Sciatica is not a disease in itself, but a symptom: irritation or compression of the sciatic nerve, usually from the lumbar spine. The pain radiates from the buttock through the leg, sometimes into the foot.
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What we do
First find the cause: a herniated disc? Stenosis? Piriformis syndrome? Then treat in a targeted way. For mild sciatica, chiropractic with targeted stretching exercises is enough. For persistent nerve pain, perineural injection therapy (PIT) can help: small doses of sugar water around the nerve are meant to calm the irritation. The research on this is still small. For sciatica related to a herniated disc, we follow our herniated disc protocol with spinal decompression.
Your recovery journey
Every course of treatment is tailored, but this is what a typical course looks like — from the first intake to recovery; how quickly that goes differs from person to person. You are not tied to anything and always know where you stand.
Nerve screening
We test the nerve with the straight leg raise test, check sensation and strength in the leg and rule out warning signs, such as problems with urination or bowel movements (cauda equina). Then we discuss the treatment.
Decompression + PIT
Decompression sessions 2-3 times a week. For superficial nerve irritation: Perineural Injection Therapy (Dordrecht). Radiance decreases.
Mobilization + exercise
Exercises that let the nerve glide smoothly, and strengthening the buttock muscles, which are often weak in sciatica. Walking becomes easier again.
Recovery
The radiating pain has eased. With exercises for your core muscles and posture advice, you can keep it up yourself.
How the investigation is going
Lying down, we test whether the nerve in your leg is stimulated, using the straight leg test, and we check your reflexes. We also examine the mobility of the back, pelvis and hips. You will always hear what we are researching and why.
Where you are treated
Examination and chiropractic care take place at our practice in Rotterdam. Injections are given by the doctors of our practice: PIT in Dordrecht. If a treatment in Dordrecht suits your condition better, we will discuss this with you.
Frequently asked questions
What is the difference with “normal” back pain?
Sciatica radiates INTO the leg; ordinary back pain remains in the back.
Can I exercise with sciatica?
Yes — walking and swimming help. Avoid heavy lifting and bending over.
Do painkillers help?
Painkillers can help with acute pain. Discuss with your doctor which medicine is suitable for you.
When to go to the ER?
Sudden loss of strength, urinary incontinence or numbness in the saddle area — these are red flags.
Does sciatica come back?
With exercises for your core muscles and good posture you reduce the chance that the complaint will return.
Sources
Independent information from Thuisarts.nl, the patient website of the Dutch College of General Practitioners (in Dutch).
