Sciatica is the name branded with pain which occurs as a result of irritation of the sciatic nerve. Everything that causes irritation of the nerve can cause pain, it can vary from mild to serious pain. Sciatica occurs as a result of compression of the nerve in the lower back (or in the buttocks).
Frequently there is a mix up between the terms “sciatica" and general back pain, however the sciatica is not limited to the back alone. The sciatic nerve is regarded as the longest and widest nerve that can be found in the human body. It covers a wide area of the body ranging from the lower back, through the buttocks and down the legs ending just underneath the knee.
The Sciatic nerve is in control of numerous muscles in the lower leg and provides the sensation to the skin of the foot and most of the lower leg. It was estimated by some experts that up to 40% of people will suffer from sciatica at least once in their life.
When discussing sciatica, it is imperative to have a better understanding of the fundamental medical cause and effective treatment that will alleviate acute symptoms.
Numerous lumbar spine (lower back) disorders can lead to sciatica. It is often described as mild to extreme pain in both the left or right leg. Sciatica occurs as a result of the compression of one or more of the 5 sets of root nerve in the lower back. Sometimes physicians refer to sciatica as radiculopathy. Radiculopathy is a medical term which is used to define pain, numbness, tingling, and weakness that affects the arms or legs which occur as a result of nerve root problem. In case the nerve problem occurs in the neck, it is referred to as cervical radiculopathy. However since sciatica affects the lower back, it is referred to as the lumbar radiculopathy.
The Most Common Causes of the Sciatica
The following are the most common causes of sciatica:
Lumbar Bulging Disc or Herniated Disc
A bulging disc is also referred to as a contained disk disorder. This indicates that the gel-like-center (nucleus pulposus) remains "contained" within the outer wall that looks like a tire (annulus fibrosus).
Breaking of the nucleus through the annulus fibrosus causes a herniated disk. This is referred to as a "non-contained" disk disorder. If the disc is swelling or herniated, the disk material can press against the adjacent nerve root and compress sensitive nerve tissue and cause sciatica.
The consequences of the herniated disk are even worse. Not only does the herniation disk cause direct compression of the nerve root into the inner side of the spine, but the disk material itself also contains an acidic chemical irritant (hyaluronic acid) that causes inflammation of the nerves. In both cases, compression and nerve irritation results in inflammation and pain; this often leads to extremity numbness, tingling, and muscle weakness.
Spondylolisthesis is a disorder that frequently affects the lumbar spine. Spondylolisthesis is characterized by vertebrae slipping forward on the adjacent spine. When the vertebra slips and moves, it compresses the spinal nerve root and often causes sciatic pain in the leg. Spondylolisthesis is regarded as been developmental meaning that it is present at birth, and develops during childhood or acquired from spinal cord degeneration, trauma or physical stress (for example weight lifting).
Lumbar Spinal Stenosis: Spinal stenosis is a disorder of the nervous compression that most often affects the elderly. Pains in the leg which are similar to sciatica may arise as a result of stenosis of the lumbar spine. Position plays a lot of impact on the pain; it is usually brought on by activities such as standing or walking and relief by sitting down.
The branch of the spinal nerve roots comes outward from the spinal cord through passageways referred to as neural foramina which are made up of bone and ligaments. In between each set of the vertebral bodies, that is located on both the left and right sides, is a foramen. The roots of the nerves pass through these openings and stretch outwardly over the spine to innervate the other parts of the body. When these parts become narrow or clogged, causing nerve compression, the term foraminal stenosis is used.
Piriformis syndrome is named after the piriformis muscles and pain that occur when the muscle irritates the sciatic nerve. Piriformis muscle can be found in the lower part of the spine; it is connected to the femur and helps in the rotation of the hip. The sciatic nerve passes under the piriformis muscle. Piriformis syndrome occurs when muscle spasms develop into piriformis muscle, which compresses the sciatic nerve. It can be difficult to diagnose and treat because of lack of X-ray or Magnetic Resonance (MRI) findings.
Degenerative Disc Disease
While a certain level of degeneration of the disk is a natural process which occurs during aging, for some individuals with one or more degenerated discs in the lower back, it may also irritate the root of the nerve and results to sciatica.
The diagnosis of the degenerative disk disease occurs when the weakened disk causes excessive micro-motion at the spinal level, and the inflammatory proteins inside the disk are exposed and irritating to the nerve root in the region. Bone spurs, which can develop with spinal cord degeneration, can also press against the nerve, which causes sciatica.
These are abnormal growth which can either be benign or cancerous (malignant). Luckily, spinal tumors are not that common. However, when the tumor of the spine develops in the lumbar region, there is a risk of developing sciatica as a result of compression of the nerves.
- Infection - ultimately affect the spine.
- Pregnancy: Although sciatic pains may be a problem during pregnancy; It is estimated that 50 to 80% of women suffer from back pain during pregnancy. Hormones formed during pregnancy, such as relaxing, which causes loosening of the ligaments and stretching, which can potentially result to back pain in some women.
Further information on Sciatic Pain - Contact Simon Evans Physiotherapy based in Solihull