Blog

Sciatica or sciatic pain refers to pain and dysfunction that radiates along the path represented by the sciatic nerve. It is a frequent injury we see at PhysioWorks. Even though it is a common problem, I would like to take some time to explain why your diagnosis of ‘sciatica’ can significantly differ from another individual’s and be so difficult to resolve.

Anatomy

The sciatic nerve is a large nerve that is made up of several nerve roots emerging from your lower lumbar and sacral region, specifically L4 to S3 nerve roots. These nerve roots converge to form the large sciatic nerve that runs deep through your buttock and travels down the back of your thigh and branches into 2 separate nerves below the knee. These 2 nerves supply muscles and sensory receptors of the posterior and lateral lower leg and finally into the foot. It supplies motor information to muscles of your lower extremity and relays sensory information from your lower extremity to the spinal cord and higher centres.

Symptoms

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark report of sciatica. Just as its anatomy indicates, one could feel discomfort almost anywhere along the nerve pathway, but it’s especially likely to follow a path from your low back to your buttock and the back of your thigh and calf. But not always in a specific order or pattern.

The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.

Numbness, tingling or decreased sensation in any area innervated by the sciatic nerve is also a common report. Even with absence of any pain. Muscle weakness in the affected leg or foot can also be evident. You might have pain in one part of your leg and numbness in another part.

Common Causes

You are probably now understanding that your family member or the neighbour’s sciatica may not be the same as yours. Therefore it is important to assess and determine what is causing the irritation on your sciatic nerve. The causes are just as variable as its symptoms. The following are few common issues that can contribute to sciatica.

• Disc protrusion or herniation that causes pressure on the nerve roots making up the sciatic nerve
• Arthritis and degeneration in the spine
• Tight muscles along the pathway
• Poor core stability

Whether it’s an intense burning pain that starts in your low back and shoots down your leg or a stubborn foot pain or numbness that persists, sciatica can present itself in many forms. It is important to have it thoroughly assessed by a health care professional who understands the complexity of sciatic pain. Our therapists at PhysioWorks are available to work with you through your recovery.

Rob Iwasaki, BScPT, BScKin, Clinical STOTT Pilates, CAFCI