Back pain is frequently accompanied by pain radiating in to the  buttock and above the knee. In severe cases it can extend below the  knee into the foot. Precise diagnosis, of the cause of leg pain is  difficult due to a multiplicity of, causes. First. it can be due to  referral from structures of the spine and pelvis, such as facet,  sacroiliac joints, spinal ligaments, and muscles. This type of pain is  characterized by a diffuse ache. Second, impingement of the nerve roots  which join to form the sciatic nerve. by mechanical means is possible  (e.g.. disc bulge, muscular tension, bony architecture. etc.) or by  swelling secondary to inflammation. If the nerve roots are affected the  pattern of pain usually follows specific derma tomes, and may be  accompanied by one or more neurologic symptom’s. These two causes may  occur concomitantly, creating a confusing clinical picture. While  special examinations such as electro diagnostic tests and imaging  studies may be helpful in making a diagnosis, they are not always  definitive and require close correlation with clinical findings.

Despite reports of effectiveness for treatments such as bed  rest, surgery, exercises, injections, physical therapy modalities and  chiropractic manipulation, no standard approach is recognized in the  profession. This is not surprising since it has been estimated that 80%  of patients with painful sciatic radiation are said to recover in within  3 months. (1) Few reports are available documenting cases and long term  follow-up with standard outcome measures (e.g., Oswestry disability  questionnaire[OLBQ], visual analog scale, or orthopedic tests). (2) This  study presents a case of chronic sciatica treated by mechanical force,  manually assisted short lever adjusting, high voltage electrotherapy and  a video assisted, home stretching program documented with common, easy  to use, outcome assessment tools over a period of two years.

Reference: Paul J. Osterbauer. D.C., Arlan w. Fuhr. D.C.  Activator Methods Inc. Phoenix, Arizona; Proceedings of the  California Chiropractic Foundation’s 293 7th Annual Conference on  Research and Education , Palm Springs , CA , June 19-21, 1992, pp. 293-5.