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How to manage the sciatica nerve pain shooting down your leg

If you find yourself Googling “buttock pain shooting down leg” you’re probably already familiar with the sciatic nerve, and the many ways that sciatic nerve pain – commonly referred to as sciatica – can disrupt your life.

It’s no wonder it can cause so much pain and disruption. Running from your lower back all the way to your toes, the sciatic nerve is your body’s longest and thickest (almost finger-width) nerve.  Just above your knee it splits into two nerves that run down and around your leg to the bottom of each foot, which is why pain can travel from your back all the way to your toes.
 
In this post we cover common causes and symptoms of sciatica, explain how to manage the sciatica nerve pain shooting down your leg, and how chiropractors diagnose, treat and help prevent it from returning.

Common Causes of Sciatica Pain

When your long, thick sciatic nerve bundle becomes compressed or inflamed it can lead to sciatica, a term for that set of symptoms — excruciatingly sharp, shooting pain, numbness, tingling and weakness — that usually affects one buttock and one leg only, making standing, sitting or sleeping difficult or impossible. Sciatica is literally a pain in the butt — for more than 3 million Americans every year. 

That pain is not always easy to explain because its causes vary depending on your age, your neuro-musculoskeletal health, your occupation and your lifestyle. The root cause of pain shooting down your leg may be found in various areas of your body.   

Your spine is made up of 33 vertebrae which support your body weight. Between the vertebrae lie intervertebral discs (layers of fibrocartilage with a gel nucleus that distributes weight during compression). These discs provide cushioning and prevent your bones from rubbing against each other.

Sciatic nerve irritation is most often the result of a herniated or slipped disc, which allows your bones to rub against each other.

Sciatica pain can also be brought on by: 

  • Tight buttock muscles causing spasms (piriformis syndrome) 
  • A narrowing spinal canal putting pressure on nerves (spinal stenosis) 
  • Vertebra slippage narrowing a nerve exit (spondylolisthesis) 
  • General wear and tear on the lower spine discs which flatten with age and can no longer reabsorb as much fluid during rest 
Sciatica

How do you know if it’s a muscular condition or the more common slipped disc that’s causing so much pain? How do you find the root cause of that stabbing, jabbing, shooting pain and numbness in your leg and buttock? That’s a question a Doctors of Chiropractic may be able to answer.

How Your DC Diagnoses the Root Cause of Your Sciatica

When discs slip out of position the vertebrae can put pressure on surrounding nerves.  Sciatica symptoms usually develop when nerve roots become inflamed, compressed or misaligned at these vertebrae:

Vertebrae L4 nerve root dysfunction may cause:

  • Hip, thigh, inner knee and calf pain
  • Loss of sensation in the inner calf
  • Thigh and hip muscle weakness
  • Reduced knee-jerk reflex

Vertebrae L5 nerve root dysfunction may cause:

  • Pain in the buttock and the outer (lateral) part of the thigh and leg 
  • Loss of sensation in the big toe and the second toe 
  • Buttock and leg muscle weakness 
  • Difficulty moving the ankle and lifting the big toe

Vertebrae S1 nerve root dysfunction may cause:

  • Buttock, back calf and side of the foot pain 
  • Sensation loss in outer foot as well as third, fourth and fifth toes 
  • Difficulty raising the heel or walking on toes 
  • Buttock and foot muscle weakness 
  • Reduced ankle-jerk reflex 

If your DC does not suspect compressed vertebrae after analyzing your symptoms, they may investigate other potential causes with a manual exam or x-ray.

How Does Chiropractic Treat Sciatica Nerve Pain Shooting Down Your Leg?

Only after observing exactly where and how your symptoms are presenting, identifying where and how your sciatic nerve is compressed, and detecting which vertebrae may be misaligned your Doctor of Chiropractic will perform the appropriate adjustment

To maintain long-term alignment and help prevent your pain from returning or intensifying they will craft a care plan that will help:

  • Decompress your nerve
  • Realign your vertebrae
  • Strengthen the muscles around each one
Sciatica adjustment

Musculoskeletal journals like the Journal of Manipulative and Physiological Therapeutics have published decades of studies demonstrating sciatica patients experienced the same level of relief from chiropractic adjustments as patients who had surgery. 

The length of your personalized care plan will depend on a variety of factors such as how long the issue has been present and what your daily routine looks like, your age, general health, and goals. Your plan should consist of both chiropractic adjustments to decompress and realign your vertebrae, and active therapies to help build muscle to support them.  

Once your adjustments have helped to relieve your pain, you’ll be able to focus on your functions — things like muscle strength, mobility and flexibility — that may have diminished while you were injured.  

Your DC will prescribe active therapies — exercises and targeted stretches to help relieve inflammation and compression to relieve your sciatica and prevent it from returning. These customized exercises go a long way toward preventing a relapse (and another day of not being able to sit without wincing). 

Randomized clinical trials published in the Physical Therapy and Rehabilitation Journal have demonstrated that active therapies joint mobility interventions led to significant clinical improvement for sciatica patients. Within 90 days patients experienced a dramatic reduction in symptoms and increased ability to return to their customary lifestyle.

Therapy

Exercises to Manage or Prevent Sciatica Pain Shooting Down Your Leg

Before starting your daily routine or preparing for a special occasion, take 15 minutes to prime your body for pain-free living. These simple stretches can not only help minimize or prevent sciatica pain, they also feel great. 

Figure 4 Stretch (Supine Glute Stretch)

  1. Lie on your back
  2. Bend your knees so that they are stacked above your hips and your shins are parallel to the floor
  3. Cross your right ankle over your left thigh and thread your right hand between your legs
  4. With your hands pull your left knee slightly towards you until you feel a stretch in your right glute
  5. Hold for 15-30 seconds
  6. Repeat on the other side
Exercise 2

Hip Flexor Stretch

  1. Use a blanket or pillow under your knee if necessary
  2. Lunge your right leg forward at a 90-degree bend and place your left knee on the pillow
  3. With your hands on your hips tuck your tailbone slightly down towards your back left foot
  4. Keeping that tilt in your hips lean forward towards your right knee
  5. You will feel a stretch in your back left thigh and hip crease
  6. Hold for 15-30 seconds
  7. Repeat on the other side
Exercise 3

Hamstring Stretch

Use a towel, strap, or long sleeve shirt to aid with this stretch.

  1. Lie on your back with legs straight and a pillow under your head if you’d like
  2. Lift your right leg until you can wrap a strap around your calf or ankle
  3. Straighten your right lifted leg as much as possible and begin to guide it closer to your face by pulling on the strap with both hands
  4. Your left leg, the one on the ground, can be bent if needed
  5. Move your hands closer to your leg along the strap so that your arms are straight, and your shoulders can relax
  6. Hold for 15-30 seconds
  7. Repeat on the other leg
Exercise 1

Which one will ease your pain most effectively? There’s no way to tell until you try them all. As you do these stretches, notice how your body responds, and then lightly adjust your position.  Pull your knees in a tiny bit more or a tiny bit less. Notice which movements help to release the pain.

How Active Therapies Help You Prevent Sciatica Pain Relapses

There is no one-size-fits-all exercise for people who have sciatic nerve pain, which is why there should be no one-size-fits-all chiropractic care plan. Your treatments and therapies should take your symptoms, health, lifestyle, and goals into consideration.  

You may get to a point where you know your body well enough to do more challenging exercises to manage your pain.  You may get to a point where you feel in control of your sciatica but be aware that anyone experiencing even mild sciatic nerve pain for more than a month should see a neuro-musculoskeletal specialist.  

What do you do when that (sciatica nerve) pain in the butt won’t go away? Anyone experiencing even mild sciatic nerve pain for more than a month should see a neuro musculoskeletal specialist.

Active therapies, in combination with regular adjustments as prescribed will usually help resolve intense pain. However, if you want to help prevent pain or misalignments from returning you should:

  • Take breaks from sitting every hour
  • Don’t carry heavy weight (those handbags, backpacks, and laptop bags) on your shoulders for long periods
  • Wear footwear that does not stress your hamstrings
  • Check in with your DC to ensure your musculoskeletal system is properly aligned

Ready to Manage or Prevent Sciatica Pain Shooting Down Your Leg?  

Check in with your nearest Chiro One doc at one of our welcoming open-plan clinics across the country. They’ll perform a thorough exam to investigate the root cause of your pain, then personalize your care plan — a combination of gentle chiropractic adjustments and active therapies so you can feel better longer.  Find a Chiro One doctor near you.

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