What Causes Sciatica?

Simply put, sciatica describes a kind of leg pain that is felt along the path of the sciatic nerve. The sciatic nerve route is from the lower back to the buttocks, to the back of the thighs, calf and foot.

Irritation of the nerve root
The sciatic nerve has its roots or origins in the fourth and fifth lumbar vertebrae, and the first, second and  third sacral vertebrae (L4, L5, S1, S2, S3).
Symptoms of sciatic pain occur as a result of an irritated or compressed sciatic nerve and this means that sciatica is actually a symptom of an underlying condition and not necessarily a "condition" on its own.

Common causes of Sciatica or sciatic nerve pain

Herniated inter vertebral disc
A herniated lumbar disc is a common cause of sciatica. A disc hernia or slipped disc occurs when the core(nucleus) of the disc leaks out of the outer fibrous tissue. This leak can then cause an irritation of a nerve root.

Spondylosis
Spondylosis is osteoarthritis or degeneration of the vertebral discs. Degeneration of these discs occur mostly as a result of age; these kind of changes in the disc can lead to the irritation of the sciatic nerve root.

Spinal stenosis
Spinal stenosis is the narrowing of the spinal canal of the vertebrae. This is an effect of the ageing process of the spine and is common in people above the age of 60.

Piriformis syndrome
The piriformis is a small muscle in the buttock under which the sciatic nerve passes. Pain similar to sciatica may be felt if the piriformis muscle compresses the sciatic nerve.

Pregnancy
In the last trimester of pregnancy where there is increase in blood flow to the spine, there may be a resulting compression of nerves.

Other causes of sciatica are muscle strain, spinal tumours, inflammation, infection and trauma.

What are the typical sciatica symptoms?

Common symptoms of sciatica are leg pain, tingling, numbness and muscle weakness. A sufferer of sciatica may likely experience pain in one leg/buttock that gets worse while sitting. He/she may also feel a burning or tingling sensation (pins and needles) anywhere between the path of the sciatic nerve from the buttock to the foot, depending on the level of the nerve root irritation.

For example, a compression or irritation of the spinal nerve root at the L4 level ( fourth lumbar vertebrae) will present with pain, tingling and numbness in the thigh area; while a compression of the nerve root at the L5/S1 level ( fifth lumbar and first sacral vertebrae) will produce pain and tingling in the foot.

It is also likely that the leg pain is more discomforting than the back pain felt by a sufferer of sciatica.
Another common symptom of sciatica is pain that worsens with increase of the abdominal pressure, like coughing or sneezing.

How can physiotherapy help?
Since sciatica is really the evidence or a symptom of an underlying condition, therapy will focus on treating this underlying cause and therefore management or treatment methods may vary.

The aim of physiotherapy management would be to relieve pain, promote healing of the affected structures and maintain normal function. Your physiotherapist will also focus on sustaining regular movement of the affected area ad this will help to accelerate healing.

Massage Therapy
Massage increases blood circulation, helps muscle relaxation and promotes healing.

Exercise Therapy
Your physical therapist can recommend back flexion exercises, extension exercises, stretching exercises and /or strengthening exercises depending on your condition or presenting symptoms.

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