One of the more broadly used terms when it comes to low back, glute and leg pain is Sciatica. It is also one of the most commonly misdiagnosed and mismanaged injuries. But what exactly is Sciatica and what causes it?
The Sciatic nerve is the longest and largest nerve in the body. It originates from your lower back and travels down the back of your leg all the way to your knee. The term Sciatica simply refers to any pain that radiates along the Sciatic nerve. It is usually felt as a pain along the back or side of the buttock and runs down your leg. As the nerve is so long, there are multiple ways that a problem can occur along its path.
OK so we know what the pain is, but why is it happening?
There are 3 major ways that the Sciatic nerve can be irritated, Disc Bulge, Joint irritation or Muscle pinch
It is known by many names; slipped disc, herniated disc, protruding disc but we will call it a Disc Bulge. One of peoples most feared diagnosis is a disc bulge. Just reading the word might make you shiver. To make you feel better have a look at this stat: 54% of people aged 40 have 2 disk bulges and don’t even know they have it! So just because you have a disc bulge doesn’t mean you will get all these problem and pains.
Your spinal discs sit between each spinal bone and acts like a shock absorber for your spine. They allow for movement between the spinal joints as well as allowing space for the nerves to leave the spine.
Spinal discs are made up of many tough fibrous rings along the outside and filled with a jelly-like substance in the middle. The easiest way to think of it is like a jelly doughnut. When the outer rings get damaged it allows the inner jelly-like substance (nucleus) to push out and cause a herniation/bulge. When this happens in the lower back, it can push out and put pressure on the Sciatic nerve as that is where the nerve originates from. Nerves don’t like pressure on them and will become irritated which causes you feel as pain.
Each spinal segment has multiple joints. Joints connecting it to the segment above and the segment below and on each side of the spine. We call these the facet joints. Your Sciatic nerve leaves the spine from the space created by the facet joints.
Facet joints can get irritated in a number of ways, repetitive movements, trauma, arthritis etc. Where there is irritation there is often inflammation and we all know how inflammation works. The joint gets swollen and produces pain. Now just like with the disc bulge, this swelling can put pressure on the nerve as it leaves the spine. And as we know, the nerve does not like being put under excess pressure. That is when your symptoms kick in.
The final one we are going to talk about is Muscle Pinching. As the Sciatic nerve runs through the buttock and leg, the surrounding muscles can pinch or put pressure on the nerve. The most common one the Piriformis muscle. This muscle is located within the buttock region and the Sciatic nerve runs right along side it. The nerve can even pierce through the muscle in some people! When the Piriformis gets tight or irritated, it then compresses the nerve. I don’t have to tell you how the nerve reacts as a result, you’ve heard me say it many times by now. The Hamstring muscles are also guilty of this. Have a read of our blog post here to learn all about the hamstrings.
Know the cause to know the solution
You can see how the Sciatic nerve can run into a problem in different ways. It is important to understand why your Sciatica is happening rather than just blanket diagnosing as Sciatica. Know why and how so that you know how to properly manage the issue.
Speak to one of our injury specialists to find out where your pain is coming from and to start a management plan specific to your issue.