The most common cause of true sciatica is a "slipped, prolapsed, twisted or bulging disc". The discs (or inter-vertebral discs) are the cushions which separate the bones of the spine (vertebrae).Sciatica may cause the sufferer to bend forward or sideways in an attempt to avoid further nerve compression (antalgia).
Chiropractors will perform chiropractic, orthopaedic and neurological tests. to determine the cause of the pain. In the case of acute, subacute and chronic low back pain treatment can be successful.
If symptoms persist or patients do not respond to treatment X-rays may be arranged. X-rays will detect curvatures in the spine and disc compression possibly from a protruding disc.
Back pain can lead to referred pain which is specifically nerve pain which may involve the posterior aspect of the thigh, calf or foot and which is caused by irritation or compression of the main nerve into the leg, the sciatic nerve. This pain may originate where the nerves pass through and emerge between the lower bones of the spine (lumbar vertebrae) or as the nerve passes through the Piriformis muscles in the pelvis. There may be numbness and weakness of the lower leg muscles and loss of reflexes. Also pressure may occur in the neck leading to pins and needles pain or numbness in the arm.
Low Back Pain
Sciatica is often combined with low back pain The order in which the symptoms appear may vary. Back pain often precedes sciatica and sometimes will follow. ‘.
Where examination indicates a very large disc prolapse with major neurological symptoms and signs an MRI scan may be requested and neurosurgical referral will be made without delay.