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SCIATICA


Lower back pain is a common cause of non-disease related disability today mainly due to the lifestyles we live. One of the more common complaints that present to my rooms is when patients walk in and say that their "sciatica" is playing up. In many ways this is true but it is not always accurate. So let's look at what sciatica is really about.


Brief description


Sciatica is a term given to describe nerve pain down the leg that may become irritated and/or compressed. The sciatic nerve is the largest nerve in the body and it travels from the back, down through the buttocks and into the leg. It supplies all of the muscles in the leg and gives sensation to the lower limb.


The key point to remember is that sciatica is not a diagnosis but a symptom of what is happening elsewhere. Let's look at some of the potential causes of sciatica:


What causes sciatica?


Sciatica may be caused by a variety of structures in the lower back and leg. They may include:

  • Lumbar disc herniation

  • Spinal stenosis

  • Degenerative disc and joint disease

  • muscle spasm (often from the piriformis muscle)

  • Sacroiliac (SI) joint dysfunction

The last two conditions listed above produce sciatic-type symptoms as the effect on the nerve at that point is a little further away from the nerve root. True sciatic nerve pain originates from the spine (nerve root). Additionally, the muscles of the buttocks (the gluteals) may also refer pain down the leg and mimic sciatica.


Treatment


Treatment for sciatica and sciatic-like symptoms is varied but a conservative approach is always the best place to start. Conservative therapy for the treatment of sciatica usually involves exercise (stretching and strengthening), medication (if required and tolerated), physical therapy (chiropractic, biokinetics, physiotherapy etc). Howe

ver, if these treatments fail (no improvement in symptoms) or the symptoms get worse, then surgery is the next viable option. Symptoms that one needs to look out for that may indicate that the condition is a little more serious are:

  • Numbness and weakness in the leg/s that is getting worse (particularly on the inside of the thighs)

  • Bladder and/or bowel problems

If you unsure as to the cause of the sciatica, please consult with your doctor or nearest healthcare professional to ensure that the correct diagnosis is made and that the correct treatment protocol can be administered.



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