Overview
Sooner or later, almost everyone will hear the term “sciatica” or “sciatic nerve pain” and will learn that somehow these terms relate to back pain. However, not all back issues can be categorized as sciatic nerve pain. It is very important for anyone experiencing back pain to receive a proper diagnosis in order to find the treatment(s) most helpful for their specific condition. In this post, we will define what the sciatic nerve actually is, the most common conditions that sometimes cause this nerve to become inflamed, and what treatments are available to treat sciatica.
Sciatic Nerve: Defined
The sciatic nerve is the largest nerve in the human body. The nerve runs down from either side of the spine, through each buttock, down the back of the thigh and ends in each foot. This nerve is very important as it provides an essential communication pathway from the spine to muscles in the legs and feet.
When it Becomes Painful
Not every person who experiences lower back pain will notice any pain, numbness or tingling radiating down their leg. Some people only experience a band of pain across their lower back. However, anyone who does notice pain, tingling, numbness or even weakness that radiates down through their buttock, continues down their leg, perhaps even into the foot, might be suffering from sciatic nerve pain.
People who lead a sedentary lifestyle and/or who carry excess weight or those with a job that requires them to sit for extended periods of time often are more likely to develop sciatic nerve pain as they age. Runners might also develop some of the conditions that can cause pain in the buttock and leg areas as well. Most individuals only experience symptoms in one buttock or leg. Rarely, some experience it on both sides with symptoms typically going back and forth between each side.
Diagnosing Sciatic Nerve Pain
Anyone experiencing any type of chronic lower back and/or pain, numbness, tingling or weakness in their buttock, leg or foot should not resign themselves to simply living with their condition. It is important to treat sciatica, not just to eliminate the pain but to avoid further degradation of the condition, which could result in marked weakness or in worst cases, paralysis in the leg(s). Typically, an MRI test will provide physicians with an accurate picture of any issues affecting the sciatic nerve. Most often, the sciatic nerve becomes compressed from a bulging or herniated disc or spinal stenosis. It can also become irritated from an SI joint problem or Piriformis Syndrome.
Spinal Structures
Each area between the bones of the spine contains a disc filled with a shock-absorbing jelly-like material. Sometimes small tears (herniations) occur in the lining of these discs, allowing the jelly-like material to spill out and press on adjacent structures. Sometimes no actual tears have occurred but the disc(s) are compressed to the point where they begin to bulge out, looking much like a flattened doughnut, into unwanted areas.
In other cases, the cause of sciatic pain could stem from an issue with the spinal canal rather than a disc. As humans age, it is not uncommon for spinal structures to weaken, causing narrowing of the spinal canal. As the spinal canal becomes narrower, the spinal cord itself can become impinged causing problems such as weakness, numbness and in severe cases, loss of bowel or bladder control, followed by paralysis.
Lastly, another fairly common cause of sciatica stems from issues with the piriformis muscle and/or an SI joint issue. The piriformis muscle runs through the buttock region, very close to the sciatic nerve. When the piriformis muscle becomes irritated, it can affect the adjacent sciatic nerve. Sometimes sciatic nerve pain arises from an issue with the sacroiliac joints that reside on each side of the spine. Some people have too much motion in these joints or too little. In the cases where the joint(s) do not move properly, the patient will often experience pain radiating down their leg, very similar to sciatic pain.
Treatment for Pain
Regardless of the cause, most doctors will try conservative treatments first unless they think weakness and possible paralysis is imminent. A physician will typically begin with a series of physical therapy treatments where patients are taught exercises that help stretch and strengthen the affected areas, they learn how to sit and walk properly and how to relax muscles through heat and ultrasound. In some cases, a physician might also recommend a series of spinal injections designed to reduce inflammation in the affected area(s).
If you would like more information on how to find the root cause of your sciatic pain, please contact us.
