By Scott Colasanti
What exactly is sciatica and how is it treated?
The definition of sciatica is pain that is typically felt from the low back down through the buttocks and thigh and radiating below the knee often to the foot.
This pain is caused by irritation of the sciatic nerve, which happens to be the largest nerve in the body.
As mentioned in previous blogs, nerve signals travel to and from the brain through the spinal cord and then the spinal nerves, which branch off of the spinal cord at every spinal level. The sciatic nerve is comprised of several of these spinal nerves from the lower lumbar and sacral (pelvic) region, which come together to form the large sciatic nerve. The large distribution of this nerve also explains the pain that arises from it when it is irritated.
So what actually causes this nerve to be irritated? Keep in mind that these nerves are in some pretty tight spots so there isn’t a lot of room for anything else. Basically, anything that can get in the way can cause irritation and pain.
A common cause of sciatica is disc herniations, which are bulges that may form in the disc that can ‘press’ on the nerves. Wear and tear from arthritis can diminish the spaces around the nerves thus causing irritation. Less commonly, tumours from structures in the pelvic region may also result in sciatica. During pregnancy, sciatica may occur as a result of the increased physical demands on the spine and or the increased competition for space in the pelvic region. As the sciatic nerve travels down the gluteal region it may sometimes be compromised or ‘pinched’ by a muscle called the pirformis. This is also known as ‘piriformis syndrome’.
As described, this is a big nerve so a lot of things can get in the way.
So, how do we treat sciatica? The simple answer is removing the factors that are causing the irritation of the nerve. Depending on the problem this may involve treatments like massage, chiropractic manipulation and acupuncture. Modalities like TENS, (transcutaneous electrical nerve stimulation) ultrasound or hot and cold therapy may also help with diminishing pain and speeding up healing. Short-term use of medication may also be necessary as this is often a very debilitating condition. Of course exercises to strengthen the back and stretch the tight muscles will help to ensure long-term relief and prevent reoccurrences.
I often have patients coming in for chiropractic care with a ‘self-diagnosis’ of sciatica when it is often not the case. Lower back pain radiating to the buttock, and hip or pelvic pain are not necessarily sciatica and proper diagnosis is important to determine the best course of action.
Please feel free to contact us if you have a question about your lower back pain.