What Is Sciatica?

Like it or not, 80% of you will experience an acute bout of low back pain at least once in your life. Of those who get this back pain, many will also experience a mild to severe pain and/or numbness, called “sciatica”, which often travels down one of your legs and potentially as far as your toes. To really understand what sciatica is and how it occurs, you need to first understand a little about the nerves exiting between the vertebrae of the spine.


The term “sciatica” comes from the name of the largest nerve in the entire body – the “sciatic nerve”. The low back, called the lumbar spine, consists of five vertebrae. Between each of these vertebrae, a nerve exits from the spinal cord. These nerves eventually combine to form one large nerve, called the sciatic nerve. It is responsible for controlling the muscles in the leg. It also tells the brain when the leg is being touched or if it has been injured and is in pain. Therefore, the sciatic nerve carries messages and instructions from the spinal cord to the entire leg and vice versa.


If one of the nerves of the spine that make up the sciatic nerve, or the sciatic nerve itself, is being irritated or pinched even slightly, problems arise. The messages and instructions passing to and from the leg will be weakened or altered. This may result in your leg, ankle or toes not being able to move with their normal strength, the skin possibly feeling numb when touched, or even mild to severe pain at specific areas of the leg.


So, what does sciatica have to do with all this? Normally, the messages that travel back and forth between the brain and the leg are very calm and quiet. If there is a pinching or irritation of the nerves at the spine, these messages can become either highly amplified or weakened. In the case of sciatica, the calm and quiet messages that travel from the leg to the spine and brain become increased to that of a roar. This amplified message travels up the spinal cord to the brain. The brain assumes that this roar of a message is legitimate and that the leg is injured. This is why you feel mild to severe pain in your leg when there is really nothing wrong with it. Therefore, sciatica is really just mild to severe pain or numbness felt in the leg when one or more of the nerves in the low back are being irritated or pinched.


It is not difficult to determine if a person is experiencing sciatica or not. The real challenge is determining where the pinching or irritation of the nerve is occurring. Only then can the actual cause of the sciatica be treated. This is something that chiropractors do in their office all day every day. In fact, no other health care practitioner cares for more patients with low back pain than chiropractors. Regardless of who you decide to consult for your sciatica, just make sure he or she does a thorough examination and makes an accurate diagnosis.


For more information on sciatica and its common causes, refer to the article “piriformis syndrome and sciatica” in the blog section of this website.


Piriformis Syndrome

“Piriformis syndrome” is caused by an entrapment (pinching) of the sciatic nerve as it exits the back of the pelvis, deep within the buttock. The sciatic nerve typically exits the back of the pelvis immediately below a muscle, called the piriformis muscle, deep within the buttock. In rare situations, the nerve actually passes right through the piriformis muscle. For various reasons, the piriformis muscle can go into spasm and entrap or pinch the sciatic nerve. This will result in pain along the back of the thigh and knee, with further pain and/or numbness extending as far down as the sole of the foot, called “sciatica”.


Piriformis syndrome can result in “sciatica”. These same sciatica symptoms feel very similar to that of a herniated disk. A herniated disk typically pinches directly on one of the five nerves that eventually make up the sciatic nerve. Because the resulting symptoms of both of these problems are very similar (pain, numbness and tingling below the knee and into the foot), it is not hard to misdiagnose what is actually going on if you don’t look for both potential causes.

Specific diagnostic tests performed by your chiropractor are what distinguish a herniated disk from piriformis syndrome. In simple terms, with piriformis syndrome your chiropractor will not find many positive test results that indicate that the lumbar spine is involved. More often, the acute pain or tenderness is localized to the buttock and hip, while the low back appears quite normal.

Many weekend athletes and people who spend long hours sitting are prone to this syndrome. The athlete’s cause is primarily due to improper stretching and warm-up exercises as well as overuse during activity. In this case it is most likely that the piriformis muscle is irritated and usually in spasm. For the patient who sits for extended periods of time, their primary cause is due to contracture or tightening of the piriformis muscle. In this case the piriformis muscle is shortened and does not allow for the smooth movement of the sciatic nerve during leg motion.

Any treatment plan must include stretching of the gluteal or buttock muscles as well as stretching of the piriformis muscles. Your chiropractor or health care practitioner can help you by instructing you on the proper stretches to perform. Many Chiropractors may also perform some form of deep tissue massage to the piriformis muscle in the gluteal region in order to relax these muscles. A series of spinal and hip joint adjustments may also be required to relieve your symptoms.

If you are currently diagnosed with a disk herniation but are wondering if the symptoms you are experiencing may at least be partially from piriformis syndrome, call my office for an appointment to have it checked thoroughly. It is always a good idea to rule out other possible causes of your sciatica before simply having surgery.


Leg Pain From the Hip

Last week I had an elderly male patient enter my office complaining of “sciatica” (leg pain that refers from the low back). He simply assumed that the pain in his groin and front of his thigh was originating from his back because he had experienced symptoms similar to this before and ended up having low back surgery to correct it. Although the leg pain he was describing could have been originating from his low back, a detailed examination of that area revealed nothing significant. Knowing well that leg pain can be from the hip joint, I examined that next. By asking a few simple questions and moving the joint around in different directions, it was very obvious that there was a problem. By turning the leg inward and outward, the leg and groin pain could be reproduced or intensified. It was then obvious that the past treatments he was given should have been directed to the hip joint and not the low back. This article will focus on leg pain from the hip.

Once this gentleman’s hip was x-rayed, my suspicion of osteoarthritis (“wear and tear” arthritis) was confirmed. I then explained to him that just because he had arthritis does not mean he should “baby” the joint. In fact, an arthritic joint will not last longer and the arthritis will not slow down if the joint does not get used. Because of the leg pain, he had not been getting hardly any exercise. This would have made the problem even worse. Any joint, arthritic or not, must get as much movement as possible to prevent further stiffness and pain. So, I started him on a light stretching and strengthening program for the muscles in and around the hip joint. He also received some chiropractic treatment of the muscles and the actual joint. This gentleman could also have benefited from losing a few pounds. For every pound extra he carried, it is three pounds more stress on his hip joint when walking. Jokingly, we decided that he should not consider taking up sprinting but instead should start a pool exercise program. This allowed him to use the muscles and move the joint without putting too much pressure on the arthritic joint. Within two weeks, his ability to walk was significantly improved and the intensity of the leg pain was much less.


If you are experiencing leg, thigh, groin, or knee pain, consider having the hip joint examined by your chiropractor or other health care practitioner.


Alcohol Should Be Consumed In Moderation


I am sure you have heard the term “everything should be done in moderation”. I couldn’t agree more. It doesn’t matter if I am talking about doing yard work, sitting in front of a computer, exercising, or even the stress that life can throw at you. Moderation in everything we do is crucial to remaining healthy. This particularly applies to consuming alcohol. When the word “moderation” is used in the context of alcohol consumption, fourteen (or fewer) drinks a week, and no more than four in a single day, is “moderate,” according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). One drink means a 12-ounce beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of 80-proof spirits. A 2012 Center for Disease Control study found that about one in four men exceed the moderation guidelines an average of five times a month! This article will discuss how alcohol should be consumed in moderation.

colin drinking a beer

Not only is consuming excess alcohol toxic for your body and make you say or do things you would never normally do, but even mild to moderate drinking can also make your belly bulge. Within minutes of your sipping a drink, your fat metabolism can wane. Because your body treats alcohol as a toxin, removing it becomes the top priority, says Angelo Tremblay, Ph.D., a professor of kinesiology at Laval University in Quebec. That can cause your body to stop burning its usual stored carbs and fat for energy and instead utilize the alcohol. The double whammy: Any other calories you take in, whether they’re carbs from your brew or protein from buffalo wings, end up as stored fat.

The average man needs an hour to metabolize 0.6 ounce of alcohol, the amount in one drink, so even a couple of drinks can have a dramatic effect. In a UC Berkeley study published in The American Journal of Clinical Nutrition, people who downed an ounce of alcohol from two cocktails showed a 73 percent decrease in fat burning after two hours. And in a study from Switzerland published in the New England Journal of Medicine, male participants who were given two beers’ worth of alcohol with each of their three meals experienced a slowdown equivalent to roughly 450 calories that day. Beyond its caloric load and impact on your fat burners, alcohol can disrupt your sleep pattern, mess with your appetite, and initiate a cascade of other weight-gaining processes, according to Donald Hensrud, M.D., an associate professor of preventive medicine and nutrition at the Mayo Clinic in Rochester, Minnesota. He states that “one reason to stop (drinking alcohol) completely is to see how (much better) you feel physically and psychologically”.

On a final note, not only will consuming alcohol encourage your body to gain weight, but excessive alcohol use is the third-leading cause of preventable death, after smoking and obesity. A toast, then, to moderation—and to finding the truth about drinking and dieting!

Portions of this article were taken from a recent Men’s Health article written by Ben Court on May 5th, 2014.


Have a More Firm and Muscular “Butt”


There are many people who would like to have a more firm and muscular “butt”. Fitness magazines encourage you to have firm buttock muscles for aesthetic purposes; however, strong hip and upper leg muscles are a very good for providing structural support for your back and hips. These muscles are very important for walking, climbing steep hills, and lifting objects from the ground level. Whether you wish to improve the physical shape of your buttocks for social reasons or you would like to be able to lift better and safer, there are exercises that can help.


If done properly, the following exercise is very good for increasing the strength and shapeliness of the gluteal and quadricep muscles. The quadriceps makes up most of the muscles at the front of your thigh. These are the muscles you use to straighten your knee from a bent position. The “gluts” make up most of the muscles in your buttock and upper hip. They are responsible for taking your hips from a bent to a straight position, as in the standing up phase of doing a squat.


The “squat” exercise is widely used by weightlifters and most athletes. It is also very good for non-athletes if it is done properly. It can even be done at home.


*First of all, stand with your feet slightly more than hip-width apart, toes out slightly, knees aligned over top of your feet. For more resistance, you can hold small weights in your hands at your sides (see picture #1).

*Keeping your pelvis in a neutral position, push your chest forward and make a small dish-shaped concave curve in your lower back.

*Maintaining this posture, look straight ahead and lower your body as if sitting back into a chair. Keep your heels on the floor and pressure on your feet evenly distributed through your entire foot. Lower until your knees almost reach ninety degrees (see picture #2). Don’t go below this level, as it is hard on your knees.

*Drive back up to the starting position (picture #1) using your gluteal and quadricep muscles. Keep your heels on the floor the entire time.

*Slowly but repetitively do this motion until your legs and hips become fatigued. If you are holding weights in your hands as well, use a weight that will still allow you to do 12-15 repetitions. Repeat this entire process two or three times.