Sciatica Treatment Toronto
Sciatica is nerve pain that shoots from the lower back or buttock into the leg and sometimes the foot. It occurs when the sciatic nerve or one of the nerve roots that forms it becomes irritated or compressed.
At My Toronto Chiropractor Clinic, Dr. Leslie Horowitz has more than 34 years of experience examining and treating patients with sciatica.
Many cases of sciatica can be managed conservatively without drugs or surgery. Your examination helps determine the cause of your symptoms, whether chiropractic care is appropriate and which treatment options may be most suitable for you.
Depending on your examination findings, Dr. Horowitz may recommend one or more chiropractic treatments for sciatica which may include spinal manipulation or mobilization, PulStar® computerized multiple impulse therapy, soft-tissue therapy, ergonomic advice and individualized rehabilitative exercises.
What Is Sciatica?
The sciatic nerve is the largest nerve in the human body. It is formed by nerve roots from the lower lumbar and sacral spine. These nerve roots join together in the pelvis to form the sciatic nerve, which travels through the buttock and down the back of the leg.
Motor Innervation
The sciatic nerve and its branches carry motor signals that help control muscles in the thigh, lower leg and foot. These muscles are involved in movements such as hip extension and knee flexion during walking, and movements of the feet and toes. When these nerves are significantly affected, muscle weakness may occur.
Sensory Innervation
The sciatic nerve and its branches carry sensory information from the thigh, leg and foot back to the nervous system. With sciatica, an irritated or compressed nerve root can cause pain, numbness or tingling. The location of these symptoms can help identify which nerve root may be affected.
Symptoms of Sciatica
The areas where sciatica symptoms are felt depend on which nerve roots are affected.
- Pain that travels from the lower back or buttock into the thigh, leg, foot or toes on one side
- Sharp, aching, burning or electric-like pain along the path of the sciatic nerve
- Numbness or tingling in the leg or foot
- Symptoms that may worsen with prolonged sitting, standing, bending, coughing or sneezing
- Difficulty bending forward and standing straight up
- Muscle weakness in the affected leg or foot
Sciatica Treatment in Toronto
Treatment for sciatica may differ from treatment for uncomplicated low back pain and may include:
- Spinal manipulation
- Spinal mobilization using an Activator instrument
- Computer-assisted spinal mobilization using the PulStar® computerized multiple impulse probe
- Electrical modalities, including ultrasound, interferential current and muscle stimulation
- Deep shiatsu-style soft-tissue therapy
- Postural retraining
- Ergonomic advice and education about spine-sparing strategies to help avoid movements and positions that may aggravate an injured disc
- Spine and core stabilization exercises
- Home rehabilitative exercises
- Cognitive-Behavioural Activation (CBA)
The goal of treatment is to reduce pain and irritation, improve spinal and joint movement, reduce muscle tension and help you return to your normal daily activities as quickly and safely as possible. Knowing which movements, exercises and positions may aggravate your condition can be just as important as knowing what to do during your recovery.
Sciatica Examination in Toronto
A thorough examination is important because leg pain, numbness, tingling and weakness can originate from various spinal conditions and a clear diagnosis is important for appropriate and timely treatment.
Your examination will include an assessment of your posture, overall spinal ranges of motion and segmental spinal movements as well as areas of pain or tenderness. Dr. Horowitz uses neurological and orthopedic testing to assess nerve function, muscle strength, sensation and reflexes in the legs. These findings can help identify which nerve root may be affected.
Based on your history and examination findings, Dr. Horowitz will form a diagnosis and determine whether chiropractic treatment is appropriate. If additional diagnostic information is needed, Dr. Horowitz will send you for X-rays or may refer you for further diagnostic imaging.
Spinal Manipulation and Mobilization for Sciatica
Spinal manipulation or mobilization may be used to treat sciatica when you have spinal vertebral segments in your lumbar spine or pelvis that are not moving properly.
The technique selected depends on your unique examination findings, your bone density, medications you may be taking and/or other factors.
Treatment is modified according to how you respond to care and your comfort with a given modality.
Goals of Treatment:
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Reduce pain
- Improve spinal and joint movement
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Provide strategies that may help reduce future aggravation
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Help you return to normal activities and work as soon as possible
PulStar® computerized multiple impulse therapy provides spinal mobilization without placing your body in a twisted position or using higher forces that may be used with some forms of manual manipulation. PulStar® provides a lower-force treatment option for patients who prefer or need an alternative to manual manipulation.
What Causes Sciatica?
- Lumbar disc herniation — a herniated disc can irritate or compress a spinal nerve root through mechanical pressure and inflammation.
- Degenerative changes in the lumbar spine — osteoarthritis affecting facet joints and degenerative disc disease can contribute to narrowing of the neural foramina where spinal nerves exit the spine.
- Lumbar spinal stenosis — narrowing of the spinal canal or other spaces around the nerves can compress or irritate nerve roots.
- Spondylolisthesis — forward movement of one vertebra relative to another can contribute to narrowing around a nerve root.
- Piriformis-related sciatic nerve irritation — the sciatic nerve may occasionally become irritated or compressed in the buttock due to pressure from the piriformis muscle.
- Tumours or other space-occupying lesions — these are uncommon causes but can sometimes affect the nerve roots or sciatic nerve.
Some people, particularly as they age, may have more than one condition contributing to their symptoms at the same time. This is one reason a thorough examination is important for establishing a diagnosis and determining the most appropriate treatment.
Risk Factors for Sciatica
Several factors may increase your risk of developing conditions that can cause sciatica:
- Age-related changes — As you age, the discs in your spine gradually lose water content, and the spinal joints may develop degenerative changes that can contribute to narrowing around the nerve roots.
- Previous injury or trauma — Previous injuries to your lower back, including those related to sports, work or other trauma, may contribute to spinal conditions associated with sciatica.
- Work and physical activities — Repeated lifting, bending, twisting and other forms of heavy physical work are associated with an increased risk of low back pain and degenerative changes in the lumbar spine.
- Prolonged sitting — Sitting for long periods, including prolonged driving, may aggravate the lower back and sciatic symptoms in some people.
- Anatomical and hereditary factors — The structure of your spine and inherited factors may increase your susceptibility to some spinal conditions and lead to sciatica
When to Seek Immediate Medical Attention for Sciatica
Most cases of sciatica do not require emergency treatment. However, severe or prolonged compression of a nerve can sometimes result in permanent nerve and muscle damage, including persistent numbness or muscle weakness.
Seek immediate medical attention if you develop:
- Loss of bowel or bladder control
- Numbness or loss of sensation around the buttocks, genitals or inner thighs
- Severe or sudden weakness in one or both legs
Book a Sciatica Examination in Toronto
If sciatica is interfering with walking, sitting, working, sleeping, exercising or your everyday activities, a chiropractic examination can help determine the cause of your symptoms and which treatment options may be appropriate for you.
Have questions before booking? Visit our Frequently Asked Questions or Fees & Appointments pages for more information.
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