Sciatica refers to pain that radiates down the path of the Sciatic Nerve. This pain can feel like a shooting, burning, or aching type sensation down the back of the upper leg but sometimes extends past the knee. The Sciatic Nerve is derived from the L4-S3 spinal nerve roots. To give you an idea of where, exactly, those nerves are located here is a quick anatomy lesson. The L4-S3 spinal nerve roots exit the spinal cord at those levels of the spine, so in general terms; it’s the low back region of our spine.
The L refers to the Lumbar spine which starts just below the bottom of the rib cage and goes down just below the top of the pelvic bones. The S refers to the Sacral region, which is the tailbone portion of the spine. The contribution of nerve fibers from the low back region join up in the buttocks region to form the large nerve that is commonly called the Sciatic Nerve. This nerve and the term “Sciatica” get much recognition due to the high number of people that have radiating pain down it’s chosen path which follows a course from the buttocks all the way down the back of the leg to its branches in the foot.
What Causes Sciatica Pain?
As we mentioned earlier, Sciatica pain is a general term relating to pain down the path of the Sciatic Nerve. However, there are many different reasons why that nerve becomes irritated and painful. It can develop from issues involving the discs in the Lumbar region of the spine (remember the nerve roots that make up the Sciatic Nerve), maybe there was compression of that nerve from an injury, or maybe you have trigger points and inflammation in the muscle tissue around that nerve.
A typical scenario that we see in the office is a person who has pain in the low back region and is also experiencing the “Sciatica” symptoms of radiating pain into the leg, typically down the back of the leg. The L4-L5 and L5-S1 discs are usually the most common discs of the low back to become injured due to the anatomy of our bodies, it’s just an area that seems to take on more stress and strain than the discs above it.
You may be wondering how the disc plays a role in causing symptoms of Sciatica. The discs are cartilaginous structures that exist between every vertebrae of our spine. They are designed to act as shock absorbers, load distributors, and cushions. If a disc starts to wear away or “degenerate”, then the opening for the nerve root that is exiting out of the spinal cord on either side of our spine will not have as big of an opening to get thru and can therefore get compressed upon by the bony structures of the spine.
Also, the disc itself could be “bulging” or “herniated”. If this is the case, the mechanism is that the disc has worn away from the inside-out, and has allowed the jelly-like substance of the central portion of the disc to actually protrude thru the disc wall. If this occurs, the protrusion can compress on the nerves or spinal cord and thus create symptoms down the path of that particular nerve root, which in most cases of low back pain, is the nerves that contribute to the Sciatic Nerve.
There are also sometimes hyper irritable spots in muscle that we call “trigger points” that can sometimes refer or cause pain that mimic Sciatica type pain. These can be located in the Glutes or butt muscles and refer pain down the leg as in Sciatica. In this instance there are still treatment options available but a thorough examination by the medical provider will help to determine if this is the cause of the symptoms.
In any case, the biggest factor to understand with Sciatica is that there is some compressive force, or irritant to that nerve. It is up to your medical provider to help in determining what is causing and where that compression is coming from.
How To Treat Sciatica
There are many ways to help you treat the symptoms of “Sciatica”. The first step is determining what is causing the compression on the nerve. A thorough examination and history can be performed to help detect what may be causing these symptoms. Sometimes special imaging studies can be performed as well to aid the medical provider’s diagnosis of your problem. This could include performing X-Ray, or MRI to detect if there are problems relating to the disc, bony spurring, or other issues that the provider may not be able to see upon examination and testing.
At Mountain View Pain Center, we treat the symptoms of Sciatic Nerve pain almost every day. The treatments that seem to work most effectively for this type of pain are spinal decompression therapy, electrical stimulation, spinal manipulative therapy, ice, instrument assisted soft tissue mobilization, massage therapy, rehabilitative exercise, and dry needling. Often times we use all of these treatment techniques, and modalities in combination to achieve the best results but we also do it on a case by case basis to determine what the correct treatment for your particular situation is.
If you or someone you know may be experiencing these types of symptoms it is important to have an examination performed to determine the cause and get the right treatment. Prolonged compression of a nerve or nerve root can lead to permanent damage of that particular nerve. Feel free to call us to schedule an appointment so that a diagnosis and treatment plan can be rendered.
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