3 myths about sciatica busted

As a common low back problem, sciatica can cause a great deal of discomfort and disruption to daily life. It’s a condition that affects people from all walks of life, from active athletes to those with a more sedentary lifestyle. This fact sheet is designed to provide you with a comprehensive overview of sciatica, its common causes, and how chiropractic care may offer a path to recovery.

In this fact sheet, Dr. Simon Nash (Chiropractor) discusses the various causes of sciatica and debunks three common myths that can prevent people from seeking effective treatment.

Please note: The information provided in this article is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for a diagnosis and personalised treatment plan.

Table of Contents

• Debunking the Myths of Sciatica
• Myth 1: Sciatica Can Only Be Repaired by Surgery
• Myth 2: Sciatica Always Comes from a Disc
• Myth 3: You Should Avoid Movement
• The Chiropractic Approach to Sciatica
• Frequently Asked Questions (FAQs)
• Book a Consult with Our Chiro Brisbane
• References
• Video Transcript

Debunking the Myths of Sciatica

The journey to recovery from sciatica is often complicated by misconceptions. These myths can lead to fear, inaction, and prolonged suffering. By understanding the truth behind these common beliefs, you can make more informed decisions about your health and treatment.

Myth 1: Sciatica Can Only Be Repaired by Surgery

One of the most pervasive myths about sciatica is that it can only be fixed with surgery. While surgery is sometimes necessary, it is rarely the first or only option. Most cases of sciatica respond well to conservative, non-invasive treatments.

Dr. Nash explains that while surgery has its place, it’s not always the starting point for treatment.

“Sometimes, when you have sciatica, depending on the cause, you will need to have surgery to relieve it. But most times, through conservative manual therapy or biomechanical therapy, we can actually reduce that,” he explains.

“So there’s not necessarily always the need for surgery.”

This approach, which focuses on physical and manual therapies, is often recommended as the first course of action after a proper diagnosis. A review in the Journal of Manipulative and Physiological Therapeutics found that 60% of patients with chronic sciatica who had not responded to other medical management found relief from chiropractic spinal manipulation to a similar degree as those who underwent surgical intervention (McMorland et al., 2010). This highlights the effectiveness of non-surgical care.

Myth 2: Sciatica Always Comes from a Disc

Another common misconception is that sciatica is always caused by a disc problem. While a disc bulge or herniation is a frequent culprit, it’s certainly not the only one. The sciatic nerve can be irritated or compressed by a variety of other issues in the lower back and pelvis.

Dr. Nash clarifies that a disc is just one of many potential causes.

“Sciatica does not always come from a disc. While that’s a common cause of sciatica, you can have facet joint irritation. You can have biomechanical dysfunction around the lumbar spine or the glute muscles.”

He adds, “And you can also have piriformis syndrome, which is a syndrome within itself that will irritate the sciatic nerve. So it does not always come from a disc.”

This is a crucial point for anyone experiencing sciatic pain. A thorough assessment by a qualified healthcare professional, such as a chiropractor, is essential to pinpoint the exact cause of your symptoms. Without identifying the correct source of the problem, treatment may be ineffective. This is why a comprehensive examination, which may include a detailed history, physical assessment, and potentially imaging, is the first step toward a successful recovery.

Myth 3: You Should Avoid Movement

The third myth is that you should avoid movement if you have sciatica. While a period of rest may be necessary for very acute, severe pain, prolonged inactivity can often make the condition worse. Movement is often a vital component of the healing process.

“Not moving is sometimes a really bad way to treat sciatica and can actually prolong it,” Dr. Nash asserts.

“Movement can actually be good for sciatica and sometimes and most of the time is a way to actually help treat it.”

Movement promotes blood flow, reduces stiffness, and helps to restore normal function to the affected area. It can also help to decompress the sciatic nerve by correcting poor posture and strengthening supporting muscles.

A systematic review published in Frontiers in Neurology on the effects of exercise for sciatic nerve injury found that exercise has a significant positive effect on reducing pain sensitivity and promoting the functional restoration of the nerve (Huang et al., 2024).

Chiropractors and other healthcare providers can guide you through specific, gentle exercises and stretches designed to relieve pressure on the nerve and support your recovery.

The Chiropractic Approach to Sciatica

Chiropractic care offers a comprehensive, non-surgical pathway to treating sciatica. Unlike approaches that only mask the symptoms with medication, chiropractic focuses on addressing the root cause of the nerve irritation.

The initial consultation at Our Chiro Brisbane involves a detailed physical examination, orthopaedic and neurological tests, and a discussion of your health history to identify which of the various causes of sciatica might be affecting you.

“We’ll get our patients to do certain exercises to help take the pressure off,” Dr. Nash says. “Certain stretches to help that. And even in clinic, we’ll actually use certain mobilisations and movements, movement patterning to actually help relieve that sciatica.”

Treatment may include a combination of techniques, such as spinal manipulation, soft tissue therapy, and corrective exercises. Spinal manipulation is used to improve joint mobility and reduce pressure on the nerve roots. Soft tissue therapy, such as dry needling or massage, can help release tight muscles like the piriformis that may be compressing the nerve. 

A key component of this approach is rehabilitation. Dr. Nash and his team work with you to develop a personalised exercise plan that strengthens the core, improves flexibility, and helps prevent future episodes of sciatica. This proactive strategy empowers you to take control of your long-term spinal health.

This holistic method not only aims to alleviate your current pain but also educates you on how to maintain a healthy spine and avoid future injuries. 

Frequently Asked Questions (FAQs)

Q1: What is the main difference between sciatica and a general back ache? A: Sciatica is a specific type of nerve pain that radiates along the sciatic nerve, often from the lower back down one or both legs. A general backache is typically a more localised pain in the back itself, without the radiating nerve symptoms.

Q2: Will I need an MRI or X-ray to diagnose my sciatica? A: Imaging is not always required. A thorough physical examination and detailed history are often sufficient for a diagnosis. Your chiropractor may recommend imaging if there are signs of more serious underlying conditions, or if your symptoms are not improving with conservative care.

Q3: Can sciatica be caused by a glute muscle problem? A: Yes. As Dr. Nash mentioned, issues with the piriformis muscle, which sits deep in the buttock, can compress the sciatic nerve and cause sciatica symptoms. This is known as Piriformis Syndrome.

Q4: How long does it take for sciatica to heal with chiropractic care? A: The healing time varies greatly depending on the cause and severity of the condition. Some people feel relief quickly, while others may require several weeks of treatment. A personalised treatment plan is created to address your specific needs.

Q5: Can I continue to work out with sciatica? A: It depends on the severity and cause of your sciatica. It’s often recommended to avoid high-impact activities, but gentle exercises and stretches can be beneficial. Your chiropractor will provide guidance on what movements are safe for you.

Q6: Is it better to use heat or ice for sciatic pain? A: In the initial, acute phase, ice can help reduce inflammation around the nerve. Once the initial inflammation has subsided, heat may be used to relax tight muscles. Your chiropractor can advise you on the best approach for your specific symptoms.

Book a Consult with Our Chiro Brisbane

We know how frustrating and debilitating sciatica can be. The constant pain and discomfort can feel like a roadblock, stopping you from doing the things you love—from playing with your kids to simply getting through a workday without pain. You might feel worried that this pain is something you have to live with forever, but that’s not the case.

At Our Chiro Brisbane, we are dedicated to helping you find relief and get back to living life to the fullest. We use an evidence-based approach to identify the root cause of your sciatica and develop a personalised treatment plan tailored to your specific needs. By addressing the source of the problem, we aim to not only relieve your pain but also restore function and prevent future flare-ups.

Take the first step towards a pain-free life. Book an appointment with Our Chiro Brisbane today.

References

McMorland, G., Suter, E., Casha, S., du Plessis, S. J., & Hurlbert, R. J. (2010). Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics, 33(8), 576–584. https://pubmed.ncbi.nlm.nih.gov/21036279/

Huang, T., Li, W., Yang, H., Chen, R., & Zhu, Z. (2024). Exercise as a promising alternative for sciatic nerve injury pain relief: a meta-analysis. Frontiers in Neurology, 15. https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1424050/full

Video Transcript

So three myths about sciatica busted. So number one that that can only be repaired by surgery. Sometimes when you have sciatica, depending on the cause you will need to have surgery to relieve it. But most times through conservative manual therapy um or biomechanical therapy we can actually reduce that. So there’s not necessarily always the need for surgery. And once you’ve had it assessed and imaging done and checked with your healthcare provider, usually running down that course of physical therapy or manual therapy is the first um first way that you would actually go about treating sciatica. Number two, that it always comes from a disc. Sciatica does not always come from a disc. While that’s a common cause of sciatica, you can have facet joint irritation. You can have biomechanical dysfunction around the lumbar spine or the glute muscles. And you can also have puriforis syndrome which is a syndrome within itself that will irritate the sciatic nerve. So it does not always come from a disc. Myth number three that you should avoid movement. Depending on the type of sciatica that can be helpful but we want to restore function to that area. Usually dysfunction sometimes trauma has caused sciatica. So not moving is sometimes a really bad way to treat sciatica and can actually prolong it. So you always check with your healthcare provider to make sure that movement is actually good for it. But movement can actually be good for sciatica and sometimes and most of the time is a way to actually help treat it. We’ll get our patients to do certain exercises to help take the pressure off. Certain stretches to help that. And even in clinic, we’ll actually use certain um mobilisations and movements, movement patterning to actually help relieve that sciatica.