The Sciatica Survival Guide

Is that sharp, shooting pain traveling down the back of your leg actually sciatica?

In this episode of Ask the Chiropractor, Dr. Brant Hulsebus breaks down what classic sciatica really is, what it isn't, and how we help people find real, lasting relief right here in Rockford, Illinois. Many people call our clinic thinking they have sciatica, but it turns out to be something else entirely—like SI joint pain, an upper lumbar issue, or piriformis syndrome.

As a proud Palmer College of Chiropractic graduate and the team chiropractor for the Rockford IceHogs, Dr. Hulsebus cuts through the noise of social media trends. Instead, he explains the precise, clinical approach to locating spinal misalignments (subluxations) at the L4, L5, or sacrum level to fix the root cause of your nerve stress.

In this episode, you’ll discover:

• Why covering up the pain with muscle relaxers or steroids doesn't fix a mechanical spinal problem.
• What to expect from a proper chiropractic exam and structural X-rays.
• How to safely start your recovery timeline and why "muscle memory" matters.
• The crucial role walking plays in bringing nutrients to your spinal discs.
• The real answer to the most common question: Should you use ice or heat for sciatica?

Have a question about chiropractic care? Leave a comment or a message on our platforms, and you might be featured as our next question of the week!

👉 Ready to get to the root of your pain? Schedule a thorough consultation and spinal examination with our team today: https://www.rockforddc.com/

📍 Visit Hulsebus Rockford Chiropractic:

• Address: 1877 Daimler Road, Rockford, IL 61112
• Phone: 815-398-3434

www.rockforddc.com

Transcript

0:00

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 another episode of Ask the Chiropractor. If you listened last week, then you know we finished up a 12-week series of a group of questions I was asked over time. During that time, I was asked more questions. So today is the first episode of another 12-episode series from questions I receive both in person and messages and comments about chiropractic. Again, I'm Brant Hulsebus, chiropractor here in Rockford, Illinois. And I started this podcast a long time ago because I saw so much people that would come to me and ask questions about chiropractic care from non-chiropractors, and they would get answers from people who weren't chiropractors answering about chiropractic care. Now, as a chiropractor, I would never ask- answer a question about dentistry. I refer you to a dentist. But for some reason, in my profession, everybody feels like they can go ahead and be the expert, even though they've never studied chiropractic. So today, I want to talk about sciatica. What is sciatica? A lot of people come in, they tell me they're having sciatica, and they say all different kinds of things. So I really want to break down how you can understand what sciatica is helping you find treatments here in Rockford, Illinois. So we've been doing for sciatica for a long time. So if you've been having sciatica, we've helped people in Rockford, Illinois, with sciatica for a long time. Basically, it's shooting pain from the lower back, down your backside, the back of your leg to your knee and everything knee down to the foot. That's the sciatic nerve. The sciatic nerve is one of the largest nerves in your body. It's about the width of your thumb when it first starts. Again, it comes out of the lower lumbar s- in the sacrum, travels through your hip, down the back of your leg to your knee and everything knee down A lot of people come in and talk to me a lot about different things they think are sciatica. A lot of times they tell me they have pain along their belt line two little spots. Those are actually your SI joints. That's not sciatica. It goes sometimes people have SI pain with sciatica, but that is not sciatica. Other times people come in, they tell me that their front of their legs hurt their thighs or their groin, and they say, "I think I've got sciatica." That's not sciatica. That's actually the obturator or femoral nerve. That actually comes from your upper lumbar spine. Still something that chiropractors help a lot with, but not classic sciatica. A lot of times people have sciatica just on one side. They'll feel it the lower back will misalign. We call that a subluxation. When one or two bones are misaligned, they'll create pressure on there. As a chiropractor, we'll find these misalignments, the, these subluxations, and we'll adjust them in order to help them function better and help take the nerve and make the nerve happier again as a side effect. How do we find sciatica? In my office, we usually do a little bit of a chiropractic exam. We do a little bit of a x-ray exam, and we put the whole puzzle together, and we're able to determine that's sciatica. There are several things that mimic sciatica. Done many podcasts on piriformis syndrome that mimics sciatica quite a bit. Torta pelvis is another one that mimics sciatica quite a bit. But as chiropractors, we usually find a lot of s- classic sciatica cases when we see an L4, L5 issue or maybe a sacrum issue. We can check your reflexes. If we still have doubts, we can check your skin, s- like doing soft and sharp to see how your skin perceives things. There's all kinds of different tests that we're taught as chiropractors to go through and tell. For the most part, if we feel fixation at L4, L5 and the x-rays verify that, then we're pretty much onto our case. We pretty much know what we're looking at or what we're dealing with. So this is, again, like we said, we've helped a lot of people here in Rockford. If you had, think you have piriformis syndrome, you're not sure, piriformis is the muscle that goes through your hip, and the sciatic nerve can hit that. When that muscle gets inflamed, it can mimic sciatica. It mimics sciatica as in it has all the same symptoms as sciatica, but the origin of the pain is different. So as chiropractors, we're always trying to find the origin or the cause of the sciatica. A lot of times you might go to your primary, they might give you a muscle relaxer or maybe a prednisone burst in order to help with the sciatica. And, as chiropractors we actually don't wanna just take medications to try to cover up, what you're feeling. We actually look more for the cause, and that's how we become really good at determining the difference between piriformis syndrome, SI problems, and the actual classic sciatica of the lower back being misaligned. I'm not a really big fan of taking muscle relaxers for this because the reason your muscles are contracted is because there's a misalignment, and the muscles are trying to protect you from further injuring that misalignment. So when you take a muscle relaxer to do that, it can definitely create an issue. The steroids, sometimes people get relief on. Still not a big fan of it because it's, you're not really having the sciatica from a lack of steroids. You're having the sciatica because of a spinal misalignment. And so as chiropractors, what you'll do is you'll come in, you'll fill out a medical history like everybody else does. Anywhere else you go, you'll sit down, have a consultation with the staff or the doctor. We'll put you through the X-rays to see exactly what's going on, then we'll do our chiropractic exam on you to see what we can find as far as the misalignment's concerned Once we're fairly confident we know what we're dealing with, we'll go ahead and proceed. What does that look like? That's usually just a good chiropractic adjustment. We'll you'll either put you on your side sometimes and adjust you. We'll do it straight down. Sometimes you might hear the table pop. Some chiropractors use instrumentation. In my office here in Rockford we do a lot of the straight down, what we call prone, when you're laying face down, adjustments to the, directly to the L4, L5. If we feel like that hasn't fully cleared it out, then we'll do a little Gonstead side posture adjustments. Maybe you've seen some of those goofy videos on, on the internet where they twist people and do stuff like that. It's much more exact and specific than the people make it seem on social media at least it is in my office. We really are aiming for a specific joint, specific line of drive and correction. What to expect when you come in the clinic when you have sciatica for results? We're gonna look at a couple different things. We're gonna try to determine how your discs look. Does your disc gap still look good? If the disc gap is decreased and the disc is dehydrated, that means you've started the arthritic process. It's gonna take longer to help you heal. The X-ray exam shows us the amount of misalignment you have. Is it open wedge and angle that I twisted, or is the spine just rotated also? The more of these things that are occurring, the more misaligned it is, the longer you can expect it to get better. The less misaligned it is, conversely the faster you'll get better. The healthier the disc, the faster you'll get better. The overall health of the patient the lifestyle of the patient will determine how fast you get better. Everybody gets hurt. I know a lot of people say I exercise, I eat right, I do my supplements. How did this happen to me?" Unfortunately, those things do not make you invulnerable to injury or invulnerable to sciatica. However, it does dramatically increase your recovery time. So on day one, you can expect an adjustment. You probably have to go home, put some ice on it, depending how acute it is, how sore and tender it is. And a lot of people start to get some serious relief by the end of the first week. A lot of people, after getting about three or four adjustments on that, they say,"Boy, I'm really starting to feel better." They're not better, but they're starting to see the light at the end of the tunnel. Usually after about two weeks they're feeling fairly good, and we usually incorporate some exercises, some stretches, and some more things that we'll do on this along the way in order to help it We teach you some basic exercises and some basic stretches that just support the chiropractic adjustment. We'll talk to you about your activity, going for walks, because the discs themselves have no direct blood supply. When you walk, the muscles contract, they push the good stuff in, pull the bad stuff out. So at some point, walking is important. However, your chiropractor needs to clear you for walking because if the joints are still swollen and acute, walking can also irritate it. So at a point, the chiropractor will introduce walking and more activities for you to proceed in part of the healing recovery. I usually tell my patients we need to have 10 good days in a row before we think we're actually over something because the muscle memory changes and adapts to it, so it's easy to re-injure in the initial phase. A lot of time people start feeling better maybe after the first two weeks and they say, "Okay I'm feeling better. I'm not gonna go back." They bend and twist, pick something up, and the muscle memory when it was injured comes right back, and they go back to where they were, and they say, "Oh, that chiropractic care didn't help me at all." Reality was you didn't finish the chiropractic care. You maybe try to diet, you lose five pounds. You say, "Oh, I'm losing weight now. I don't need to keep dieting. I'm gonna go back to eating how I was eating," and then blame the diet for why you didn't get better. That's not quite how it works. So A lot of people too, they want to know what should I do when I go home? Should this, is this a ice thing? Is this a heat thing? What do I do? Or, tell me what's going on. So what's going on is those bones have rotated, and when they rotate, they create inflammation. They create stress. The stress in that joint now is under more of a load-bearing situation. It's, its biomechanics have been altered, and chemicals get released. They're called catecholamines. We don't ask you to say that. But those hit the nerve, and wherever that nerve goes, that nerve signal travels with it. It goes into a state of fight or flight or a catabolic state for survival. So what happens is those… that misalignment hits that, that nerve gets, picks up those signals. That nerve then picks up that stress and wherever that nerve goes down your leg. So what happens is the L3, 4, and 5 combine with the S1. Sometimes the L3, sometimes the S1. It's, you know what? No one's perfect, and they come out, they form one big nerve about the size of your thumb. It goes through your hip, down your backside, down your leg, and as it goes down, there's several branches that kick off of it, but all the way down to your toes. So when it's misaligned like that, what we want to do is we want to restore the motion inside that joint. And again, when a chiropractor has X-rays and a chiropractor does a proper exam, they'll know the line of correction, the line of drive in order to go in there and make that precise adjustment to make it easy on the patient. A lot of times I see these goofballs on social media just yanking and pulling on things. I would never let anyone do that to me, never. There's always an initial, they feel good immediate- immediately because there's an endorphin release, but they never show them two or three hours later. That's when I meet them. I meet them two or three hours later when they're in more pain. So I'd like to find a very specific, precise chiropractor. And the biggest question is people come home a lot of times like, "How do I put heat or ice on my sciatica?" The basic answer is you always want to try to put ice on it because it's all inflamed and swollen. If you're hunched over in pain, that means you have swollen and inflamed joints. You want to ice it down. And again, this is just a broad general statement. This is not something to go off of. The only way we can really answer you is during our chiropractic exam to tell you should be icing or heating and when to use the ice and the heat. It's kinda, there's no generic answer, and that's why not everybody knows the answer, so- There you have it, the classic sciatica question we get asked a lot about. And again I would say roughly half the people that come in and tell me they have sciatica when they call in, they come in, they don't actually have sciatica. They have other issues that need to be addressed, but they don't typically have sciatica. So I want to take a minute to describe to you what sciatica is and what it isn't. I hope I answered those questions, and now if you have a question for me, go ahead and leave a comment or a post wherever you're watching or listening to this, and maybe next week you'll be the question of the week. The other thing people call in a lot up to me is about herniated disc. They say, "Hey, they tell me I have a herniated disc. I think it's causing my sciatica." So why don't you come back next week, and next week we'll talk a little bit more about herniated discs, and we and answer a little bit what that is. Hey, thanks for tuning in.