The sciatic nerve is the largest nerve in the body. It is so large that it has its own blood supply! It starts all the way up at the 4th lumbar vertebra in your lower back and has multiple branches that come through what is called the sacral plexus. This nerve supplies your hamstrings and all the muscles in the leg and foot, as well as the skin in these areas. Due to the location of the sciatic nerve, it can become “pinched” and cause a condition known as sciatica. Sciatica is pain going down the leg caused by pressure on the sciatic nerve. This pain can be in the hip, buttocks, down to the knee, and even all the way down to the toes. It can be a dull pain or excruciating pain, and typically goes hand in hand with lower back pain. The pain can be on either side or affect both sides.

How does this happen? There are two reasons why. One is the piriformis muscles. The sciatic nerve comes right under, over, or sometimes even through the piriformis muscle. If we have a tight or inflamed piriformis, it can put pressure on the sciatic nerve, causing sciatica. The second reason is compensations in the spine. When the spine is compensated, usually presenting as an abnormal curve, it can put pressure on the nerve roots of L4 and L5 (where the sciatic nerve starts) causing sciatica.

A chiropractor can help with this problem. As an upper cervical chiropractor, I get to the root cause of the sciatica. By adjusting, or correcting, the top bone in the neck, we can reshape the spine to take pressure off the sciatic nerve, helping to eliminate the sciatica. Sciatica is one of the most common conditions I see in my office, and I hear it all the time, “How can correcting the top bone in my neck help my low back and legs?” Let me explain.

The top of the neck is your body’s balance center. When the top bone in your neck misaligns to either side, it makes the head and brain unlevel. The brain must always be level due to something called the righting reflex. When the top bone in the neck misaligns from some type of trauma (car accident, slip and fall, sports injury, chronic desk work, etc.), it causes the head to tilt, making the brain unlevel, causing the righting reflex to kick in. This reflex forces the spine to contort, or compensate, with the sole purpose of balancing the brain. Over time, these compensations put pressure on certain areas, including the low back and hip.

The compensations from the misalignment at the top of the neck turn into weak spots, and these weak spots put pressure on the sciatic nerve. A hip can be a weak spot, causing a tight or inflamed piriformis. This is exactly why sciatica happens and why, when we see patients with low back pain and sciatica, we get them the relief they need. We address the cause and not the effects.