do. Sometimes simple shifts make the biggest differences, and that’s especially true when it comes to your daily habits. We’ll make sure you know what those shifts are to avoid injury and get the best results in our office.

Common Causes of Sciatica in Ramsey, NJ

Sciatica comes in many different styles. Remember, sciatica is common, but not normal. Here are a few of the ones we see most frequently:

Disc Problems

Discs are like shock absorbers between the bones of the low back. Think of them like jelly donuts, with a thick outside (“annulus”) and a soft, gel-like inside (“nucleus”). Discs wear down and dehydrate over time and frequently cause two stages of problems – bulging discs and herniated discs.

In a bulging disc, the thick outer fibers begin to tear, and the soft gel inside takes the path of least resistance to get out. This causes low back pain and can sometimes create sciatic pain, where it radiates to the buttock or leg. With a disc herniation, the outer fibers tear more and the “nucleus” breaks through the outermost fibers. This frequently causes more buttock and leg pain (often going into the foot) and more intense low back pain. Surgery may be necessary if it doesn’t improve, which is why it’s so important to fix it early.

Degenerative Disc Disease

This is an age-related condition where the discs break down at a faster rate than normal. Certain factors speed this process up, such as obesity, smoking, and work that is physically hard on the spine.

When the disc starts to get thinner, the hole where the nerve exits the bones above and below gets smaller, causing that sensitive nerve to reduce how well it works. Depending on what areas are affected, it can have significant effects on not only your range of motion but overall health. Unfortunately, this process can’t be reversed, but it can be slowed with increased motion and restoration of good posture.

Piriformis Syndrome

The piriformis is a small muscle deep inside the buttock that directly contacts the sciatic nerve. If the piriformis is chronically too tight, it presses on the nerve harder; the tighter the muscle, the farther down the leg the pain will typically go.

Piriformis syndrome is often overlooked as a cause of sciatica, mimicking the presentation often shown by a herniated disc. However, if you’ve had an MRI and it is negative for a disc bulge or herniation, the piriformis is one of the causes that need to be addressed.

Pregnancy

One of the most common conditions associated with pregnancy is sciatica. This occurs due to changes in the spine’s normal position as the baby grows. The larger the baby gets, the more pressure that goes on the lower back, which ultimately can create inflammation of the sciatic nerve roots. Women with pregnancy sciatica often find that the side of irritation will change as the baby changes position.

Spinal Misalignment

When the bones of the low back are misaligned, it results in pressure on the nerves of the spine. This can be caused by poor posture with sitting, sleeping, or standing, and can lead to sciatic pain and other symptoms such as weakness or numbness and tingling in the legs and feet.

You can likely spot some aspects of your own poor posture in a mirror but identifying spinal misalignment can be subtle and difficult to detect on your own. A combination of specific chiropractic adjustments, exercise, and lifestyle changes are just some of the ways to help recover and restore poor posture.

Frequently Asked Questions About Sciatica

When should you see a chiropractor in Ramsey, NJ for sciatica?

There’s no wrong time to see a chiropractor for sciatica. Whether it has been going on for a short time or chronically for years, an evaluation of your spine and overall posture will benefit you at any point.

Is a massage or chiropractic better for sciatica?

Both modalities can be helpful. Massage will work on the muscular aspect of sciatica; whereas chiropractors frequently have multiple modalities for addressing the structural component as well.

How does sciatica feel?

Sciatica is typically painful, ranging from dull to sharp, and radiates symptoms from the lower back to the buttock, leg, calf, or foot. Sciatica is frequently one-sided and can also present with numbness, tingling, and weakness. It can be difficult to walk due to pain as well.

What causes sciatica?

The most common causes of sciatica include herniated discs; poor posture; spine degeneration (such as with arthritis); prolonged sitting; lifting or carrying; pregnancy; and being overweight or sedentary.

How should I sleep with sciatica?

Your sleep position should be as neutral as possible, using a pillow under the knees to keep them bent (for back sleepers) or a pillow between the legs (for side sleepers). Avoid sleeping on the stomach and positions where the pelvis is rotated.