What is Sciatica and Why does it happen?
Sciatica is defined as pain affecting the back, hip and outer side of the leg, calf and foot. Compression of the spinal nerve roots in the lower back or hip can cause sciatica. The sciatic nerve originates from the low back at the levels of L4-5 and S1-3. These five nerve roots join to form the sciatic nerve which runs from the low back down the back of the leg, into the calf and foot. Not only is sciatica painful but it can also be very limiting in daily activities.
Sciatica in itself is not a diagnosis, but rather a symptom. Sciatica simply means that the sciatic nerve is compromised in some fashion. Subsequently this nerve compression causes neurogenic pain which is defined as any pain caused by a nerve.
Signs and Symptoms:
- Pain
- Numbness
- Constant deep dull ache
- Tingling
- Loss of sensation
- Burning
- Decreased muscle tone and muscles loss
- Loss of deep tendon reflexes
- Decreased muscle strength
When looking at the symptoms of nerve pain there are both subjective and objective findings. Any findings that are relayed by the patient and cannot be physically tested are considered subjective. On the other hand, objective findings are those that can be tested and recorded by the examining doctor. For example, symptoms such as loss of reflexes, decreased muscle tone, muscle loss and decreased strength are all objective findings.
Aggravating factors that can make the symptoms worse usually include bending and lifting, prolonged sitting, bad posture, coughing, sneezing, straining, repetitive strenuous activities, prolonged walking, cycling etc. On the other hand relief can be found with changing positions, short walks, lying flat on your back, going into extension of the low back, icing the low back and stretching. It is important to recognize that the aggravating and relieving factors can vary in each unique case based on the causation.
While the symptoms and presentation are very similar, there are a variety of injuries that can cause sciatic nerve pain. The common denominator is that most of the injuries cause pressure on the nerve somewhere along its path.
Common Causes of Sciatica:
- Disc herniation/bulges
- Piriformis syndrome
- Boney growth (Osteophytes)
- Spinal Stenosis
- Spondylolisthesis
- Sacroiliac Joint Dysfunction
- B12 deficiency
- Diabetic Neuropathy
Due to the variety of causative factors for Sciatic nerve pain, it’s imperative that you seek an assessment and treatment for the symptoms. While the prognosis is dependent on the causation, conservative care such as Chiropractic care has been shown to have significant benefit. In addition to pain relief, your Chiropractor can provide a medical diagnosis and help you navigate the healthcare system if images or other referrals are indicated.
Once you have determined the cause of your sciatic nerve pain you will be better equipped to determine which treatment options are going to provide the most relief. Treatment options include soft tissue therapy, activity modification, stretches, Chiropractic adjustments, rehab exercises, acupuncture, nerve root flossing, injections and surgery. It is some combination of the above treatment options that typically leads to the quickest recovery. In conclusion, there are a variety of causes and treatment options for Sciatica.