Many people use the term sciatica incorrectly. Sciatica is pain along the path of the sciatic nerve which extends from the lower back down each leg. Sciatica is a symptom (like itching), it is not a diagnosis (like Parkinson’s disease). Sciatica can range from an occasional nuisance to excruciating pain that makes walking near impossible. There can be multiple underlying reasons for your sciatic nerve pain. Causes can range from trauma (falls, auto accidents), to disc herniations and other pathology. We can help find the root cause of the problem with an exam and may also order some diagnostic imaging such as an x-ray, MRI or CT scan to examine the underlying structures.
To answer the question, ‘what is sciatica’ it is helpful to explain some of the relevant anatomical structures. The sciatic nerve is both the longest and the widest nerve in your body. It begins in the lower back as five separate nerves that extend from five different vertebrae – L4, L5, S1, S2, and S3. These nerves meet up to form one large bundle, which runs through the buttocks and down the entire length of the leg. The sciatica nerve is responsible (directly or indirectly) for nearly all the sensation in your leg including the skin of the thigh and gluts.
Sciatica occurs when there is compression or irritation of the sciatic nerve. The pain is felt in the low back and leg, but the site of the pain isn’t always the site of the underlying issue. Since the sciatica nerve is so long and travels around or through the large muscles of the buttocks, it takes an expert to determine if the pain is coming from disc compression, from muscle spasms or from something else. Again, sciatica is a symptom, not a diagnosis.
While sciatica is most often associated with pain, other symptoms may be present such as tingling, numbness, or muscle weakness. The pain can be nearly constant or intermittent. If you think you are experiencing sciatic nerve pain, keep a record of the location, duration and intensity of the pain. Your specific history plays an important role in determining the cause of the pain.
Treatment for sciatica depends on the underlying cause, so there is no one recommended course of treatment for all sciatic pain sufferers. At Total Health Family Clinic, we use a variety of non-invasive approaches that include spinal manipulation, physical therapy, targeted stretching and active muscle release. We also discuss the role that nutrition and hydration play in reducing tissue inflammation and keeping discs healthy. The spine, discs, muscles and soft tissue all have a role to play in sciatica and should be evaluated and treated as a connected system.
The most important thing to take away from this article is that sciatica (sciatic nerve pain) is a symptom of an underlying condition. You’ll only start to get better once the underlying condition is identified and this is done through a combination of an exam, history and recommended diagnostic imaging.
Yours in Health
Ashkan Aazami, DC
Total Health Family Clinic, Landover Hills, District Heights, Rockville, MD