Oh My Sciatica! – By Brett Qualls, PT, DPT, OCS
In my clinical practice, I always start a new patient evaluation with an interview process. It is during that time that we discuss what my new patient is feeling, how their problems started, and what their goals in physical therapy are. It is during this time that many patients will describe what they think is going on with their body. Often times they are 100 percent correct, while other times it is unclear what is the source of their pain or dysfunction.
One of the more commonly described problems in my clinic is “sciatica”. While this is a fairly specific diagnosis, you would be surprised how many times the sciatic nerve gets unfairly blamed for things. Due to this unjust blame, I typically continue that conversation by asking the patient “What does sciatica mean to you?”. You would likely be surprised by the wide variety of explanations of what sciatica means to people. Many other conditions often get mislabeled as sciatica. Misnaming your condition as “sciatica” does not mean that your pain isn’t real, it simply means that you may be ascribing blame to the wrong character.
Sciatica is defined as pain that radiates along the trajectory of the sciatic nerve. The sciatic nerve is the longest and largest diameter nerve that we have in our body. It originates in the low back and runs down the thigh into the lower leg. Therefore, irritation of the sciatic nerve would cause pains that radiate from the low back/buttock region and into the lower leg. It is certainly possible to have sciatic pain without any pain in your back and vice versa. Above all, the key to being diagnosed as possible sciatica is the radiating leg pain.
Sciatica can cause extreme amounts of pain, numbness/tingling, and even weakness in your leg. Sciatic pain can truly be debilitating and can interrupt all facets of your life. The good news: sciatic pain doe not have to be permanent. Understanding what causes your sciatica puts you in a better position to manage it.
Causes of Sciatica
There are a whole host of things that can cause true sciatic irritation. This irritation could be coming from inflammation around the sciatic nerve, a disc bulge, thinning discs, or even a bone spur. Being diagnosed with sciatica suggests the symptoms that you are having, but does not necessarily define the cause. It is through a thorough examination/evaluation process that you can start to hone in on what might be the likely cause of the irritation of the sciatic nerve.
Sciatic nerve irritation does not have one universal cause, and therefore does not have one universal treatment. Sciatica associated with bone spur formation would be treated differently that sciatica stemming from an inflammatory condition. Once the likely cause of sciatic irritation is identified, it is then that we can start looking at strategic treatment interventions. In short, the key here is getting a good diagnosis. Treatments vary from self-stretching, physical therapy, medications, injections, and even surgery. Typically we will start with more conservative measures prior to moving onto those that are more invasive.
In clinical research we see that they longer that sciatic nerve pain persists, the harder that it is to treat. Early diagnosis and early intervention seem to offer the best chance at a successful treatment and resolution of the radiating leg pains.
“Sciatica” is often thrown around as a slang term, it is a very specific condition with several different treatment options. If you are having some of the symptoms that were described above, I encourage you to reach out to your medical professionals and get the diagnosis process started!
*Copyright Havasu Living Magazine