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“Sciatica” is a term in reference to symptoms experienced when there is a compression or irritation involving the sciatic nerve. The sciatic nerve is comprised of 5 nerve roots stemming from the spinal cord. The nerve starts in the lower back, goes through the buttocks and down the back of each leg. Sciatic symptoms include pain, tingling, numbness and sometimes weakness. Usually symptoms are only experienced on one side of the body. These symptoms are provoked when the nerve is being compressed or irritated. There are multiple causes of sciatica . The most common cause is from a disc herniation. The disc compresses the nerve root where it exits the spine. When the nerve is compressed it causes a referring pain down the sciatic nerve. This is referred to as a radiculopathy (sciatica caused by compression of the sciatic nerve at the nerve root, where it exits the spine). Some of the other causes include spinal stenosis (narrowing of where the nerve roots exit), spondylolisthesis (where one vertebra slips forward over another one), degenerative disc disease (breakdown of disc), piriformis syndrome (the muscle tightens up or goes into spasms and pinches the sciatic nerve), trigger points, and pregnancy. Treatment and symptoms differ based on the underlying cause. If you are experiencing sciatic symptoms, make sure to discuss this with your doctor. Physical therapy may be an appropriate means of treatment to correct the problem.

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Sciatica refers to pain that radiates or shoots along the path of the sciatic nerve and its branches, from your back down through your buttock and leg. The sciatic nerve is the longest nerve in your body, running from your spinal cord through your buttock/hip area, down the back of the leg and into your foot.  It is a large nerve formed from the nerve roots of lumbar levels 4 and 5, and sacral levels 1, 2, and 3 in your low back. The sciatic nerve controls many of the muscles in your lower legs and provides sensation in your thighs, legs and feet.

Sciatica is a symptom of several types of injuries, all of which irritate the nerve, causing pain.  The cause of sciatica can come from a number of different sources, which may affect the type of treatment needed, so knowing the source is very important for recovery.  Most commonly, sciatica is a result of a herniated disc in the lower back.  This puts pressure on the nerve root, causing irritation of the sciatic nerve.   A herniated disc occurs  when the gel-like substance in the center of the disc protrudes through the outer fibrous layer of the disc, putting pressure on the nerve root itself.  This disc protrusion can cause swelling and irritation of the nerve root.

Another cause of sciatica is spinal stenosis, which is a narrowing of the spinal canal (space in which the spinal cord passes).  This narrowing can compress the spinal cord and  the nerve roots.  Spinal stenosis can often present as sciatica in both legs whereas most other causes present as sciatica in one leg.

Piriformis syndrome is another cause of sciatica.  The piriformis muscle is located in the buttock and it can become severely tight or spasm, putting pressure on the sciatic nerve causing shooting pain and irritation.  Sciatica is also very common during pregnancy, as the changes in joint mobility and body mass can lead to irritation of the sciatic nerve.  Many other causes, such as trauma, muscle imbalance, and bad habits like poor sitting posture and sitting on a large wallet can cause sciatica.

Sciatica is very well known, and most people have had an episode of what they call sciatica, or know someone who has.   However, sciatica is only a symptom, and knowing the cause is very important in recovery.  Physical therapy can help treat many causes of sciatica, and can relieve your symptoms while helping to correct the cause. 

Through stretching, core strengthening, massage, traction (stretching of the spine), exercise, and education, a physical therapist can help get you on the road to recovery.  Too many times people are diagnosed with sciatica and end up just resting and icing.  While this may be enough during an acute phase to relieve the symptoms, the underlying cause will not go away with rest and ice.  It is important to go through a thorough evaluation to determine what is causing the sciatica, so appropriate treatment can be initiated to provide a full recovery and prevent it from being a recurring issue. 

If you are experiencing symptoms that sound like sciatica, talk to your doctor and/or physical therapist for a proper diagnosis and intervention.  Please contact me at Scott@JointVenturesPT.com if you have any questions about sciatica.

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