Sciatica. What a pain in the bum!
Updated: Aug 3
What is Sciatica?
Despite being an incredibly common phrase in the publics vocabulary these days, the term ‘Sciatica’ is not actually a medical diagnosis. It is more of a description of the symptoms caused by the actual diagnosis. To understand sciatica, we have to go back to where it all started, well, where all your nerves start that is. Nearly all the nerves in your body originate in the spine and the nervous system can be categorised into two main sections, central and peripheral. All nerves start centrally, at their root in the spinal cord, then travel out of the spinal cord into the body, branching off as they go (Peripheral nerves). Now then, sciatica gains its name from the nerve which it is associated with, the Sciatic nerve. Makes sense huh? The sciatic nerve is approximately the same thickness as your thumb, and begins within the spinal cord, more specifically the levels in your spine L4 (the fourth lumbar vertebra) to S3 (Sacrum 3). Irritation of the L4 nerve root can send pain down your sciatic nerve, making you feel pain in your buttock and even down to the foot.
What causes Sciatica?
There a numerous causes of Sciatica. A common cause is Intervertebral disc herniation (commonly known as a “Slipped disc”). This is where the jelly like substance on the inside of the disc pushes through the harder outer layer of the disc and pushes on the nerve causing pain. Whilst these can be incredibly painful and debilitating they are usually self-limiting and usually heal on their own. Disc herniation’s are actually more common in the age range of about between 20-40. The likelihood of a disc herniating starts to decrease after the age of 40, however that doesn’t mean it’s impossible.
2. Spinal Stenosis.
Stenosis means , the point at which the nerve exits the spine called the has narrowed causing irritation to the nerve. Bony protrusions in your spine known as can irritate the nerve as it exits the spinal column. These can be caused by arthritis in the spine or from trauma. You may also hear this referred to as spinal stenosis. Stenosis is more common in men over the age of 50.
A spondylolisthesis basically means that one vertebral body has slipped and moved forward compared to the vertebral body below it. As a result of this movement, irritation to nerve roots can be caused. The most common type of spondylolisthesis is known as an isthmic spondylolisthesis. This term refers to a small facture through a part of the vertebral body known as the pars interarticularis. Despite popular belief, direct trauma is not a common cause of fracture to the pars, the fracture is usually due to a build-up of stress over a period of time. It most commonly occurs at the L5 – S1 level of the spine but is also found at L4-5 and L3 – 4, though usually these levels are fractured due to trauma and not due to a build-up of stress.
4. Lumbar Degenerative Disc Disease (DDD)
Much like how the joints in your spine and other parts of your body may deteriorate over time, the same can be said for the discs in between your vertebrae. This is not a disc herniation (slipped disc). The discs are soft tissue structures made up of a softer, jelly-like interior and a tougher more fibrous exterior. These can degenerate over the years of one’s life through general wear and tear. Discs in the spine do not have a blood supply which means that once they begin to damage they cannot heal themselves. Whilst the disc is degenerating, inflammatory proteins will leak out of the disc irritating the sciatic nerve. However once the all of the proteins have leaked out the disease tends to settle down and the pain decreases. For example, if one is diagnosed with DDD in their early 40’s, the pain will usually subside for the most part in their 60’s.
5. Piriformis Syndrome
The Piriformis is a muscle in the buttocks that externally rotates the hip, making your foot point outwards. In some individuals the sciatic nerve naturally pierces this muscle as it travels down the leg. Sometimes, this muscle can become tight and can tend to irritate the sciatic nerve.
Can chiropractic help with Sciatica?
Well, the answer depends on what is causing your sciatica. Here at Ashwood Chiropractic our Chiropractors will be able to determine what is causing your sciatic nerve pain by conducting an in depth examination of neurological and musculoskeletal systems as well as looking at your posture and your general lifestyle. We will be able to guide you in the right direction to make sure you recover back to your best. Whether that be with Chiropractic treatment or through other methods, we will make sure you are in the best possible place to recover.
Don’t live with the pain in the bum that sciatica can be and get it sorted so that you can return to being you again.