So you bent over in the morning to tie your shoe, felt a pop, and the next thing you know is you are limping, and the leg pain is intense. Our office sees many patients with pain called sciatica. What is sciatica? According to Wikipedia, “Sciatica is pain going down the leg from the lower back. This pain may extend down the back, outside, or front of the leg. Onset is often sudden following activities such as heavy lifting, though a gradual onset may also occur. The pain is often described as shooting. Typically, symptoms occur on only one side of the body; certain causes, however, may result in pain on both sides. Lower back pain is sometimes present. Weakness or numbness may occur in various parts of the affected leg and foot. This explanation is very broad; however, sciatica is often used to describe leg or hip pain by most patients. My sciatica, which is another common description, suggests that it happens periodically. It has been my professional experience that my sciatica is usually a sacroiliac problem rather than a disc-related one as sciatica is. Medical doctors often hear leg pain in the patient’s history, perform minimal evaluations and histories on the area of main complaint, and order an MRI first in many cases, which is the most overordered diagnostic test. Then the referrals begin with everyone looking at the patient’s back and the MRI findings. Often, these findings are unremarkable; at other times, in older patients, considerable degeneration or disc damage has occurred over time. A common misconception is that back and disc problems just happen. For an understanding of the motives behind this behavior, read my blog on RVUs. While injury does happen, the mechanics of the lower back are dependent on the hip, leg, ankle, pelvis, and the compensations that occur above the lower spine. The fascial system plays a large role in how we move, and one recent study supports my idea that the core and how it may malfunction and put stress through the lower back joints may play a larger role in most lower back and sciatic nerve problems. If any part of this system, from the ground up, is tight, dysfunctional, or not moving properly, back pain is a common complaint over time. The NY Times is right that movement relieves sciatic pain, no matter what type. Sitting often worsens it, and doing a poor evaluation and waiting for an MRI while the patient takes drugs have all proven to be ineffective, according to the Annals of Internal Medicine recommendations. Ever since the 2017 recommendations to avoid drugs and tests such as the MRI, medical providers continue to overprescribe these tests because they do not fully evaluate the patient and do not conduct a thorough history. They are then either sent to one-size-fits-all rehab, which rarely resolves the issue, or to a surgeon for their options. Nobody really cares for the patient as they are passed around. Perhaps this is why so many visit a chiropractor on their own, and they often feel better without drugs, surgeries or specialists. Patients then continue for years, having back episodes and referring to their MRI from years ago as the reason they hurt. You can further read the NY Times article below To Ease Sciatica, Keep Moving Why not see the chiropractor first for sciatic pain of any type? Chiropractic evidence-based care is extremely effective for sciatic pain and the many conditions that may cause it. Gait, also known as the way we walk, is one of the most common causes of the condition. Other common reasons include Old injuries or trauma to the back. Coccygeal pain Chronic back or even upper back pain. Assymetrical gait. Spinal stenosis Tight legs Poor flexibility Your initial visit includes a thorough holistic approach to evaluation and your history. Holistic is important because we look at everything. While we too use electronic records, the patient is evaluated from the ground up, and everything the doctor finds is explained to the patient in simply understood language. If an MRI is medically indicated, we will order one, but most of the time, our on-premises x-ray can determine most concerns quickly and cost-effectively. If patients have a gait imbalance, off-the-shelf foot orthotics can help reduce the pain immediately, and most patients can feel how they can walk better and even get out of their car with the improved leverage the orthotics provide. Chiropractors will place a patient on a trial of care for some visits, and most improve quickly. This eliminates the routine MRI, which may yield false positives for most sciatic and back pain because even the healthy population has these issues. Chiropractic flexion tables, such as the one in the above photo, are clinically proven to relieve and, in many cases, resolve disc pain and sciatic pain. Our offices have them, and we get great results. Who you decide first will determine your results, costs, and risks for sciatic pain. Seeing a chiropractor first improves outcomes, reduces chronicity, and eliminates unnecessary testing. If the patient does require tests such as an MRI, we order them as medically necessary following best practices. Have sciatic pain? Think chiropractic first. Book online or call either of our offices.