Chiropractic & Sciatica

About Sciatica, Spinal Degeneration, and Radiating Pain

MRI Unreliable For Diagnosing Sciatica

Sciatica is a relatively common medical condition, affecting an estimated 13-40% of people during their lifetime. The most common cause is a herniated disc. Magnetic resonance imaging (MRI) is frequently used to examine patients with sciatica symptoms and lumbar-disc herniation.

However, the link between MRI findings and clinical outcome is controversial. Several studies have shown a high rate of disc herniation in people who have no symptoms. This has led some researchers to question the value of MRIs for sciatica patients, given the high rate of MRI abnormalities found in patients with no pain. Abnormal MRI findings often result in invasive procedures such as surgical treatment or epidural injections, despite the debate over the value of MRI findings.

A recent study sought to add to the understanding of MRI imaging for sciatica patients. The study involved 283 patients, all of whom underwent MRI at the start of the study and after one year. The researchers assessed the MRI for visible disc herniation.

After one year, 84% of patients reported a favorable outcome. Disc herniation was visible in the MRI images of 35% of patients who reported a favorable outcome, and 33% with an unfavorable outcome.

Therefore, MRI assessment of disc herniation after one year did not appear to be effective at distinguishing patients with a favorable outcome and those with an unfavorable outcome. Further research is needed in order to fully assess the value of MRI in making clinical decisions for patients with persistent sciatica.


el Barzouhi A, et al. Magnetic resonance imaging in follow-up assessment of sciatica. New England Journal of Medicine 2013; 368(11):999-1007. doi: 10.1056/NEJMoa1209250.

Smoking Linked to Sciatica and Chronic Pain

New research suggests that smoking may increase your odds of developing chronic pain including sciatica. A study surveyed 6,000 Kentucky women who were asked about their experience with pain. Women reported suffering from chronic pain conditions including sciatica, fibromyalgia, nerve problems, and chronic pain in their lower backs, necks, and joints.

Daily smokers were the worst off of all participants; they were 104% more likely than non-smokers to have chronic pain. Occasional smokers were 68% more likely and former smokers were 20% more likely to experience chronic pain than non-smokers. In fact, daily smoking was more closely linked to chronic pain than other common factors like obesity, age, and lack of education.

Despite the strong link between chronic pain and smoking, researchers hesitated to draw conclusions just yet on whether smoking actually causes chronic pain. Researchers wondered whether smoking is a direct cause of chronic pain or if women started smoking in order to cope with pain. Although further research is needed, it is clear that safer methods of relaxation exist to treat chronic pain like chiropractic treatment, massage, and relaxation therapy.  A chiropractor can counsel you on safe methods of  treating and coping with sciatica pain.


Mitchell, Michael et al. “Associations of Smoking and Chronic Pain Syndromes in Kentucky Women.” The Journal of Pain 12.8 (August 2011): 892-899. Accessed October 10, 2011. doi:10.1016/j.jpain.2011.02.35.

Is Sciatica Worse for Women?

Women with sciatica are more likely to have a slower recovery rate than men with the same condition. In a recent study, 28% of women had unsatisfactory outcomes after one year of treatment, compared to just 11% of men. Patients with unsatisfactory outcomes suffered from higher pain and disability levels as well as slower recovery rates compared to other patients.

The researchers tracked the progress of 283 patients with severe sciatica. The patients were treated with surgery, conservative care, or a combination of both. By the end of the study, 83% of patients had recovered, reflecting the generally positive prognosis of sciatica. But 17% of patients were still experiencing severe pain, and the majority of those patients were women. Gender differences in recovery rate were not affected by the type of treatment patients received.

Previous studies have shown that women are also more likely to have chronic pain and disability from other musculoskeletal conditions. Research suggests that there are various biological and social factors that could play a role in these gender differences. Smoking and obesity have also been linked to sciatica and chronic pain in women.

Since most of the women in the study did recovery after one year, it’s important to remember that being female doesn’t guarantee a poor recovery. Still it’s crucial to take steps to prevent chronic pain with early treatment, exercise, and improved posture.



Peul W, Brand R, Thomeer R, and Koes B. Influence of gender and other prognostic factors on outcome of sciatica. Pain 2008;138: 180-191.

Inheriting the Risk of Sciatic Pain

Scientists have discovered a new risk factor for developing sciatic pain: your genes. Though scientists have suspected that genes play a role in sciatica, this study examines the impact of familial history on the risk of lumbar disc disease. The term lumbar disc disease refers to a set of spinal degenerative disorders that leads to sciatica characterized by  low-back pain and  radiating leg pain.

In the study, researchers analyzed records  from the Utah Population Database, which includes data dating back to early settlers. Using familial genealogy of 1264 patients, researchers were able to track the presence of lumbar disc disease over several generations. They found that having a close relative quadrupled your risk for lumbar disc disease. But if you’re parents didn’t have lumbar disc disease, you’re not off the hook: even having a distant cousin can elevate your risk.

Genetics isn’t the only cause of sciatica; mechanical stress on the spine, occupational loading, aging, and even smoking has been linked to sciatica. Learning whether you have a genetic risk of lumbar disc disease can help you take additional steps to prevent or minimize sciatic nerve pain.References

Patel, Alpesh. William Ryan Spiker. Michael Daubs, Darrel Brodke, and Lisa A. Cannon-Albright. “Evidence for an Inherited Predisposition to Lumbar Disc Disease.” The Journal of Bone and Joint Surgery. February 2011; 29(3): doi

The Effects of Sciatica on Your Muscles

Patients who suffer from sciatica are at risk for developing muscle atrophy. A recent British study found that patients with sciatica had decreased muscle mass, also known as muscle atrophy.

Muscle atrophy occurs in people that have a restricted range of motion due to an injury or medical condition. Developing atrophy can further reduce muscle strength and mobility. In patients with low-back pain, weakened muscles can cause patients to compensate in other ways leading to further injury.

That’s why it’s important to seek treatment for sciatica before it worsens. Unlike medications, chiropractic treatment actually addresses the cause of sciatica – an injury or disc herniation pinching the sciatica nerve. Chiropractors adjust and realign the spine to reduce pressure on the sciatica nerve, and in doing so, significantly relieve the pain. Chiropractic treatment, along with strong core and back muscles, is a powerful way to recover and prevent sciatica.


Ploumis A, Michailidis N, Christodoulou P, Kalaitzoglou I, Gouvas G, Beris A. Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease. British Journal of Radiology. November 2010.0: 58136533.

Feelings About Work and The Outcome of Lumbar Discectomy

Surgical decompression for prolapsed/herniated lumbar intervertebral disc is the most frequently performed spinal intervention. This recent study explored psychological assessments, in particular the psychosocial aspects of work, in predicting the outcome of lumbar discectomy. The authors also assessed general medical data and utilized MRI scanning to identify abnormalities. Their hope was that these varied assessments would help predict postoperative outcome and return to work status.

46 patients who had lumbar discectomy surgery were followed for two years. Before the operation the authors evaluated the patients' low back pain history, performed a physical, and ran the MRI examinations. All patients reported at least radicular leg pain. 27 patients had minor neurological deficits and 11 had major deficits.

Two years later, with questionnaires, the authors investigated the patients':

  • Work-related mental stress
  • Job Satisfaction
  • Job Resignation
  • Support Network at Work
  • Level of Pain Relief
  • Disability in Daily Activities
  • Return to "any" work
  • Surgical Outcome

The authors found that a high occurrence of job resignation, which is a feeling of dissatisfaction coupled with feeling forced to accept the job as it is, predicted disability in daily activities. Other significant predictors of disability and pain relief were MRI-identified nerve root compromise and neural compromise. The authors found that in most patients, the pain is likely to subside after resolution of the neurological problem. In cases where the irritation persists, however, "disc protrusion could be the initiating factor for low back and leg pain, but psychological factors might be more relevant in perpetuating pain."

Yet, psychological aspects—not physical findings—played a vital role in predicting return to work. Since occupational mental stress, job satisfaction, and depression were major predictors, the authors then considered working conditions, rather than low back pain, as influencing return to work status. They write:

"These findings indicate that patients with stressful work conditions do not tend to return to work even if the discectomy was successful from a surgical point of view. Improvements in working conditions, particularly from the psychological point of view, could play a significant role in the rehabilitation of a patient after discectomy, a finding which needs further attention and evaluation...Furthermore, this study highlights the importance of psychological aspects of work which should be taken more into account, in further research. It also implies that psychologically favorable working conditions may be an important preventive factor for chronic disability."

Schade V, Semmer N, Main C, Hora J, Boos N. The impact of clinical, morphological, psychosocial and work-related factors on the outcome of lumbar discectomy. Pain 1999;80:239-249.

What Causes Radicular Pain After an Auto Collision?

Radicular pain, or radiating pain, is caused by interference or pinching of the spinal nerves. This results in pain, tingling, or numbness in parts of your body far from the actual source of the problem.



If your spine is injured, there are a number of things that can affect the nerves.Injured ligaments and muscles can cause inflammation of the nerve root, which can disrupt the function of the nerve. If a spinal disk is damaged, it can cause the disk to bulge or herniate, pinching the nerve. And if the spinal joints begin to calcify, it can cause spinal stenosis, or a narrowing of the canal that the spinal nerves pass through.

All this can lead to a number of conditions such as sciatica, carpal tunnel syndrome, low-back pain, shoulder pain, and more. It's crucial to treat these conditions to prevent further nerve damage or worsening symptoms.

The key to treating radicular pain is to pinpoint its source in the spine. After determining the root of your pain, a chiropractor can relieve pressure on the impinged nerves. This allows the nerves to heal by reducing inflammation and irritation.

Multiple studies have confirmed the efficacy of chiropractic adjustments in alleviating radicular pain. If you're looking for a natural, effective pain relief, chiropractic could help. Call our office to learn more.


Christensen KD, Buswell K. Chiropractic outcomes managing radiculopathy in a hospital setting: a retrospective review of 162 patients. Journal of Chiropractic Medicine 2008; 7(3):115-25.

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.

Rodine RJ, Vernon H. Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index. Journal of the Canadian Chiropractic Association 2012; 56(1):18-28.