Sciatica is a symptom rather than a disease. It involves irritation and inflammation of the sciatic nerve. The pain caused by sciatica can vary between an intermittent annoying dull ache to extreme pain in the entire leg. It is a difficult condition to treat but when it is really bad patients often seek out a surgical intervention.
It a common condition. May come and go. Just because you experienced sciatica once, does not necessarily mean the symptoms will return.
The sciatic nerve originates in the lumbar spine by bundling together lumbar and sacral nerves (L4, 5, and S1-3).
It courses deep through the buttocks continuing down the posterior-lateral aspect of the leg and ends in the soles of the feet.
There is a sciatic nerve on both sides.
Irritation of the sciatic nerve causes a condition called sciatica.
The sciatic nerve is the largest nerve in the body and is almost the diameter of your thumb.
The slightest perceptible touch of the sciatic nerve can cause sciatica and is very painful.
Medication, regardless of the type or dosage, does not always relieve the pain.
Typically sciatica is insidious, meaning it comes on gradually, no specific 'event' caused it to occur.
Injuries - Not Necessarily Traumatic
Sciatic pain following a slip-and-fall is understandable. The impact of your butt hitting the ground throws off your back. A few days later you notice sciatica.
But, not all spinal injuries are trauma related. Possibly you lifted heavier than usual at the gym or work. Maybe spring cleanup pushed your back a bit too far. Now you look a bit crooked, no big deal, it will go away. Right?
Unless you are very crooked you may not even notice how far out of alignment your spine really is. This is a perfect set up for sciatica. That crooked spine could also lead to a knot between shoulder blades.
Thinning Lumbar Discs
Most of the time discs thin slowly over years. Poor postural habits accelerate wear and tear to the discs in the spine. Under an unequal load (being crooked), the discs begin to erode, they become thinner.
Thin discs decrease the area where the sciatic nerve exits, between two vertebra. This scenario is called degenerative disc disease and is common.
When the discs are thin a wrong unguarded movement cant tap the sciatic nerve. Then sciatica begins.
Herniations occur when the end plates of the vertebra become weak and a small crack in the bone occurs. A lumbar disc is always under load (unless you are laying down) and part of the disc begins to move into the area of weakness in the bone.
Disc bulges can also cause sciatica. That is when the outer layer of the disc get weak and begin to bulge out between the two vertebra. Sometimes even a piece of the disc may break off and start floating around the area.
If the disc, or part of the disc, comes into contact with the sciatic nerve, sciatica occurs.
Only one-third of disc herniations are symptomatic and are usually found as a secondary condition to something else.
The piriformis is a small muscle deep in the butt, it lays on top of the sciatic nerve. The piriformis muscle is responsible for internal and external rotation of the hip but also helps to keep the sciatic nerve in its correct place, deep within the butt.
Piriformis Syndrome can be the result of overuse such as walking or running too far. It can also be caused by doing to many leg presses or squats.
Conversely, If the butt muscles are weak, a sudden movement can cause the piriformis to grab and stay tensed putting pressure on the sciatic nerve.
Anterior Pelvic Tilt
(the one on the right shows an anterior pelvic tilt)
An anterior pelvis occurs when there is too much curve in the small of the back. The excessive curve brings the joints in the lumbar spine closer together, closing down the room needed for nerves exiting the spine.
Often, anterior pelvic tilt is the result of excessively tight hip flexors, particularly the psoas muscle.
The rapid "front-end load” during pregnancy requires Mom to lean back for balance. This brings the lumbar vertebra closer to each other. Pregnancy causes both loose joints as well as muscle cramps and frequent sciatic pain. This is generally temporary and sciatica recedes after giving birth.
A Couple of Stretches - Do Frequently
MOST SCIATICA IS CAUSED BY MISALIGNMENT IN YOUR SPINE.
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