Sciatica is a fairly common form of back-related pain that is sometimes confused with other, more general types of back pain. However, the two terms are not equivalent. General back pain is a much broader concept. Sciatica is a very specific type of the former. Because of this, managing one or the other may require different methods and techniques.

Chiropractors in Anchorage here at Better Health Alaska often see patients who are unsure if their back pain is sciatica or not. Fortunately, we, as experts of the musculoskeletal and nervous systems, are well-suited to help clear up this confusion.

So, let’s dig in and cover some of the highlights of this question.

What Is Sciatica?

Many people have heard the term “sciatica,” but not everyone knows what it means. By definition, sciatica is the pain caused by irritation or compression of the sciatic nerve. Typical symptoms include radiating pain down one leg as well as numbness, tingling, and/or weakness in that leg. 

In some situations, sciatica affects both legs. Many times, it evolves by having its symptoms progress down the affected leg or legs. That is, pain may start in the hip, but over time, it may progress down to the thigh, then the knee, and so on.

As far as medical conditions go, it is not uncommon. 

In fact, a systematic review from PubMed on the National Library of Medicine website states that the prevalence of sciatica in the general population ranges from 2 to 5%, and as high as 43% in certain cohorts of the working population.1 

Like other places, Anchorage, AK has its fair share of sciatica and back pain patients, too. And here, at our chiropractic clinic, Better Health Alaska, we have the skills and training to treat both.

What Is Regular (Nonspecific) Back Pain?

In contrast to sciatica, regular back pain, or nonspecific back pain as it is technically called, refers to localized pain in the lumbar spine (the lower spine without radiating leg symptoms. It is usually caused by muscle strain, poor posture, or one of several types of degenerative changes such as arthritis or DDD (degenerative disc disease).

The 2000 UK guideline, cited by a systematic review by PubMed (on the National Library of Medicine website) – and challenged by that same review – states that “90% [of acute low back pain cases] will recover within six weeks.” However, in contrast to that estimate, that same review found that most cases resolve within a single month.2 

Regardless, much like sciatica, many cases of regular back pain can be dealt with through conservative means.

Key Differences: Sciatica vs. Regular Back Pain

There are several key differences between sciatica and regular back pain. They are as follows: 

1. Pain Location:

  • Sciatica: This is typically denoted by pain radiating down the buttock, the leg, and sometimes even the foot..
  • Back pain: In cases of nonspecific back pain, the pain usually stays in the lower back region and does not progress elsewhere.

2. Type of Pain:

  • Sciatica: Sciatica usually causes a sharp, electric, burning sensation.
  • Back pain: Pain associated with nonspecific back pain is usually dull, achy, and stiff.

3. Neurological Symptoms:

  • Sciatica: The neurological symptoms associated with sciatica are usually sensations of numbness, tingling, or even weakness in the legs.
  • Back Pain: In contrast, back pain usually doesn’t involve associated nerve symptoms.

4. Aggravating Factors:

  • Sciatica: Sciatica usually worsens in the presence of coughing and sneezing or sitting for prolonged periods of time. In fact, a study on PubMed found that “Worsening of leg pain during coughing, sneezing, and straining has a significant diagnostic value for the presence of nerve root compression and disc herniation on MRI in patients with sciatica.”3 
  • Back Pain: Back pain, however, gets worse after heavy lifting or twisting as well as in people with poor posture.

Most Common Back Pain Conditions in Anchorage Residents

Many people in the Anchorage area suffer from back pain. Here at our chiropractic clinic in Anchorage, we’ve seen many different types of common back pain conditions through the years. Here is a brief list of the most common.

a. Herniated Disc

Although it can occur anywhere in the spine, herniated discs are the leading cause of sciatica. They involve a rupture in a spinal disc so that the inner gel like fluid of the disc leaks out and possibly irritates a nerve.

b. Spinal Stenosis

This refers to a narrowing of the spinal canal – the spinal “tunnel” through which the spinal cord passes. It often results in nerve compression in older adults.

c. Sacroiliac Joint Dysfunction

Also called SI Joint Dysfunction, this condition refers to pain that results from abnormal movement from one or both of the SI joints – joints that connect the pelvis to the base of the spine. It is characterized by localized low back/hip pain.

d. Degenerative Disc Disease

Also abbreviated as DDD, this condition refers to the general wear and tear associated with simply the passage of time. As people get older, their joints, discs, and other spinal structures weaken and degrade. This causes certain age-related changes including pain.

e. Muscle Strains

This condition refers to a simple tear in a muscle or other damage that results from stretching the muscle too far. It is common in labor-intensive jobs such as in the oil industry, the military, or construction.

Of all these conditions, the one most commonly linked to sciatica is the herniated disc. A herniated disc can occur anywhere along the spine, and aggravate any nerve nearby. In cases of sciatica, however, one of the lower lumbar discs has extruded enough material to reach and aggravate the sciatic nerve. 

Although there are other potential causes of sciatica, according to a study by PubMed on the National Library of Medicine website, “In about 90% of cases sciatica is caused by a herniated disc with nerve root compression, …”4

How Chiropractors Diagnose the Difference?

Here at Better Health Alaska in Anchorage, our team of expert chiropractors, led by our founder, CEO, and chief chiropractor, Dr. Brent Wells, is well-trained to tell the difference between sciatica and other types of back pain. It starts with your first appointment.

One of the first things we’ll do is take a patient history. Basically, we’ll start by looking at the onset of the condition – that is, how and when it started. Then, we’ll see if we can find any triggers for the pain (like the coughing or sneezing we mentioned above) or any other pain patterns that might give us more information.

After the history, we’ll do a physical exam. This involves neurological testing as well as testing reflexes, strength, and mobility. One sciatica-specific test is the Straight Leg Raise Test or SLR Test. If your chiropractor suspects sciatica, he/she will likely give you that test to see if it confirms his/her suspicions or not.

Additionally, multiple imaging tests can be run, like MRIs or X-rays. These are usually employed in cases where the symptoms are severe or persistent.

Finally, your Anchorage chiropractor will perform a chiropractic assessment. Look at spinal alignment, posture, and nerve interference. From there, he/she will make an assessment and render a diagnosis.

Treatment Options

Because sciatica and regular back pain are two different diseases, they are normally treated differently. Here is a brief overview of the treatment options commonly used for each condition that sets the two of them apart:

Sciatica

The goal here is to eliminate the irritation of the sciatic nerve.

I. Chiropractic adjustments: these serve to realign the spine reducing pressure on herniated discs.

II. Spinal decompression: this reduces pressure on the discs in the spine

III. Physical therapy & nerve mobilization: this is intended to restore function and reduce pain in nerves by alleviating irritation

Regular Back Pain

The goal here is to eliminate the underlying cause of the pain which many be one of several things.

I. Chiropractic care: this will entail both chiropractic adjustments as well as mobilizations.

II. Exercise therapy & core strengthening: stronger muscles make it easier for the body to maintain better posture and keep your spinal alignment natural and healthy.

III. Ergonomic corrections: this involves incorporating better furniture and tool use in your workspace. For example, you may be advised to use a standing desk rather than a sitting one to alleviate pressure on your lumbar spine.

Regardless of whether the patient is suffering from sciatica or regular back pain, the conservative treatment options mentioned above are usually sufficient to address the problem. Here at our chiropractic clinic in Anchorage, Better Health Alaska, we’ve been treating both these conditions for many years. 

With respect to the science of the matter, a study from the Spine Journal published on ScienceDirect, found that “Active [chiropractic] manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion.”5 

Additionally, a systematic review from the Annals of Internal Medicine, published on the ACP Journals website found that “Exercise therapy … may improve pain and function in chronic nonspecific low back pain.”6 

Rest assured that, in the majority of cases, heavy-duty measures like surgery, for example, are not needed. However, there is, of course, the occasional exception.

When to Seek Immediate Care

When nerves are irritated long enough and strongly enough, it is possible for permanent nerve damage to develop. That is a very bad thing. There are several signs that you should seek immediate medical care. These include:

  • Loss of bladder/bowel control: sometimes sciatica affects the nerves that control your bladder or bowels. This requires immediate redress.
  • Severe leg weakness: this is another issue that must be dealt with immediately.
  • Pain is worsening in spite of conservative care: if you are receiving conservative care (like regular chiropractic sessions or physical therapy), and the pain continues to get worse, it may be time to look into more potent remedies.

Generally speaking, if you suspect you have sciatica or even just regular back pain, seeking out some form of medical treatment is usually a good idea. Just realize that there is always a possibility that the condition is more severe than it at first appears. So, don’t delay seeking out the necessary help.

Anchorage Lifestyle Connection

Of the many factors that contribute to the presence and prevalence of any disease, one often cited is the environment in which the patient lives. Here, in Anchorage, AK, we know how significant an influence a rough environment can be.

Anchorage residents face many unique risk factors that people elsewhere do not. First, we have a number of adventurous outdoor activities that can pose a significant challenge. These include: hiking and skiing, among other things. 

There are also occupational risks. Many people in the Anchorage area work in the oil industry, the military, and the fishing industry. These are all industries in which heavy lifting and/or prolonged standing are common.  

Last, of course, is the cold climate. It can cause muscle stiffness and can lead to an increasing risk of back pain flare-ups.

Conclusion 

Although sciatica is a form of back pain, not all back pain is sciatica. Understanding the difference is key to living a quality life while coping with sciatica – or back pain, for that matter. Chiropractors, like those here at our Anchorage chiropractic clinic, are experts in the musculoskeletal system and are well-suited to diagnosing and helping patients manage both conditions safely. 

So, if you are suffering from sciatica or back pain, and live in the Anchorage area, don’t wait. Reach out and contact Better Health Alaska’s chiropractic clinic. Your back and body will thank you for it!

Sources and Studies:

  1. Giménez-Campos MS, Pimenta-Fermisson-Ramos P, Díaz-Cambronero JI, Carbonell-Sanchís R, López-Briz E, Ruíz-García V. A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain. Aten Primaria. 2022 Jan;54(1):102144. doi: 10.1016/j.aprim.2021.102144. Epub 2021 Oct 9. PMID: 34637958; PMCID: PMC8515246. 
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8515246/ 
  2. Pengel LH, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. BMJ. 2003 Aug 9;327(7410):323. doi: 10.1136/bmj.327.7410.323. PMID: 12907487; PMCID: PMC169642.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC169642/
  3. Verwoerd AJH, Mens J, El Barzouhi A, Peul WC, Koes BW, Verhagen AP. A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI. Eur Spine J. 2016 May;25(5):1389-1392. doi: 10.1007/s00586-016-4393-8. Epub 2016 Feb 2. PMID: 26842881.
    https://pubmed.ncbi.nlm.nih.gov/26842881/ 
  4. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007 Jun 23;334(7607):1313-7. doi: 10.1136/bmj.39223.428495.BE. PMID: 17585160; PMCID: PMC1895638.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC1895638/ 
  5. Valter Santilli, Ettore Beghi, Stefano Finucci, Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations, The Spine Journal, Volume 6, Issue 2, 2006, Pages 131-137, ISSN 1529-9430, https://doi.org/10.1016/j.spinee.2005.08.001.
    https://www.sciencedirect.com/science/article/abs/pii/S1529943005008338 
  6. Jill A. Hayden, Maurits W. van Tulder, George Tomlinson. Systematic Review: Strategies for Using Exercise Therapy To Improve Outcomes in Chronic Low Back Pain. Ann Intern Med.2005;142:776-785. [Epub 3 May 2005]. doi:10.7326/0003-4819-142-9-200505030-00014
    https://www.acpjournals.org/doi/abs/10.7326/0003-4819-142-9-200505030-00014