What is Sciatica?
Everyone has heard of the sciatic nerve. There is a sciatic nerve on each side of the body. Sciatica is pain down the back of the leg because something is putting pressure on the sciatic nerve and it hurts. The sciatic nerve originates at the lumbar spine. A few different nerves combine to form one very large nerve that runs down the back of your thigh. When something is placing pressure on this nerve, pain can be felt at any point down the length of the nerve spine from the low back to the feet.
The sciatic nerve is the largest nerve in the body. In most people, the sciatic nerve splits around the area of the knee into two other nerves that supply sensory information to the lower leg, the tibial nerve and common peroneal nerve. Each of these nerves, in turn, split into more smaller nerves that supply the foot. Nerves are all connected to one another, either directly or indirectly. So, a problem that originates in the lumbar spine may be affecting and causing pain or other symptoms all the way down to your toes.
Sciatica itself is not a diagnosis. It’s simply a word people use to describe this condition. The causes of Sciatica are the same causes that would be explained to you in the case of a bulging or herniated disc in the spine. Which nerve the disc hits will determine where in the body you experience symptoms.
There is one condition that is specific to the Sciatic nerve, however. This is called Piriformis Syndrome. There is a small muscle in your buttocks that runs over the sciatic nerve as it travels down to your thigh. It is thought that in some cases, this muscle becomes extremely tight and places pressure on the sciatic nerve and may cause Sciatica symptoms. In order to treat this condition, it is imperative that you obtain an accurate diagnosis as to what is originally affecting the nerve, and not just treating symptoms. Causes may be:
- A herniated or bulging disc in the lumbar spine
- Disc degeneration
- Spondylolisthesis in the lumbar spine
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Sciatic nerve symptoms will generally be felt on only one leg, but it is possible to experience symptoms on both legs simultaneously. Symptoms that may be experienced when the sciatic nerve is affected are:
- Pain that is generally described as burning or shooting, mostly present in the leg rather than the low back
- Weakness, numbness, or tingling from the leg down to the toes; these symptoms don’t have to run the entire length of the nerve. You may experience symptoms in your feet and at no place superior on the leg
- Change in posture
How Sciatica is Treated
The first line of defense for treating Sciatica is always a course of physical therapy which will attempt to pinpoint that location of the origin of pain and direct treatment based on that: This treatment will include:
- Posture education
- Body mechanics education
- Specific directional movements aimed at reducing the size of the disc bulge in your low back
- Strengthening and flexibility exercises
- Pain relieving modalities such as electric stimulation which can target the nerve, interrupt the pain signal providing relief
In severe cases where conservative treatment has failed to relieve pain, surgical intervention to the lumbar spine may be indicated.