Sciatic Nerve, showing impingement and sites of pain
Sciatic pain, or sciatica is probably a term you’ve come across before. But what actually is it? How do I know if I have it? And what can I do to treat it? Well I am here to debunk the mystery around it and reassure you, it’s not always a life-sentence.
Some Quick Anatomy for Context
To understand what sciatica is, we need some context of the human anatomy. Your sciatic nerve, is a nerve that emerges from your spinal cord and through the lumbar (lower) spine on each side of your body. It travels downward, at the back of the pelvis and down the leg all the way to the foot. When you want to move your leg, your brain sends a message through the spinal cord and sciatic nerve to innervate the muscles to contract or relax. It is also responsible for the feeling in the skin of your leg and foot.
If this nerve is impinged or damaged, this can result in sciatic pain, causing pain in the glute muscles, down the leg to the foot and often the lower back. It can also cause altered sensations in your leg or foot such as numbness and tingling. The sciatic nerve can be impinged in a couple of different ways.
Ways the Sciatic Nerve can be Impinged
- Lower back disc herniation with a nerve root impingement.
Out of the 2 most common ways, this one is the more severe of the two, but also the least common in my experience. If you sustain an injury to the lower back that causes one of the discs in your spine to herniate, it can sometimes be severe enough to pinch the nerve. This needs to be diagnosed via a scan, and depending on severity, you may be able to rehab this with prescribed exercise and manual therapy. In more severe cases, your doctor may recommend alternate treatment such as a cortisone injection. *It is important to note that not all disc herniations will impinge a nerve, and a disc herniation that shows up on a scan is not an accurate source of identifying the cause of your pain.
- Piriformis Syndrome
This is the most common cause of sciatic pain, and luckily, the most easily treated! You have a muscle that lies underneath the big gluteus maximus muscle called the piriformis. The sciatic nerve runs underneath, or in some people, through this muscle. When the muscle is tight, it can compress on the sciatic nerve and cause sciatic pain, numbness, and tingling.
This can be caused by prolonged periods of sitting or standing, weakness in the muscle, of muscle overload. I most commonly see this in people who are quite sedentary and sit down for a job, or in people who stand for long periods.
Treatment Options
To treat this, your remedial therapist will look at and treat the muscles in the pelvis, most commonly the glutes and piriformis, but may also treat the muscles in the lower back, hip flexors, and/or hamstrings. They will then be able to give you some exercises to stretch the glutes and piriformis, as well as any other stretching or strengthening exercises we believe you could benefit from, based on your individual assessment.
Do you, or someone you know experience sciatica or sciatic pain? Get in touch! Email kailee@backontrackremedial.com.au or book an appointment online!
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