“I think my sciatica is flared up”, is this you or someone you know anytime lower back pain is talked about? Lets clear up what sciatica really is!

After being in practice I have heard sciatica used to describe pain anywhere from the lower back to the foot and anywhere between these. This blog is here to clear up the confusion and explain what it really is! Sciatica is a term that should be used to describe pain that goes from the lower back into one of the legs, we also call this radicular symptoms. The sciatic nerve starts in the lower back, travels into the leg and branches into many different nerves to provide sensation and function. To start this is a giant nerve that comes from 5 different spaces starting at L4 and finishing at S3. These 5 nerve roots come out of the lumbar spine and sacrum to join together to create the sciatic nerve. This giant nerve then proceeds down the leg to allow you to both move and feel!

Now there are a multiple of factors that can create this pain that goes down your leg. The pain is primarily going to come from 3 different areas that are either the nerve, a joint or a muscle. The nerve can be broken down into a few different options as well, a disc herniation compressing the nerve, the nerve being pinched at the intervertebral foramen or inflammation around the nerve. What we most commonly see in practice is a disc herniation that is creating compression at one of the previously mentioned nerve levels creating lower back pain primarily, with symptoms into the lower extremity of the patient. The facet joints of the lower back can get “stuck” and lose range of motion creating pain in the lower back. The Sacroiliac Joint (SIJ) can create lower back pain that wraps around the hip like a C into the groin. And lastly the gluteus medius, a stabilizing muscle of the hip, can develop knots that we call trigger points (TrPs) that can mimic sciatic pain and have symptoms into the leg of the patient. The question now becomes: how do we figure this out and how can we treat it?

An examination by the chiropractor will help to determine what the cause of your pain is and the best way to move forward with this. Now there are too many symptoms to just list everything but a few to get us headed in the right direction are as follows:

Better with movement, hurts to sit, worse in the morning – possibly disc  Worse with movement, stretching might help, point tender on the muscle – possibly muscle Feel stuck or lack of mobility, tender over the “butt bone” or right on the spine -possibly joint

Now this is not an exact list and should not be used to diagnose but is a great way to start looking at your pain.

Treatment for these symptoms can look similar for all the possible factors but will be directed toward the specific pain generator. Possible treatment options at the clinic will be manipulation or adjustments, soft tissue work, and/or rehab exercises.