Sciatica a thorn in your Gluteus maximus?
Before I started on the inspirational journey of chiropractic, before learning and realising how complex and
incredible the human body is I thought that sciatica was just a pain in your backside related to low back pain? Well I was partly right but it is easy to say to a patient that yes you have sciatica but I want to be able to tell you as much as I can about it, to educate and prevent it from happening in the future!
Sciatica is an umbrella term many people use because it can happens for many different reasons. The sciatic nerve is a large nerve originating in the lumbar spine (lower back) and is responsible for the proper function of the muscles in your upper legs as well as most of the sensations you feel in your legs also. This nerve can get pinched, damaged or irritated for various reasons.
Sciatica usually starts as a dull ache in the lower back or gluteal area but can also come on quickly as a sharp shooting pain that can cause pain, numbness, tingling and weakness that is usually only on one side of the body. We call this a radiculopathy, this means that where a nerve is either trapped, pinched, irritated or damaged, it can radiate pain to another area along that same nerve. If you think of a nerve like an electrical cable it transmits and receives information to and from the brain, if part of this nerve/cable is damaged then the signals are not going to work properly causing pain and dysfunction.
Below are the most common and less common reasons why this happens:
Lumbar disc damage: If a disc within the spine is damaged it can pinch on the nerve causing shooting pain, tingling, weakness and numbness to the gluteal region and legs.
Myofascial trigger point: A specific place within a muscle where the muscle fibres become tangled together in a small area causing pain and possible radiculopathy.
Degenerative disc disease: As we age the disc size decreases, unfortunately this can lead to radiculopathies depending where the degeneration occurs.
Piriformis syndrome: The sciatic S1 nerve in some instance runs through this piriformis muscle instead of behind it and can cause pain if the muscle is overly tight or restricted causing pain when moving, standing and even sitting.
Spondylolisthesis: A bit of a tongue twister but a painful one at that. This is where one lumbar vertebra has slipped forward over the top of another causing either damage or compression to the sciatic nerve causing a radiculopathy.
Spinal stenosis: This is where the canal where the spinal cord runs through, it can narrow causing compression or damage to the nerve, usually affecting the elderly more but can also be caused less commonly by a tumour or degenerative disc disease.
Tumour: A much less likely diagnosis as it is much rarer than the above but safety is always paramount and a full case history and examination will determine its cause.
Information overload? Possibly, but knowledge is power and a knowledgeable patient empowers us all!
So now you know what sciatica is all about, remember there is help out there in the form of your local chiropractor! Acupunture and physical therapy has also been shown to help and remember to use an ice pack on a daily basis to reduce inflamation and pain!!