Sciatica – a pain by any other name would hurt as much

thorns describing sciatica painSciatica is a troubling name and a troubling condition.  The term is thrown around quite frequently by people and  is often used as a blanket statement for lower back and leg pain.  Whenever you feel pain in your back, hip, or leg, someone will usually comment “Oh that’s sciatica acting up”.

What Is Sciatica?

So where does sciatica come from and what does it really mean?  Sciatica refers to irritation or impingement of the sciatic nerve – a large nerve originating in the low back and made up of several nerve roots coming off of the spinal cord.  In practice the term sciatica is actually used to describe varying symptoms of an underlying medical condition and is not a condition in and of itself.

 – A patient with a low back disc herniation, for example, may have resulting inflammation around the nerve roots in the low back due to this disc herniation and this can cause the symptoms of nerve pain.  He/she may experience pain in the low back, numbness in the back of the thigh and pins and needles into the calf.  This would be described as sciatica.

 – Another patient may have a chronically short and tight piriformis muscle (a muscle in the buttock region) due to prolonged sitting, excessive exercise or just poor biomechanics.  In this case, the piriformis muscle which lies on top of the sciatic nerve presses down on it causing pain to radiate into the buttock and the back of the thigh. Here the cause is different but it is still called sciatica.

– A third example in which a patient may describe sciatic symptoms is called spinal stenosis – a narrowing of the openings where the spinal nerves exit the spinal column, often due to age related changes in the spine.  Symptoms of sciatica in this case may include difficulty with prolonged walking which is relieved with flexing the spine forward.

So, you may wonder, why do the semantics matter?  They matter because it is important to differentiate the cause of these seemingly similar types of pain as each of these diagnoses has a different prognosis and treatment protocol.   The patient with a piriformis syndrome may be given specific hip stretches that could otherwise aggravate the symptoms of a patient with a disc herniation.  Conversely, a patient with a disc herniation may undergo spinal adjustments, and someone with piriformis syndrome may have muscle release therapy and TENS.  And the spinal stenosis patient may be recommended exercises such as riding a stationary bike, while walking may be the preferred activity for a disc herniation.

If you think you may be suffering from the symptoms of sciatica it is important to visit your chiropractor or another qualified healthcare professional and have the underlying cause diagnosed so that the right course of treatment and at home care is applied.  For more information on sciatica, how it can be treated and other types of back pain contact us at Clear Path Chiropractic in downtown Guelph.

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  • Cody Scharf, DC
    Reply

    In most cases in my practice, I have found adhesion along the sciatic nerve that restricted proper flossing of the nerve with motion to be a major problem. Once adhesion is removed, the sciatica disappears.

    • Dr. Mark Kubert
      Reply

      I can dig it, Cody. What types of soft tissue therapy do you like to use?

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