The sciatic nerve originates at the bottom of the spine, running out of the lower lumbar and sacral areas through the buttocks to the legs. Pain in the sciatic nerve is referred to as sciatica.

Sciatica is a common problem. I see patients who suffer from sciatic nerve pain on a near-daily basis. Many experience pain along the entire trajectory of the sciatic nerve, ending in the ankle or foot. The pain from sciatica is asymmetrical; it presents on either the left or the right side of the body, never on both sides.

The most common cause of sciatica is spinal stenosis — the narrowing of the lumbar or sacral spinal canal, which pinches the sciatic nerve.

Degenerative disc disease — in which the lower lumbar discs collapse on one another and pinch the sciatic nerve — is another common cause of sciatica.

Other reasons for sciatic nerve pain include injury, inactivity, and muscle spasms that cause a pinching of the nerve.

I’ve found spinal manipulation very helpful for patients with sciatica. This is particularly true for those suffering from acute sciatica, but it can even be helpful for those with chronic, long-term sciatica.

Oftentimes, one adjustment of the lower spine is all that is needed to free up the sciatic nerve. But in other patients, it’s not that easy.

Chiropractors have extensive training in spinal manipulation. A good chiropractor can be essential for helping a person overcome sciatica. But like other physicians, not all chiropractors have the same skill sets. As with all professions, there are good chiropractors and not-so-good chiropractors.

Osteopaths are also trained in spinal manipulation techniques, but few osteopaths use osteopathic manipulation treatment (OMT) in their practices.

Once again, if you need spinal manipulation, it is important to find an osteopathic physician who regularly performs OMT in his or her practice. I work closely with skilled osteopaths who help my patients with musculoskeletal problems.

I’ve found that the root cause of sciatica is often simple dehydration. The discs that line the spine are very sensitive to a person’s hydration status. Many sciatica patients can resolve their pain just by rehydrating with water.

In fact, one of the best initial treatments for any type of back pain is to drink water. Hydration also helps in cases of herniated discs, injuries, and spondylolisthesis.