Understanding your sciatica and releasing the nerve pain.
Sciatica is the name given to a condition which is characterised by tingling or numbness, a sharp, burning sensation or pain that radiates along the path of the sciatic nerve. Pain is caused by compression or irritation of the sciatic nerve roots from the lower back. Sciatica can be extremely painful, disruptive and can stop you doing the most basic everyday tasks, severely interrupting your life.
The Sciatic Nerve
The sciatic nerve is the longest and thickest nerve in the body. It is made up of two nerve roots that exit from the both sides of the lower lumbar spine, and three nerve roots that exit from the sacrum, at T4 to S3. It then travels from your lower back through your buttock and hips, and down your posterior thigh where it divides into two branches at the knee, continuing on to the foot. The sciatic nerve innervates all muscle activity and superficial nerve sensations in your leg and foot. It is vital for the control of all movement, sensation and balance.
Sciatica is often characterized by:
Pain felt primarily in one side of the buttock or leg (rarely in both legs)
Searing pain that radiates down the leg, possibly into the foot and toes (it rarely occurs only in the foot)
Pain felt during prolonged sitting
Pain can be accompanied by burning, tingling or ‘pins and needles’
A sensation like an electric shock along the nerve
At times numbness and muscular weakness in the leg
Weakness that can cause your knees to buckle when you stand up from sitting.
Foot drop, a condition in which you are not able to flex your ankles enough to walk on your heels.
Reduced reflexes in your Achilles tendon and knee.
Difficulty moving the leg, foot, and/or toes
It may occur with or without low back pain
A sharp pain that may make it difficult to stand up or walk
Loss of control of your bladder or bowels
A physical examination by a Doctor and an MRI and further studies may be required to diagnose if any structural abnormalities are present if symptoms persist for > 6 wk.
Causes of Sciatica
Compression or irritation of the sciatic nerve roots from the lower back is the main cause of Sciatica. The sciatic nerve passes directly underneath the piriformis muscle that lies deep underneath the gluteal muscles of the buttocks. When the muscles and fascia of the Gluteal, Piriformis and thigh muscles contract and shorten they can compress, irritate and inflame the Sciatic nerve beneath. In 2005, a study in the Journal of Neurosurgery: Spine showed that nearly 70 percent of sciatica cases are caused by the Piriformis muscle.
Compression can be caused by a herniated intervertebral disk (bulging or sticking out).Sciatica is the name for a syndrome which is characterised by pain that radiates along the path of the sciatic nerve. The sciatic nerve is the longest and largest nerve in the body — it is as thick as one of your fingers where it arises in the lower spine. It then travels from your lower back through your hip and buttock and down your leg where it divides into two branches at the knee. Each leg has its own sciatic nerve
Compression or irritation due to Osteophytes or Bone Spurs that are bony growths that form where cartilage is worn away in the spine.
Lumbar spinal canal stenosis is narrowing of the space available for nerves in the lumbar spine. Narrowing of the lumbar spinal canal puts pressure on the nerves including the Sciatic Nerve.
Risk Factors for Sciatica
Risk factors that may contribute to spinal issues and compression include;
Prolonged sitting or not maintaining good body posture while sitting. A sedentary lifestyle.
Repetitive tasks that cause undue stress on the disks of the lumbar spine, as in lifting heavy loads and excessive driving, etc.
Age related changes to the spine such as herniated disks and bone spurs.
Excess body weight can contribute to additional stress on the spine
Diabetes, as this condition affects the body’s use of sugar therefore increasing the risk of nerve damage.
Treatment of Sciatica
Massage is a very success modality for the relief of Sciatica. Massage is a holistic approach that mobilises contracted tissues, relieves pain, improves blood flow and reduces swelling. Remedial massage using a variety of techniques such as Trigger Point Therapy and Myofascial Release to improve muscle extension allowing more flexibility and mobility within the body, especially vertebrae and joints that may have limited mobility and feel locked.
Myofascial Dry Needling is an important modality to assist in relief of taut bands and trigger points in muscle tightness. Releasing tight bands of muscle tissue improves muscle stretch and contraction releasing compression of nerves.
Management of Sciatica
Key requirements to maintain a healthy back and to prevent Sciatica and the re-occurrence of sciatica are good body mechanics when working, lifting, etc. Maintaining good posture when standing, walking and especially sitting with good ergonomics and support. Using chairs with good lumbar support, moving around more and sitting less during the day. Taking warm baths and sleeping on a mattress with good back support also help.
Yoga Exercises for sciatica during yoga practice heavily involve the spine and aim to develop space between the vertebrae. Yoga helps us extend the spine (and many other areas of the body) through moving, twisting, and flexing.