Sciatica Part 1
Definition of sciatica
: pain along the course of a sciatic nerve especially in the back of the thigh broadly : pain in the lower back, buttocks, hips, or adjacent parts
This is how Webster defines sciatica. What I want to dig into here is a little more detail on what sciatica is, how it presents and things we can do to help.
What makes up the sciatic nerve is the individual spinal nerves. As the spinal nerves come together in the lower lumber spine and sciatic region, they form the sciatic nerve. The sciatic never is the largest and longest nerve in the body. It measures about three-quarters of an inch in diameter. As the sciatic nerve travels south, it passes through the buttock and into the lower extremities. As it passes through the buttock it branches off to innervate (supply info to and from) specific areas if the legs and feet.
There are a couple anatomical structures that can cause sciatic symptoms and possibly mimic sciatica. When most people think of sciatica, they associate it with a “slipped” or “herniated” disc. While disc issues are a common cause of sciatica there are other structures that can cause compression of the spinal nerves. Most people have heard of arthritis or stenosis and their association with the aging process. Arthritis is found most commonly in the aging population but depending on the bumps and bruises we have taken throughout our lives we can also see this in younger patients. Stenosis is basically a narrowing of the spinal canal itself or the foramen where the nerves exit the spinal canal. When we have injury to a vertebral segment our body, over years, tries to glue things together. As your body “glues” things together, more bone is laid down. When this happens in the spine, that bone occupies space and can compress the spinal cord or the individual spinal nerves. With arthritis, like stenosis, bone is laid down and sometimes that extra bone can compress a nerve. Now you couple this with a disc that is diseased, and we have a problem. Another area where we can see compression of the sciatic nerve is when it travels under the piriformis muscle which runs from the sacrum to the greater trochanter of the femur.
Pain in or into the leg isn’t always due to compression of the sciatic nerve. Most of us know that one of the common symptoms or signs of a potential heart attack is pain in the left arm pain, in women sometimes jaw or back pain is noticed. And what about an acute appendix attack? A common finding with appendicitis is umbilical pain. So what causes these “phantom” type symptoms? Since we all started as two cells, which turned in to 37 trillion, there are some embryonic connections that go way back. What happens is when we are suffering with a heart attack or acute appendicitis those connected cells fire off too. What does this have to do with sciatica? Well, we can have some disc, joint or muscle problems that have that same embryonic connection that can give us pain into the leg. Typically, these somatic referral pain syndromes do not cause pain below the knee so that is one of our fist questions during an exam.
How do we find out where the pain is coming from? Stay tuned for more info on sciatica; how it is diagnosed, what you can do at home to help yourself and what we as chiropractors can do to help you.
If you are experiencing any symptoms radiating into your legs, give us a call so we can help you get to the bottom of it.