What is Sciatica

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Sciatica

Published: 06 December 2015

An Introduction to Sciatica

So, what is Sciatica? I myself suffered severely from sciatica in my early twenties and it took that horrible experience to fully understand just what sciatica really is!

I never tire talking about sciatica and working with my clients who experience sciatic pain! Now I will aim to answer the question - just what is sciatica?

Sciatica is where a nerve in your back and leg called the sciatic nerve is compromised and inflamed either at its source (in your lower back), or somewhere along its course down the back of your leg.

The Sciatic Nerve

Sciatic nerve pain is, in my experience, one of the most painful feelings around! It can frequently put your life on hold!

So, in order to fully understand your sciatica, it is important that you first have a picture and understanding of your sciatic nerve in your head!

Your sciatic nerve is the biggest peripheral nerve in your body, so this explains in a nutshell how it can cause such a problem to your life when it is not functioning well. So, how does your sciatic nerve become compromised? Now this is where the fun and confusion begins as there are so many reasons and causes of sciatica.

I am going to tell you about the most frequently encountered sciatica presentations that I treat on a daily basis in my own physiotherapy clinic.

• Disc prolapses: Are where a disc in your lower back is out of its correct position and physically pinches your sciatic nerve. It is the most common cause of sciatica both in my physiotherapy practice and with other practitioners worldwide (from what I see documented).

• Piriformis syndrome: Is where your piriformis muscle becomes tight and pinches your sciatic nerve (See the diagram above). It is often associated with buttocks pain and it usually results from an impact to your hip - usually a number of days before the sciatic pain arrives. It can also result from poor sitting or standing over the long-term.

• Back Arthritis: Is narrowing of your spinal joints from wear and tear or systemic arthritis. Arthritis can cause inflammation to your sciatic nerve either directly from bony impingement, or from the poor movement patterns that evolve from ongoing inflammation.

• Spondylolisthesis:: Is where there is a forward slippage of one of your spinal vertebra relative to another, causing the sciatic nerve to be compressed at its origin in your lower back.

• Spinal stenosis: Is where part of your spinal canal is narrowed, most commonly by excess bony or tissue growth, which then impinges on your sciatic nerve. There are many causes of spinal stenosis (also see symptoms of spinal stenosis).

Although the above are the main causes of sciatica - ultimately poor posture and movement techniques are the underlying cause of 70% of sciatica patients that I see. So, to prevent sciatica or help manage it - start working on a good posture at once (see my article on a good sitting posture)!

Sciatica - in Summary

In summary, sciatica is where your sciatic nerve is pinched, damaged or inflamed - resulting in leg pain radiating from your buttock down the back of your thigh (most commonly). Understanding and diagnosing the cause of your sciatica is the key! Once the cause is identified treatment is usually very effective from a physiotherapy perspective.

While manual therapy is the primary treatment for sciatica - it will unload your sciatic nerve and resolve your symptoms - a full resolution usually requires posture correction to address the primary causes and to prevent re-occurrence.

A lot of people, when they first experience sciatica make the mistake of relying on medical treatments without fully understanding the cause. In my own case, once the cause of my sciatica was found - the results were quick and effective. I saved myself months of pain and dysfunction because I went and sought the correct physiotherapy diagnosis at the outset.

Seek the cause and then you will find the cure is my personal and professional advice!