Sciatica and Low Back Pain: How Chiropractic Care May Help

Sciatica and Low Back Pain: How Chiropractic Care May Help

Low back pain is one of the most common reasons people seek healthcare, and when that pain begins traveling into the buttock, hip, or leg, many patients immediately wonder:

“Do I have sciatica?”

At Moreland Chiropractic Clinic in Rolla, Missouri, low back pain and sciatica are conditions I have evaluated and treated throughout more than 30 years in chiropractic practice.

One of the most important things I tell patients is that sciatica is not simply another name for low back pain. Sciatica generally refers to symptoms involving irritation or compression of nerve roots that contribute to the sciatic nerve.

Understanding what is causing the symptoms is an important first step toward determining the appropriate treatment.

What Is Sciatica?

The sciatic nerve is the largest nerve in the human body. It originates from nerve roots in the lower spine and travels through the buttock and down the leg.

When one or more of these nerve roots become irritated or compressed, symptoms may include:

Low back pain

Buttock pain

Pain traveling down one leg

Burning or electric-like pain

Tingling or “pins and needles”

Numbness

Leg or foot weakness

Pain aggravated by sitting, bending, coughing, or certain movements

Some patients have significant low back pain along with their leg symptoms. Others may have surprisingly little back pain but considerable pain traveling down the leg.

That distinction matters because not every case of low back pain is sciatica, and not every pain traveling into the leg is necessarily caused by the sciatic nerve.

What Causes Sciatica?

There are several possible causes.

Lumbar Disc Problems

Between the vertebrae of your spine are intervertebral discs that act as cushions and help allow normal spinal movement.

A disc can become irritated, bulge, protrude, or herniate. Depending upon its location and severity, a disc problem can irritate a nearby spinal nerve root and produce pain that travels into the leg.

Degenerative Changes

As we age, the discs and joints of the lumbar spine naturally change.

Degenerative disc disease, arthritic changes, and narrowing around the spinal nerves may contribute to low back pain or nerve irritation.

Spinal Stenosis

Spinal stenosis means there is narrowing within areas of the spine through which the spinal cord or nerves travel.

Lumbar spinal stenosis becomes more common as people age and can sometimes produce leg pain, numbness, heaviness, or weakness, particularly during standing or walking.

Other Causes of Leg Pain

This is where a proper examination becomes especially important.

Hip disorders, muscle problems, vascular conditions, peripheral nerve problems, sacroiliac disorders, and other medical conditions can sometimes produce symptoms that resemble sciatica.

Treating the symptom without first considering its cause is not good healthcare.

Do You Always Need an MRI for Sciatica or Low Back Pain?

No.

Patients are sometimes surprised when I tell them that an MRI is not automatically necessary simply because their back hurts.

Current clinical guidelines recommend against routine imaging for uncomplicated low back pain and sciatica in a nonspecialist setting. Imaging becomes more appropriate when the results are likely to change treatment or when the history or examination raises concern about a more serious condition. [1]

That is why a good history and physical examination remain so important.

Depending upon the patient's symptoms, examination may include evaluating:

Spinal motion

Posture

Muscle strength

Reflexes

Sensation

Orthopedic tests

Neurological findings

The location and pattern of pain

When imaging or additional medical evaluation is indicated, I believe it should be obtained.

How Can Chiropractic Care Help Low Back Pain and Sciatica?

Chiropractic care is not simply about “popping” someone's back.

The goal should be to determine what structures may be contributing to the patient's symptoms and then develop an appropriate conservative treatment plan.

Depending upon the patient's condition, chiropractic management may include spinal manipulation or mobilization, gentle manual techniques, exercise, activity modification, stretching, and recommendations for improving spinal mechanics.

Clinical guidelines recognize manual therapy, including spinal manipulation and mobilization, as an option for managing low back pain with or without sciatica when used as part of a treatment program that includes exercise. [1]

That last part is important.

I don't want patients to become dependent upon treatment.

My goal is to help patients move better, function better, and give them tools they can use outside my office.

Cox Flexion-Distraction for Low Back and Disc Problems

One technique I frequently use in my Rolla chiropractic office is Cox Flexion-Distraction.

Flexion-distraction is a gentle, controlled chiropractic technique performed on a specialized treatment table. Instead of relying solely on a traditional high-velocity adjustment, the technique allows the lumbar spine to be treated through controlled movement and mobilization.

I often consider this approach for patients with conditions such as:

Low back pain

Sciatic-type symptoms

Lumbar disc problems

Degenerative changes

Restricted lumbar motion

No single technique is appropriate for every patient. Treatment should be selected according to the patient's history, examination findings, age, health status, and individual condition.

Exercise Is an Important Part of Low Back Pain Treatment

One of the biggest changes in the management of back pain over the years has been moving away from prolonged rest.

For most uncomplicated cases, current recommendations encourage people to remain active and gradually return to normal activities. Exercise is also an important component of managing many cases of low back pain and sciatica. [1]

That's why I frequently give my patients specific home recommendations.

Depending upon the condition, these may involve:

Core stabilization

Gentle mobility exercises

Stretching

Postural correction

Proper lifting techniques

Ergonomic changes

Gradual return to activity

What you do between office visits can be just as important as what happens during treatment.

Sitting May Be Part of the Problem

Modern life isn't particularly friendly to the lower back.

Many people spend hours sitting at a desk, driving, working on a computer, or looking at a phone.

Prolonged sitting can aggravate certain types of low back and sciatic pain, particularly in patients with disc-related symptoms.

I often encourage patients who sit for extended periods to change positions regularly, get up and walk periodically, pay attention to workstation ergonomics, and avoid remaining in one position for hours at a time.

For some patients, a few small changes made consistently throughout the day can make a significant difference.

When Is Back Pain More Serious?

Most episodes of low back pain are not caused by a dangerous medical condition. However, there are times when back pain requires additional or urgent medical evaluation.

Guidelines emphasize considering alternative diagnoses when patients develop new or changing symptoms and evaluating for conditions such as trauma, infection, cancer, or inflammatory disease when clinically appropriate. [1]

Seek prompt medical evaluation for symptoms such as:

New loss of bowel or bladder control

Significant or rapidly progressing leg weakness

Numbness around the groin or saddle region

Severe pain following significant trauma

Fever or signs of infection associated with back pain

Unexplained weight loss

A history of cancer with new unexplained back pain

Severe or rapidly worsening neurological symptoms

New bowel or bladder dysfunction associated with neurological symptoms is particularly important and warrants urgent medical attention. [2]

Good chiropractic care includes knowing when chiropractic treatment is appropriate—and when a patient needs to be referred for additional medical evaluation.

Does Sciatica Always Require Surgery?

No.

Many patients with low back pain and sciatica can initially be managed conservatively, depending upon the cause and severity of their condition.

Surgical evaluation becomes more important when significant neurological deficits are present or when persistent sciatica has not improved with appropriate nonsurgical treatment and imaging findings correlate with the patient's symptoms. [1]

My philosophy has always been straightforward:

Start conservatively when it is medically appropriate, monitor the patient's progress, and refer when the condition requires something beyond conservative chiropractic care.

Looking for a Chiropractor for Sciatica or Low Back Pain in Rolla, Missouri?

If you are searching online for a “chiropractor near me,” “sciatica treatment near me,” “low back pain chiropractor,” or “chiropractor in Rolla MO,” the most important thing isn't simply finding the closest office.

You want someone who will take the time to determine why you are hurting.

I am Dr. David J. Moreland, DC, CCSP, a Certified Chiropractic Sports Physician with more than 30 years of experience treating musculoskeletal conditions.

At Moreland Chiropractic Clinic in Rolla, Missouri, my approach to low back pain and sciatica emphasizes careful evaluation, appropriate chiropractic treatment, gentle techniques when indicated, home exercise, and helping patients return to normal activity.

I also believe strongly in working with a patient's primary care physician or other healthcare providers when their condition requires additional testing, imaging, medication management, injections, or surgical consultation.

Low Back Pain Doesn't Have to Control Your Life

Whether your back pain began yesterday or has bothered you for months, understanding the source of the problem is the first step.

If you're experiencing low back pain, sciatica, buttock pain, or pain traveling down your leg, contact Moreland Chiropractic Clinic in Rolla, MO to schedule an evaluation.

Feel Better, Live Better.

References

National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). Recommendations include self-management, remaining active, exercise, and consideration of manual therapy as part of a treatment package that includes exercise.

National Institute for Health and Care Excellence (NICE). Suspected neurological conditions: recognition and referral. Guidance addresses neurological warning signs, including new bowel or bladder disturbance associated with radiculopathy.

National Institute for Health and Care Excellence (NICE). Low back pain and sciatica: the care you should expect. Patient guidance addressing evidence-based assessment and management of low back pain and sciatica.