The sciatic nerve is the longest nerve in your body. It runs from your pelvis, through your hip area and buttocks and down each leg. The sciatic nerve branches into smaller nerves as it travels down the legs providing feeling to your thighs, legs, and feet as well as controlling many of the muscles in your lower legs. The term sciatica refers to pain that radiates along the path of this nerve.
You may have heard the term “slipped disc” used to
What causes Sciatica?Sciatica is actually a sign that you have an underlying problem putting pressure on a nerve in your lower back. The most common cause of this nerve compression is a bulging or herniated lumbar disc. Piriformis syndrome is another common cause of sciatica. The piriformis is a muscle that lies directly over the sciatic nerve. If this muscle becomes tight or if you have a spasm in this muscle, it puts pressure directly on the sciatic nerve. Occasionally, sciatic pain in men is caused by sitting on a wallet.
How do I know if I have sciatica?Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. Sciatica may be accompanied by numbness, tingling, and muscle weakness in the affected leg. This pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. Sciatic pain often starts gradually and intensifies over time. It's likely to be worse when you sit, cough or sneeze.
How is Sciatica Treated?The vast majority of the time, sciatic pain can be relieved through a combination of stretches, deep tissue massage of the piriformis muscle and chiropractic care. Occasionally, in cases where chronic spasm of the low back or piriformis muscles is causing the sciatic pain, it may be necessary to do a procedure called a trigger point injection, where a medical pain specialist injects a small amount of anesthetic directly into a spasmed muscle to break the spasm cycle. However, this is typically not necessary.
You may have heard the term “slipped disc” used to describe a low back injury. Discs do not actually “slip”. Rather, they may herniate or bulge out from between the bones. A herniation is a displaced fragment of the center part or nucleus of the disc that is pushed through a tear in the outer layer or annulus of the disc. Pain results when irritating substances are released from this tear and also if the fragment touches or compresses a nearby nerve. Disc herniation has some similarities to degenerative disc disease and discs that herniate are often in an early stage of degeneration. Herniated discs are common in the low back or lumbar spine.
What causes discs to herniate?Many factors decrease the strength and resiliency of the disc and increase the risk of disc herniation. Life style choices such as smoking, lack of regular exercise, and inadequate nutrition contribute to poor disc health. Poor posture, daily wear and tear, injury or trauma, and incorrect lifting or twisting further stress the disc. If the disc is already weakened, it may herniate with a single movement or strain such as coughing or bending to pick up a pencil.
How do I know if I have a disc herniation?Herniated discs are most likely to affect people between the ages of 30 and 40. Disc herniations may be present without causing pain. The most common symptom will be pain in the area of the herniation that may radiate across the hips or into the buttocks. You may also experience numbness or pain radiating down your leg to the ankle or foot. If the herniation is large enough, you may notice weakness with extension of your big toe and you may be unable to walk on your toes or heels. In severe cases of lumbar disc herniation, you may experience changes in your bowel or bladder function and may have difficulty with sexual function.
How is a disc herniation treated?Mild to moderate disc herniations can usually be treated conservatively with stretching, exercise therapy and chiropractic care. More advanced cases will often require some form of spinal decompression, such as traction or mechanical decompression, in conjuction with chiropractic care.
Occasionally, a herniation may be severe enough to warrant surgical intervention. These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.
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