We have patients visiting us at the clinic everyday complaining of “sciatica”. For some, they report pain along their buttock, going down to their calf. For other patients, their discomfort starts in the groin and goes down the side of their knee. Often, it is because they have either strained their back gardening or pulled their leg muscles during a long hike. How can pain in different parts of the lower limbs all be called sciatica? Is all leg pain called sciatica?
What is Sciatica?
Sciatica is not a diagnosis, but rather, a term used for leg pain and/or weakness as a result of irritation and/or injury to the sciatic nerve. This is a major nerve that runs down the back of each buttock and thigh. If this nerve is pinched, stretched or tethered anywhere along its path, it will result in pain or weakness going down the buttock, back of the thigh, lower leg and/or foot.
Sciatic nerve pain can vary from burning, aching, throbbing to tingling and numbness. Patients can also experience weakness in their leg muscles, often the calf.
It is unlikely that pain along the front of the thigh is sciatica; this is usually due to injury to another major nerve, the femoral nerve.
What Causes Sciatica?
Sciatic nerve irritation or injury can be caused by several things. Two of the most common are:
- Injury to the Low Back
The sciatic nerve is actually a nerve bundle, made of several nerves exiting your lower spine. These nerves meet up and become the sciatic nerve. If there is injury to the low back, causing swelling in the area, the individual nerves leaving that part of the spine may get pinched or stretched.
Sometimes, old injuries resulting in bony scar tissue called bone spurs or osteophytes may also be pinching the nerve.
Another common cause of sciatic nerve pinching in the low back is the hardening of the fluid discs sitting in between our bony vertebrae. The discs lose their height, resulting in decreased space for the nerves to travel through.
- Muscle Tightness in the Hip/Buttock Region
Another common area where the sciatic nerve may get compressed or stretched is near the buttock region. If the muscles in the buttock are strained or tightened, they compress the sciatic nerve as it passes through the area.
How Can Sciatica be Treated?
Treatment for sciatic nerve symptoms depends on what is causing the nerve injury or irritation. As the symptoms can feel the same, regardless of where the nerve is being compressed or stretched, it can be tricky to determine the cause. An experienced therapist will perform tests to narrow down and find the root cause of your sciatic pain.
Once they have done this, treatment will focus on removing the pressure or stretch placed on the sciatic nerve. This can include:
- reducing any inflammation to the sciatic nerve and/or surrounding tissues
- stretching exercises to lengthen any tight muscles that may be compressing the sciatic nerve
- exercises to remove or reduce the pressure placed on the nerve
- possibly mechanical traction, to help reduce the compression on the sciatic nerve. The use of mechanical traction depends on what is causing the nerve to be pinched, and is not safe to use on all people with sciatic nerve pain.
This is just a brief description of causes of, and treatment for, sciatic nerve pain. Because nerves are very sensitive tissues, it is important that you ask your physiotherapist which exercises and treatment modalities are suitable and safe for your specific situation.