SCIATICA 

Sciatica can stop you in your tracks. The pain might be a deep ache in the buttock or a sharp, shooting sensation that runs all the way down the leg to the foot. Sitting, standing, walking and sleeping all become difficult, and it can be frightening when you don't know what's causing it.

Sciatica occurs when a nerve root in the lower spine is compressed or irritated. The most common cause is a lumbar disc herniation, but spinal stenosis, degenerative changes and even a tight piriformis muscle in the buttock can all be responsible.

Most people with sciatica recover without surgery. A New England Journal of Medicine study found that 80 to 90 percent improve within four to six weeks with conservative care, and a separate meta-analysis showed that disc herniations spontaneously resorb in roughly two-thirds of cases. A large BMJ Open study of over 11,500 patients found that those who received chiropractic manipulation had 31 percent lower odds of needing disc surgery within a year.

We see a lot of sciatica at our Sandton practice, and every case is different. Assessment starts with a thorough history and neurological exam, testing reflexes, strength, sensation and nerve tension to identify exactly which nerve root is involved. In most cases we can diagnose the problem clinically, but we can arrange imaging or specialist referrals when needed.

Treatment includes gentle spinal adjustments to take pressure off the affected nerve, soft tissue therapy for the surrounding muscles, and targeted rehab exercises to build stability and prevent recurrence. We tailor everything to the severity and stage of your condition. Acute sciatica needs a very different approach to a long-standing case.