Can Chiropractic Help with Sciatica? What Patients Actually Need to Know

Sciatica can cause sharp, burning, or shooting pain down the leg — but the real cause is often in the lower back, not the hip or leg itself. In this episode, Dr. Brant Hulsebus explains what sciatica really is, why the pain travels, and how chiropractic care helps relieve sciatic nerve irritation effectively and safely.

If you’re struggling to sit, stand, or walk because of leg pain, this episode gives you the answers you’ve been looking for.

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 and welcome to a most popular chiropractic topic, sciatica. Let's talk about what sciatica is and what sciatica isn't. In your lower back, you have five lumbar vertebras. The bottom of these vertebras, L five, L four, sometimes L three, and sometimes you're sacrum. Nerves come out and they come out independently. They gather together and form one large nerve. That nerve is about the size of your thumb, and it's called the sciatic nerve. It goes down behind your glutes and travels down the back of your leg, and then everything knee down, so it intervates the, your back of your leg, your hamstrings and everything knee down. This is called the sciatic nerve and where the nerve goes. Now those reflexes, it does the skin areas of this and it does pain down this area and also muscles. So if we wanna check your sciatica, there's different places we can hit you with the reflex hammer and see how it's going. We can do different leg strengths. We can look at the way your legs are stronger. We can look at your calfs and see which one's bigger, which one's larger. We can look at your Achilles and see a little bit what's going on too with all this whole area. So that's the sciatic nerve. And sciatica simply means irritation of this nerve. So if this nerve is irritated or inflamed, we call that sciatica. Now what this is not pain in the front of your legs or your thighs. This is not pain in your groin. This is not pain when you take a step up, this is not pain across those two little spots near your belt line on the backside. People come in all the time and they grab what we call your SI joint or your sacred iliac joint. They tell me, I've got sciatica. It's right here. That's not sciatica. That's a misaligned hip. Most commonly confused. I Maybe there's too many S'S and i's in both SI, joint and sciatica. I don't know, but that's not sciatica. If you go back and listen to previous podcasts, you'll hear me talk about pure formative syndrome and a little bit about irritation of your hip flexor muscle. Now this is called toto pelvis of my grandpa's day, and this mimics sciatica because the piriformis muscle will get a flame and irritated and it'll hit the sciatic nerve. So the pure form of syndrome is really close to sciatica, but it has a lot more hip involvement where sciatica just has a lower back issues. Now, how does this sciatica get flared up in your lower back? You get one or two bones that are misaligned or under stress, and we call that chiropractic or subluxation. When the subluxation occurs, the joint itself feels the danger. It knows something's wrong, and what starts to happen is it starts to fixate and lock into place. There's also hormones and chemicals that get released here, stress hormones and stress receptors, stress chemicals that hit that nerve and travel down that nerve and tells that nerve that we're in a state of stress, and then the str, then the nerve doesn't respond properly. I don't like to say a pinched nerve. Because if you've ever had screaming sciatica, it's hard for me to believe that nerve isn't being pinched and cut off when it's screaming that loud. It's more about the chemicals and stuff that hit the nerve and change the signal coming and going. So that's what we see when it comes to sciatica. People will tell me they have bad reflexes on one leg. They'll have pain down the leg coming from the lower back. They'll have. Maybe a cold feeling, maybe a burning feeling on their leg. And so what we'll want to do is we wanna take a look at that and get aggressive with it. Now, a lot of times people will hope maybe this will go away in its own. Your nose is getting really bad if you cough or sneeze and it gets really bad down your leg. Those are kinda like red flags that we probably have a really bad disc involvement and this is getting really serious. You wanna try to come in while it's just a little irritation of before the whole disc goes out, while just a little irritation of the little joints in the back, cough, face set joints, when those are just a little inflamed. That's really easy for us to work with and take care of. But if you're coughing or sneezing or bearing down having lightening pain on your legs, now you've got a really big disc problem. And again, the earlier you get in and get checked, the likelihood of this lasting a long time is less and less. So if it's been bothering you for two or three or more days, it's time to come in and get checked. It's probably not gonna go away And. Or if this is like your 15th episode of this and you're like, okay, you normally last one or two days. This time is lasting a lot longer. By that point, now we're actually getting some real changes in damage in those joints, and it's gonna take a lot longer to get you better. So what should you expect when you go to the chiropractor? I can talk about my practice when you have sciatica and you come to my office, the first thing we're gonna do is we're gonna do a lower back exam on you. Take a complete history like you would any other kind of physician's office, and then we're gonna take some x-rays of your spine. Because we want to make sure that we're dealing with this. I talked about the Piriform syndrome. How do we know this is really sciatica and not piriform syndrome Definitively. Today one of the best things we have is images. So we'll take some images of your lower back and hips and see what's going on. If your L 3, 4, 5, and sacrum line up totally straight, then we have to think it's piriformis syndrome. If your L three, four and five are twisted and misaligned and your hips are pretty level, then we have to think it's sciatica. So that's the definitive test. There's lots of other tests that we can do, but that test definitely spells it out crystal clear in the imaging. So we'll take some images of you. We will review our findings with you. We'll show you the images of what we see, we'll tell you about your disc height. Your disc height kinda gives us an idea of how long it's been there. The longer it's been there, the smaller your disc height, the more damages that occurred. The more rotation the vertebraes are, the longer it'll take to get you better and the better overall healthier, and the longer the shorter it takes to get better. So we'll assess those things and we'll, usually in the second or third visit, we'll give you a game plan or schedule when we think we're gonna start taking care of you. How many visits it takes to come in. Now, a lot of people will call me on the telephone. They'll say, Hey, I have sciatica. How many visits is that? That's a really hard question to answer on the telephone Because I don't know what your disc kites look like. I don't know how much rotation you have in your vertebrae. Heck over the telephone. I don't even know if it's sciatica, SI pain, or just pure form syndrome without actually doing an evaluation. So how long does it take to get better? How much do you have to get better? How long does it take me to lose weight? How much weight do you have to lose? How committed are you to doing the things that we're gonna ask you to do? So we try to come in and meet with you, and talk to you, and give you a game plan on what it takes to get better. Now, the research shows, in order to feel a change in Chiropractic Care U usually takes between 12 adjustments, right around 12 adjustments. So you can expect, if you have really bad sciatica, you're gonna come in at least 12 times according to the research. Now, that's not always true for everybody. That's the average. So a lot of people come in, they'll tell me, Hey, I've tried a bunch of things that my neighbor told me to do, or friends of mine told me to do. I thought maybe I could just stretch this out. If your disc are swollen and those facet joints are swollen and there's inflammation building up, there's no more stretching it. A matter of fact stretching, it could create more inflammation if it's not properly done. People talk to me about an aversion table. I want to hang upside down and maybe traction my back out and my attitude about an aversion table and lots of other things that people have. Those are really good tools to help you a good back stay well, but not get a bad back. So if you have had ongoing issues, you're like, what more can I do at home? Your version tables are great. They'll definitely help you keep you well, but they don't make you well. People tell me they try to buy a new mattress. Maybe that would help. Again, if the disc are inflamed, things are swollen. It doesn't matter what you do, you can buy all the new beds in the world. Until we take care of the inflammation and swelling that's causing this. Attica, you're not gonna get well. So who makes a good candidate for a chiropractic patient? Anybody with a spine we always used to say, but if you've had this pain going on, we can take an x-ray of you. We can tell you if you're a good candidate or not, whether or not we can help you. So the idea is that we'll take a look at you and we'll look at your x-rays and we'll tell you if you're a good candidate who's a bad candidate. If you've got fusion going on, you've got really bad degeneration in your lower back. Or if you've got what we call ankylosing spondylosis, which is a autoimmune issue where your vertebrae start growing together, we can give chiropractic a try, but typically you've got too much damage. How do you avoid getting in these two things? Don't wait to come. Don't wait four or five years. As soon as the vertebras or misalign or subluxated, they stop moving. The body tries to protect them, and as they stop moving, what happens is over time the joint space starts to deteriorate, degenerate, and it gets smaller and smaller as it gets smaller and smaller. Boning spurs of the grow. This is our arthritis process. So if you've been having this for a long time, or somebody deals with this for a long time, you want to come in and get checked right away. How can you tell if someone in your family has this issue? You start to see the way they go to get up or sit down, they really struggle. You start to see the way they walk, they'll start to see a long stride and a short stride, maybe a long stride on the left side, and a short stride on the right side. So you start to see, they start to compensate the way they walk, sit and stand, and they can't stand very long. They can't lift very big, and they're starting to limp. These are all red flags. If there's something going on, it's time to get evaluated by a chiropractor. Now, should you ask your primary doctor whether or not chiropractor can help you, your sciatica? Probably not. Obviously, the majority of orthopedic doctors and primary doctors have no idea what chiropractors do. You should ask a chiropractor. If a chiropractor could help you, just like you wouldn't ask your primary whether or not the dentist is a good choice for it. What's going on with your tooth? You would just ask your dentist. Medical doctors typically are not trained on chiropractic. They're trained on what they do. They're not trained on everything. They don't know everything about everything. So you should ask a chiropractor. That's the whole point of this podcast, right? Ask a chiropractor if you have a question about chiropractic or chiropractic care. So if you have a question about chiropractic or chiropractic care that you'd like me to answer, go ahead and leave a comment wherever you're watching, listening to this, and maybe next week you'll be the question of the week. Thanks everybody.