Decoding Leg Pain: Part 2 - Sciatica Symptoms and Solutions

In this edition of 'Ask the Chiropractor,' Dr. Brant Hulsebus from Rockford, Illinois, delves into the topic of sciatica. This episode is part two of a series where Dr. Hulsebus discusses the common misconceptions and accurate diagnosis of sciatica vs. Piriformis syndrome. He explains the anatomy of the sciatic nerve, the symptoms of true sciatica, and the importance of chiropractic care in treating this condition. The episode includes details on diagnostic tests, the role of x-rays, and the significance of following a chiropractor’s care plan for effective treatment. Dr. Hulsebus also emphasizes the need for exercises and stretches to complement chiropractic adjustments and prevent recurrence of the condition.

www.rockforddc.com

Transcript

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Hello, Dr. Brant Hulsebus here and welcome to another edition of Ask the Chiropractor. Ask the Chiropractor is my little podcast that I do when someone has a question about chiropractic or chiropractic care, I try to answer. I'm a chiropractor here in Rockford, Illinois. I'm a proud graduate of Palmer College of Chiropractic and I'm happy to be the team chiropractor of the Rockford Icehogs. Let's dive into it. Hello, welcome to part two. So if you are just jumping in and you didn't hear last week's podcast, this week is part two. So this week we're gonna dive into sciatica. Last week I talked a lot about people coming in the office and they tell me, I've got sciatica. It's the number one thing people come in that they self-diagnose themselves with on the internet, and they're positive they have, but we found a lot of times they don't have sciatica, they have Piriformis syndrome. Piriformis was a very complicated issue with the upper, lower back, the pelvis, and the sacrum all rotating different ways, pulling on different muscles, hitting different nerves, and mimicking sciatica. I'm not going to get into all that again this week. If you want to listen to that, just wherever you listen to this, go back one episode, listen to that, and then come back here and let's know about sciatica. Because now I'm going to talk about what sciatica truly is. Alright, let's get into this sciatica. By the way, I love the way people come in and tell me they got this because most of them can't pronounce sciatica. I hear all kinds of, I got schizia, I got scichiata, and stuff like that. It's, I always, whenever I hear it, I just, I try to keep a straight face, right? Because I know you're in pain, I know you're angry, I know you're upset, I know you got an issue. You don't want to be laughed at, but I love the way people come in and try to say that word. But it's called sciatica. The sciatic nerve itself is a big nerve. It comes from your lower lumbar, your sacrum. Those nerves come out of your spine, join together to form one very big nerve about the diameter of a thumb. That nerve leaves the spinal cord area, comes together right there, enters the pelvis as one big nerve, travels through the pelvis down the back side of your leg. And then it goes everything knee down. It does not do your thighs. That's called the femoral nerve. That comes from L1, L2, L3. It's a different nerve, different issue. So if you're having issues in your thighs, then we're thinking more about last week's episode, not this week's episode. So if you have pain in your thighs or in your groin, go back, listen to last week's episode. sciatica today, real sciatica. Sciatica involves a lower back being misaligned. When those lower lumbars are misaligned, in chiropractic rule we call that a subluxation. One or two bones misaligned, they create pressure on the nerve, stress on the nerve, and the stress kicks down the nerve. The nerve goes into what is commonly called fight and flight response. So it's not healing, it's not improving, it's trying to survive. And when you try to survive, it's called catabolic, meaning it's going to waste away unless it's corrected. And when we talk about the sciatic nerve going down the leg, then we talk about the leg getting weaker. We talk about the leg having pain. We talk about the leg itching, burning, all these different things. We talk about muscles not working the right way. One of the worst cases of sciatica is when you have foot drop. Meaning the L4 isn't doing its job anymore. The L4's job is to lift your toes when you walk so your toes don't drag. And so because you can't lift your toes, you're lifting your foot up really high and slapping it down. They call it foot drop. These are bad cases. Sometimes chiropractic should help you. Sometimes if they happen really quickly, we should maybe get some help from the MDs. That's your chiropractor can navigate that for you. Your chiropractor can make the determination. I've had people come in, they were fine one day. The next day they couldn't control their foot. We got them all right away. Got them right where they needed to be. Again, this is your chiropractor's job to figure this out. Don't ask the medical doctor they should go to the chiropractor because they don't know what chiropractors do. Chiropractors are trained. to send you out when it's outside of what we should be taking care of our scope. We say, oh, this isn't a typical chiropractic. We're going to send you to the MD. The MD will never say, oh, you know what? This is easily fixed at the chiropractor. Go there. They don't say that. It doesn't happen. I've been practicing for 21 years. This practice has been open since 1949. It just doesn't happen. So this is why we do these videos. So if you're L4, L5, missing line, you get subluxated, that nerve gets affected. Now what happens when it's subluxated, it moves. It turns a twist. And what happens is on the side of the vertebrae, there's two holes called the IVF, the intervertebral foramen, where the nerve comes out. If this IVF is stressed out, if it has irritation, inflammation, problems with that nerve is going to be affected and that's going to go down your leg. So when you go to the chiropractor, how do we know if it's sciatica? We do different tests on you. Some of the simple tests we have, you lay on your back and we lift your legs and see if it hurts. Because if you lift it in a straight way while you're laying on your back and you get shooting pain on your leg, that's called a straight leg raiser test. We know it's a disc and we know the stress in the joint, we know it's inflammation, we know what's going on. Now we can do other tests to see what's going on with your pelvis. If your pelvic's not involved, then we know it's sciatica. We know it's nothing else other than sciatica. Now you can have pelvic involvement with sciatica, which is why we do the sciatic nerve first. So we always test that to see what's going on. So if you're complaining about the back of your upper legs and everything knee down, we're taking sciatica. If you fail a couple of quick orthopedic tests, we're taking sciatica. If you're going to do reflex tests on you, that doesn't help because piriformis can cause reflex problems, sciatica can cause reflex problems. So how do we know for sure? If we're still not sure, an x ray. If you have a patient in a standing position, you take an x ray, and the L4, L5, or sacrum are all misaligned, there's another huge clue with sciatica. Another huge clue you have about subluxation and that lower back area that needs a chiropractic adjustment. What do we look for in that x ray? Like I said, at the L, if you look at the spinous process on the vertebrae, the little bump you feel in someone's back, that should be straight, dead centered in the block of the vertebrae. If it's rotated left or right, we're talking subluxation. If we look at the spine itself from a front to back view and it's a nice straight line, we're happy. If we see a curve or a bend, we're not happy. If you look at your posture. And your lower back posture is supposed to have a forward curve. If that forward curve is not there, then all the weight is crashing down on the bottom nerve of your back and that's the sciatic nerve. We're not happy. These are the tests and exams that we do to see what's going on to see if we're happy or not. This confirms sciatica. Now if it is sciatica, the chiropractic adjustments over time will get you that lower back to loosen up and it can start to hold. Now, I'm going to jump right back. I skipped a topic. If you've had x rays from your medical doctor on your lower back, bring those x rays, not the report, the x rays to the chiropractor. The x ray report tells us it's safe for us to take care of you, but it doesn't give us guidance on how to take care of you. We need the x rays. Medical doctors and chiropractors are both trained to look at x rays for pathogens, abnormalities, trauma, injuries. But that's where the education comes in. stops to match. Chiropractors are also trained to look at the alignment issues to see if something's out of alignment or needs to be corrected. Only a chiropractor is trained to do this. So if a family doctor or orthopedic doctor or someone says, no, your spine's in alignment, the chiropractor can't help you. Boy, I'll bet you, however, I'll take you to Vegas and put wagers down that's probably not accurate. And I don't know why they say this because they don't have the education of the training, but that's typically what we see. If you're having these issues, make sure that you take your x ray itself to the chiropractor with a look at it. Today in 2025, most x rays are the exact same. It used to be that you used to lay down for your x rays at the medical office and stand up for the chiropractor. They say when you lay down, you don't move as much and you get a better x ray for looking for pathologies. But today the x rays and the digital computers and stuff, they're so fast. Most lumbar x ray shots are less than a second. The movement just doesn't a factor anymore. So today more and more doctors are taking your x ray standing up. So if you have standing up x rays take them with you to the chiropractor. They look at those x rays and they should be able to tell you yes or no the moment they look at those x rays whether or not you're a chiropractor candidate. So what does Care Plan look for this? Care Plan is pretty simple. We adjust that lower back. You have to come in. How many times do you have to come for sciatica? People call all the time. Hey, I've never been to your office. You've never met me. You've never seen me, but I'm just curious. How many times do I have to come? I don't know. How long has it been there? How acute are you? Can you stand up straight? Is there Is your rotation and spinous, is the spinous rotated and the spine bent, or is it just one or the other? What's your posture look like? How healthy are you? If you're grossly unhealthy, it's going to take much longer to heal than somebody who goes to the gym four days a week. We're going to be able to adjust them and get them back happy right away. You have to talk to the chiropractor about what it's going to take after you meet the chiropractor. This is not a question that any real chiropractor can answer on the telephone. Research does show it takes 12 adjustments to make a change. Now, does that mean go 12 days in a row it's gone? I don't know, does it go once a week and after 12 weeks it's gone? Again, it's going to depend on the individual. It's going to depend on what you're doing. It depends on how you look. And it's really important that you keep your care plan because the chiropractor is going to give you one based on what it takes to get you better. Being that you're coming in there frequently, a lot of times people say I just, I'm going to cancel Wednesdays and keep Fridays. You're going to add more visits on your thing. You're ultimately going to be coming longer. Keep that in mind too. So your chiropractor will give you a care plan, and then after the care plan is over, the chiropractor will talk to you about stabilization exercises to keep the gluon head adjustment. That's what you should expect when you go there. That's what you would get here if you came here. Now, sometimes if it's really bad, we'll incorporate help down the street from us. We have a, Place called Movement Fitness that we refer a lot of patients to for strength and conditioning. They have athletic trainers and strength coaches that we work side and side with. We actually, they come over with the appointment. They see the x rays with me and they get to see what's going on and they go back and we work together. We give each other feedback as we continue to see each other. We have a great relationship. Hopefully your chiropractor has something similar, but bare minimum just get the exercises and stretches from your chiropractor and the chiropractor can watch you to make sure you're getting along with them. And then be honest with your chiropractor if you're going or not going. Say, I don't like it when someone comes to me and says, I'm just not getting better. I don't feel like this is helping. Then I'll look at them and say show me one of the stretches I taught you. And they're not doing the stretches. Because a lot of times those things have to work together. The adjustments itself. Now, the adjustments itself will work, but you have to be willing to give it a lot more time. A lot more visits, a lot more time with the chiropractic clinic. But the exercises and stretches, it should go faster. So that's what you should expect. So there you have it. If you went to your MD and they told you have sciatica, go to the chiropractor. I can't tell you how important it is. Nobody has sciatica for a lack of steroids. Okay, so if they give you a steroid pack, that'll make you feel better. But you didn't get that sciatica because you lacked those steroids. Go to the chiropractor, bring the x rays with you. Let the chiropractor determine if it's the pure former syndrome we talked about last week, or if it really is sciatica. Two totally different chiropractic adjustments. Two totally different care plans and strategies. Then the chiropractor can work with you to make sure this goes away. Then the chiropractor should give you homework, exercises and stretches to help make sure to decrease the odds of this ever coming back. That's the way I do it. That's the way we do it at our office. That's the way we've been doing it since 1949. There you have it. Go see the chiropractor. If you know someone that's dealing with sciatica, go see the chiropractor. They might be doing physical therapy is great. After the back's been adjusted. After the correction's been made. After the spine's stabilized. Go to the physical therapist. Please go to the physical therapist. Afterwards. Let them teach you how to hold it in place once it's in place. Not hold it in place while it's wrong. Get it straightened. Don't keep buying new tires before you get your tires aligned. Get your tires aligned and go buy your new tires. Alright, there you have it. I don't mean to get too excited. If you have a question about chiropractic or chiropractic care, or if you've gone to the doctor and you've asked the doctor, Am I a chiropractic case? This is just bad. Always ask the chiropractor. It's just because it's not part of their curriculum. Again don't ever ask your chiropractor about a cavity. Don't ever ask your dentist about an ingrown toenail. Everybody has their own profession, their own lane. Make sure you ask the right person, the right line. All right, come back next week. We'll have some more fun topics And if you have a question about chiropractic or chiropractic care leave a comment after this wherever you're seeing or watching this subscribe, share Remember, if you have a question about chiropractic, ask a chiropractor. All right, let's wrap it up. Thanks