Sciatica and Gonstead Chiropractic: Understanding the Cause of Sciatic Pain

Sciatica is a common condition that can cause pain extending from the lower back into the buttock, hip, thigh, or leg. For some people, the pain may be sharp, burning, or electric. Others may experience numbness, tingling, or weakness along the affected leg.

Because sciatic pain can be extremely uncomfortable, many people immediately look for a way to stop the pain.

But an important question should come first:

Why is the sciatic nerve being irritated?

Understanding the possible source of the problem is an important part of evaluating sciatica.

What Is Sciatica?

The sciatic nerve is the largest nerve in the human body. It is formed by nerve roots originating from the lower lumbar spine and sacral region and travels through the pelvis and buttocks into the leg.

The term sciatica generally describes symptoms caused by irritation or compression of one or more of these nerve roots.

Common symptoms can include:

• Pain in the lower back or buttock
• Pain traveling down one leg
• Tingling or pins-and-needles
• Numbness
• Burning or electric-type pain
• Weakness in the leg or foot
• Symptoms that become worse with certain positions or activities

Sciatica is a symptom pattern rather than a single disease. Several different conditions can produce sciatic-type symptoms.

What Causes Sciatica?

One of the most common causes of sciatica is irritation of a lumbar nerve root.

This can occur for several reasons, including:

• Disc herniation or disc bulging
• Degenerative changes in the lumbar spine
• Narrowing around the spinal nerve
• Spinal stenosis
• Spondylolisthesis
• Injury or trauma
• Changes in spinal and pelvic mechanics

Sometimes the cause is relatively straightforward. In other cases, several factors may be involved at the same time.

For this reason, it is important not to assume that every case of leg pain is caused by a disc problem.

Is a Herniated Disc Always the Cause?

Not necessarily.

Imaging studies such as MRI can identify disc bulges, herniations, and degenerative changes. However, these findings do not always explain a person's symptoms.

Some people have disc abnormalities without experiencing pain.

This is why the physical examination and the patient's history are important.

A good evaluation considers the imaging findings together with the patient's symptoms, neurological findings, movement patterns, and physical examination.

The goal is to understand whether the imaging finding is actually consistent with the patient's clinical presentation.

How Can Spinal Mechanics Affect Sciatic Symptoms?

The lumbar spine and pelvis are designed to move and support the body while standing, walking, bending, and lifting.

When movement becomes restricted or uneven, surrounding muscles and joints may compensate.

For example, following an injury, a person may unconsciously shift their weight away from the painful side. The muscles around the lower back and pelvis may become increasingly tense as the body attempts to protect the area.

This can change the way a person stands and walks.

Over time, these altered movement patterns may place additional mechanical stress on certain areas of the lower back and pelvis.

This does not mean that spinal misalignment is the cause of every case of sciatica. Rather, spinal and pelvic mechanics are factors that should be considered as part of a complete evaluation.

Why Does Sciatica Sometimes Feel Worse When Sitting?

Many people with sciatica notice that prolonged sitting aggravates their symptoms.

Sitting changes the position of the lumbar spine and pelvis and can increase stress on certain spinal structures. If a particular position irritates an already sensitive nerve or nerve root, symptoms may become more noticeable.

This is why some patients find that standing, walking, or changing position provides temporary relief.

However, the response to sitting varies from person to person. There is no single position that is correct for everyone with sciatica.

How Gonstead Chiropractic Approaches Sciatica

The Gonstead System places particular emphasis on a detailed examination of the spine to identify areas of altered motion and spinal mechanics.

Rather than simply asking, "Where does it hurt?", the examination looks at the patient's history and physical findings to determine which spinal areas may require attention.

Depending on the individual case, an examination may include:

• Patient history
• Postural observation
• Palpation
• Evaluation of spinal motion
• Instrument findings
• Weight-bearing assessment
• Leg and pelvic mechanics
• Orthopedic and neurological examination when appropriate
• Review of available imaging and medical records

The purpose is to develop a clearer understanding of the patient's condition before deciding whether chiropractic care is appropriate.

Gonstead Chiropractic and the Lumbar Spine

When a patient has sciatica associated with a mechanical problem of the lumbar spine, Gonstead chiropractic care may be used to address specific areas identified during the examination.

The adjustment is not intended simply to "push the spine back into place."

Instead, the Gonstead approach uses a specific analysis to determine whether an adjustment is indicated and, when appropriate, which segment and technique are appropriate for that individual.

Treatment should always be individualized because not every patient with sciatica has the same underlying problem.

What About Sciatica From a Disc Problem?

Disc-related sciatica requires careful evaluation.

A disc herniation can sometimes irritate or compress a spinal nerve root and produce leg pain, numbness, tingling, or weakness.

Some patients improve with conservative care, while others may require additional medical evaluation or treatment.

Chiropractic care may be appropriate for some patients, but it is important to determine whether the patient's symptoms and examination findings are consistent with a condition that can be appropriately managed conservatively.

If significant neurological deficits or other concerning findings are present, referral for medical evaluation may be necessary.

Don't Ignore Warning Signs

Most cases of low-back and leg pain are not medical emergencies. However, certain symptoms require prompt medical attention.

Seek urgent medical evaluation if back or leg symptoms are accompanied by symptoms such as:

• New loss of bladder or bowel control
• Numbness in the saddle or groin region
• Significant or rapidly progressing leg weakness
• Severe neurological changes
• Major trauma
• Fever or other signs of serious illness

These symptoms can indicate a more serious condition that requires immediate medical assessment.

Recovery From Sciatica Takes Time

One of the most frustrating things about sciatica is that recovery is not always immediate.

Even after pain begins to improve, the muscles and movement patterns surrounding the lumbar spine may still need time to recover.

The speed of recovery can depend on many factors, including:

• The cause of the symptoms
• Severity of nerve irritation
• Duration of the problem
• Previous injuries
• Physical conditioning
• Work and daily activities
• Sleep and recovery
• Overall health

Some people improve quickly, while others require a longer period of conservative care and rehabilitation.

Chiropractic Care Is Part of the Recovery Process

Treatment is only one part of recovery.

Patients also play an important role in their own improvement.

Depending on the individual's condition, a recovery plan may include:

• Appropriate physical activity
• Core and hip strengthening
• Improving movement patterns
• Avoiding activities that significantly aggravate symptoms
• Gradually returning to normal activities
• Improving posture and lifting mechanics
• Maintaining a healthy body weight
• Following the recommendations of the treating healthcare professional

The goal should not simply be to eliminate today's pain.

The goal is to help the patient understand the factors affecting their condition and develop better movement and lifestyle habits for the future.

How Nova Gonstead Chiropractic Can Help

At Nova Gonstead Chiropractic in Fairfax, Virginia, we evaluate patients with sciatica by looking beyond the location of their pain.

The lower back, pelvis, hips, and legs function as a connected system. A detailed examination can help determine whether spinal or pelvic mechanical findings may be contributing to the patient's symptoms.

When chiropractic care is appropriate, the Gonstead approach uses specific examination findings to guide individualized care.

If you are experiencing lower-back pain, buttock pain, or pain traveling down the leg, don't assume that you simply have to live with it.

Understanding the potential source of your symptoms is the first step.

Nova Gonstead Chiropractic can evaluate your condition and help determine whether Gonstead chiropractic care may be appropriate for your sciatica.

NoVA Gonstead Chiropractic Clinic
9514 Lee Hwy (Route 29), Suite B
Fairfax, VA 22031
(703) 359-6262