Fact about Sciatica

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What is Sciatica?

What is Sciatica?

 

 

Technically speaking, sciatica is a symptom not a diagnosis It is a

non-specific term commonly used to describe symptoms of pain radiating downward

from the buttock over the posterior or lateral side of the lower limb. It is

usually assumed to be caused by compression of a nerve but this is not

necessarily so.

 

 

A common neurolgical cause of this pain is entrapment of the sciatic and/or

posterior femoral cutaneous nerves. But the pain may be caused by trigger points

in the soft tissue. This latter case is easily overlooked and requires manual

palpation of the musculature associated with the hip if the pain is not to be

misdiagnosed.

 

Background

 

It is often assumed that there is sciatic nerve root entrapment, resulting in

the compression of the nerve. Pain and symptoms being transmitted or referred

from the low back to one of the buttocks and down the back of the leg along the

pathway of the sciatic nerve. Hence the term sciatica.

The exact cause of sciatica is not fully understood but is commonly thought to

involve a slipped or herniated disk. This means one of the disks, which lie

between each of the vertebra in the lower back (lumbar area), has cracked and

allowed some of the inner disk material to protrude out, putting pressure on the

adjacent nerve root, which in this case is the sciatic nerve. The term 'lumbago'

is often banded about as well which is a general term for low back pain.

However, some people have been found to have a slipped disk but have no pain.

 

Sciatica Symptoms

 

Symptoms can vary from extreme pain in the low back radiating into one buttock

and down the leg. Pain often increases on exertion or bending forward.

Alternatively, there may only be a mild sensation in the leg or buttock. There

may be numbness in the area, weakness in the leg and diminution of the reflexes.

Pain may be triggered by coughing or straining and can be so severe that the

lower back becomes locked in sideways bending position (scoliosis) caused by a

strong contraction.

 

 

Alternatively, it may only come on when sitting or standing in a certain

position. Clinical experience indicates that these certain positions are usually

associated with continually holding a poor posture either at home or at work.

For example, protruding the head forward peering at a computer all day or

regularly lifting a baby out of the back of the car. But some or all of these

symptoms are also associated with other conditions which is probably why the

name is often misused as a catchall word for any pain affecting the buttocks or

other parts of the leg. In this case the pain is triggered by a local trapping

(trigger point) or straining of the nerve along its pathway.

 

Piraformis Syndrome Symptoms

 

May be a mixture of seemingly unrelated symptoms. Pain and paresthsias (pins

and needles) may be apparent in one or more of these areas: the low back, groin,

perineum, buttock, hip, back of the thigh, leg and foot or the SI joint.

Swelling can occur in the painful leg and sexual dysfunction can occur. The

condition can be aggravated by sitting, getting up, or standing. Conversely,

activity can worsen the symptoms. It can also cause the buttock muscles to

atrophy. Numbness of the foot and loss of position sense (proprioception) can

lead to an unstable walk.

 

Activation

 

Piraformis syndrome can be activated in numerous seemingly different ways. For

example, long drives in the car result in the accelerator foot being flexed for

long periods, resulting in the tightening of the piraformis muscle. Lifting or

lowering of a heavy weight, catching oneself from falling, twisting sideways

while bending or lifting a weight such as a baby out of the back of the car.

Direct trauma such as hitting the muscle itself or impact caused by a car

accident particularly when the impact is from the side. Morton's foot (second

toe is longer than the big toe) can initiate the syndrome after a long walk.

This is because the condition tends to cause medial rotation and adduction

(inward movement) of the thigh, which puts a strain on the piraformis.

 

 

 

 

 

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