Sciatica is a symptom consisting of radiating pain down the back of your leg. This pain may vary from an ache or cramp to excruciating, shooting pain that makes standing or sitting nearly impossible. The leg pain may also be accompanied by weakness, numbness, or a burning/ tingling (“pins and needles”) sensation down your leg. Common symptoms might include the inability to bend your knee or move your foot and toes.
There are several different causes of sciatica. Each of these conditions involve irritation of the sciatic nerve, which runs from the low back down the back of the leg and eventually into the top of your foot. The sciatic nerve can become irritated in several different locations and the key for proper treatment is first determining the location and trigger for sciatica.
Herniated disc – A bulging or herniated disc puts pressure on a nerve root and is the most common cause.
Spinal stenosis – This condition results from narrowing of the spinal canal which can put pressure on the nerves.
Spondylolisthesis – This is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits the spinal canal.
Piriformis syndrome – This develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight and can place pressure on the sciatic nerve.
Pain Referral – Often times Sciatica is misdiagnosed for referred pain coming from your hip. As the muscles in your hips become tight and develop imbalances they often then can refer pain often times down the back of the leg. While true sciatica is irritation of the sciatic nerve pain referral patterns also can cause sciatic like symptoms.
A complete medical history and orthopedic and neurological exam should be preformed to diagnose sciatica to determine its cause. They key to proper treatment with sciatica is determining the proper location of the cause. X-rays, MRI, NCV, and EMG’s may also be ordered to help determine the location and cause of sciatica but often times treatment does not have to wait for those diagnostic tests to come back.
The first step in properly treating sciatica is determining the location and the cause. The next step in treatment is helping to not only decrease the pain but centralize the symptom. As pain likes to travel throughout the healing process we should notice that pain would start to centralize (meaning come back to the center or origin). Research shows that anything that helps to centralize pain is a good thing and should be continued while anything that make the pain travel is often times a warning sign to stop and reassess.
Once pain is centralized the goal should be to restore function to the hips or back to help prevent this condition from reoccurring. Corrective exercises should be given to help stabilize your core but also focus on movement to help prevent irritating your condition further. Depending on the location of your sciatica, Active Release Technique, Graston, Post Isometric Relaxation,and chiropractic adjustments may also be performed to help ease tension of the tight muscles of your hips, increase quality of the muscles in your low back and restore proper mechanics to your spine.