Chiropractic & Sciatica

Chiropractic & Sciatica

Chiropractic & Sciatica

Pain in the legs and lower back may be caused by compression of the sciatic nerve.

Learn more about how chiropractic and massage therapy can help relieve the pain of sciatica.





Articles on Sciatica Treatment


About Sciatica, Spinal Degeneration, and Radiating Pain

Sciatica Pain Relief: No drugs, No surgery!

Backaches are very common ailments affecting nearly 80% of adults at one time or another in their lives. Backaches can stem from compressed or herniated disks in the spine, muscle strains and a combination of these. Often times, excessive weight (especially abdominal weight) and improper lifting are to blame.

Sciatica and Piriformis Syndrome affect the sciatic nerve that begins at the sacrum and extends down both legs. In sciatica, the sciatic nerve is not being directly compressed, but the nerve roots at the base of the spine that connect with the sciatic nerve are being compressed. In piriformis syndrome, the piriformis muscle in the buttocks region is directly compressing the sciatic nerve.

In either case, the classic marker is shooting pain down one or both legs. Though surgery and drugs (anti-inflammatories and pain meds) are often used to treat back problems, there are other options. First, it is imperative that a person loses weight, strengthens abdominal muscles and learns to lift properly. This may be difficult, however, if pain is not relieved in another way.

This is where massage therapy for sciatica pain can enable a person to carry on with daily activities and begin the path towards weight loss and strengthening their body. Your massage therapist may begin by assessing the lower back and buttock area to see if the pain stems from compression in the lower back, sacral area or buttocks. They will then concentrate on the piriformis. At this point, the massage therapy will depend on your particular pain. Your therapist may use gentle vibrations or deep massage to relieve the pressure and pain.1

Your massage therapist can also give advice on exercises that you can do at home to relieve pain. For drug-free, surgery-free pain relief, contact a licensed massage therapist today!

1. Barrett C. Massage Therapy for Sciatica: How to Reduce Pain in the Sciatic Nerve

Chiropractic Can Be Effective Treatment of Work-Related Sciatica

Work-related sciatica is clinically challenging and an expensive problem for our health care systems. One recent study found that workers with sciatica are significantly more likely to be prescribed opioids for their condition.1 Another study found that workers with low back pain and sciatica showed the highest level of disability of all back pain patients.2

With these issues in mind, the orthopedic medicine department of a hospital in Norway has examined the effectiveness of chiropractic treatment with patients with severe sciatic pain. This new study3 looked at 44 workers who presented at the hospital with severe sciatic pain that required hospitalization. “The patients underwent clinical, neurologic, and radiological examinations as well as laboratory screening, including urine specimens, parameters of infection, and system diseases.”

The hospital chiropractor then performed a chiropractic examination on each patient that included an analysis of posture and gait, passive and active range of motion, and palpation of the lumbar spine. “The main treatment consisted of joint adjustment techniques of the lumbopelvic fixations, usually performed in a side posture position...Joint adjustments in other parts of the spine and limbs were usually necessary as a result of the compensatory dysfunction.” Ice treatment was applied after the adjustment, since there was soft-tissue soreness experienced by the patients.

“Patients were treated daily while they were in the hospital; they were treated for 3 days a week for the first 2 weeks while they were in the clinic. Depending on need, some patients received follow-up treatment once or twice a week for some time. Following Norwegian public health regulations, cost refunding is limited to 14 treatments; therefore, the total number of treatments rarely exceeded this number.”

The authors found the following:

  • All of the patients had experienced three or more weeks of pain before hospitalization.
  • 35 patients underwent MRI and 7 had CT scans; there were no structural changes on any of the imaging tests.
  • After the treatment, 40 patients (91%) returned to work full-time within an average of 21.1 days.
  • Two patients returned at reduced work levels: one at 80% and another at 50%.

“The positive effects of cooperation between orthopedic surgeons and chiropractors may be measured in the reduced duration of sick leaves.” The study refers to Norwegian public health records that show that the average patient with sciatica is disabled for 72 days; in this study, the time to return-to-work was just 21 days—a 70% reduction.

The authors point to how chiropractic can improve functioning in the spine:

Stimulation of “muscle spindles caused by sprain strain has been shown to be capable of starting a long-lasting train of action potentials in the motor neuron (i.e., long-lasting muscle contraction in the motor unit in question). Similarly, a brief inhibitory impulse, such as that from antagonistic muscles, may stop the signal train in the motor neuron. Chiropractic joint adjustment probably provides a similar inhibitory impulse. The chiropractic joint adjustments must cross the barrier of passive joint motion range to stimulate muscle spindle receptors.”

Stover BD, Turner JA, Franklin G, et al. Factors associated with early opioid prescription among workers with low back injuries. Journal of Pain 2006;7(10):718-25. 

Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.

Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.

Physiotherapy Eases Sciatica

According to analysis of a recent study, physical therapy sessions provide both immediate and long-term relief for patients with sciatica.

The research involved 165 patients with moderate or severe sciatic pain. They participated in physical therapy sessions for three months. Immediately after a PT session, 85 percent of patients reported reduced leg pain through centralization. Centralization happens when the radiating leg pain associated with sciatica retreats to the spine, where the pain originated, and is associated with a good prognosis in sciatica patients. In this study, researchers were investigating whether certain patients were more likely to experience centralization following a PT session.

The researchers concluded that because the majority of participants experienced centralization, physical therapy can reduce sciatic pain, regardless of the type of disc lesion causing pain. Following three months of physical therapy, all of the patients involved in the study reported a reduction in leg pain and improved ability to perform daily activities. Those who saw immediate centralization reported the most significant improvement, but even those who did not find immediate relief after one physical therapy session experienced long-term improvements in sciatica symptoms. All patients involved found that these benefits remained at a follow-up visit one year after the therapy sessions.

This study confirms that physical therapy reduces radiating leg pain for many patients, providing both short and long-term results.


Albert H, Hauge E, and Manniche M. Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions? European Spine Journal201; DOI 10.1007/s00586-011-2018-9.

Albert, Hanne and Claus Manniche. The efficacy of systematic active conservative treatment for patients with severe sciatica.: A single-blind randomized clinical controlled trial. Spine 2011; doi: 10.1097/BRS.0b013e31821ace7f.

Exercise Could Help Sciatica Patients Avoid Surgery

Studies on the efficacy of surgery for sciatica have produced conflicting results. An estimated 5-10% of patients that undergo microdiscectomy suffer from recurrent disc herniation after the operation. For patients undergoing another common sciatica surgery, lumbar laminectomy, 20-30% do not experience significant improvements in pain and function. Surgeries for sciatica also carry the risks of nerve root damage, infections,cerebrospinal fluid leakage, and more.

Recent research suggests that many sciatica patients could avoid the risks of surgery with exercise and chiropractic therapies. In a study published earlier this year in the journal Spine, Danish researchers tested the efficacy of active conservative treatment in patients who would normally qualify for surgery.

Half of the patients were assigned to perform symptom-targeted exercises while the other half were assigned sham exercises. The latter were designed to increase blood circulation but did not specifically target back pain. Patients were also advised to stay as active as possible without aggravating their leg pain.

By the end of the eight-week treatment, both groups had statistically and clinically significant improvements in pain, global assessment, functional status, and vocational status. But those in the targeted exercise group experienced substantially better outcomes. Although this isn’t the first study linking exercise with improved outcomes in sciatica patients, the findings confirm that surgery is not the only option for treating severe sciatica.

Previous research has also shown that patients with sciatic pain who may normally qualify for surgery could benefit from chiropractic care. In a 201o study comparing chiropractic adjustment to microdiscectomy , 63% of patients experienced substantial improvements with chiropractic treatments.


Albert HB and Manniche C. The efficacy of systematic active conservative treatment for patients with severe sciatica: a single-blind, randomized, clinical, controlled trial. Spine 2012; 37(7):531-42.

Drug-free Sciatica Treatment

Pain medication is frequently prescribed for patients with sciatica, but a new article from the prestigious British Medical Journal reveals that there may be little efficacy in this practice.



In the article, researchers reviewed 23 studies that compared placebo pills to various drugs typically prescribed for sciatica. In study after study, drugs were found to be no more effective than a placebo in relieving pain. Drugs also did not significantly help  radiating leg pain, one of the primary symptoms of sciatica. Though two drugs did reduce overall pain, it was unclear how effective they were in the long-term.

This led researchers to conclude that there is no clear evidence demonstrating the efficacy or tolerability of common pain medications prescribed for sciatica.

Chiropractic is a better approach to sciatica than drugs. A 2010 study found that chiropractic does not pose the same risks as surgery yet it is just as effective.

Call our office today for natural, effective treatment of sciatica.

McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics. 2010; 33(8): 576-584.

Pinto,Rafael Zambelli. Chris G Maher, Manuela L Ferreira, Paulo H Ferreira, Mark Hancock, Vinicius C Oliveira, Andrew J McLachlan, Bart Koes.Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis. British Medical Journal. 2012, February; 344:e497 doi: 10.1136/bmj.e497.

Drugs Ineffective for Sciatica Relief

The efficacy of common drugs for sciatica treatment has been called into question in a recent  literature review. Although there are consistent guidelines for prescribing medication for low-back pain, “this is not the case for sciatica.” To address this lack of clear guidelines, researchers analyzed the results of current literature on treatment for sciatica using non-sterodial anti-inflammatory drugs (NSAIDs).

After evaluating 23 studies, researchers concluded that there is no clear evidence demonstrating “favourable effects of NSAIDs, corticosteroids, antidepressants, or opioid analgesics in the immediate term [relief of pain] even compared with placebo.” That means that in many studies, drugs were no more effective than a placebo in relieving pain. Several drugs also did not significantly impact leg pain, one of the primary symptoms of sciatica. Though some NSAIDs and an anticonvulsant called gabapentin did reduce overall pain in the short term, the long-term effective  were unclear.

For long-lasting relief of sciatica pain, chiropractic care combined exercise may ultimately prove more effective by addressing the root cause of sciatic pain instead of simply easing symptoms.


    Rafael Zambelli Pinto, Chris G Maher, Manuela L Ferreira, Paulo H Ferreira, Mark Hancock, Vinicius C Oliveira, Andrew J McLachlan, Bart Koes.”Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis.” British Medical Journal. 2012, February; 344:e497 doi: 10.1136/bmj.e497.