What’s Causing Your Sciatica?
One of the most common complaints addressed in chiropractic clinics is “#sciatica”. The number of phone calls and medical histories that include the patient informing me of the “#diagnosis” of “#sciatica” is something in the realm of over 40%.
With this very frequent complaint, what exactly causes it, and how is it best addressed? After reading this, if you have #sciatica, you should be able to figure out what causes it, or at the very least know what direction to head in to get it resolved.
Firstly, we must established the difference between a #SYMPTOM and a #DIAGNOSIS. #symptoms describe the patient’s presenting condition. For example, a patient may present with a runny nose, sore throat, and fever. Each of these elements may be considered as a “#symptom”. The “#diagnosis” is the doctor’s attempt at describing the root cause of these #symptoms. With the aforementioned patient, the #diagnosis could be the cold, influenza, or COVID. Note that none of a “runny nose”, “sore throat” or “fever” is a possible #diagnosis.
#sciatica is a #SYMPTOM. It describes #pain traveling down the back of the #leg, in the #sciatic Nerve’s distribution. Someone using “##sciatica” as a #diagnosis, is the equivalent to entering a doctor’s office with a complaint of “arm #pain” and the doctor giving you the #diagnosis of “arm #pain”. Not particularly helpful & completely redundant.
To discuss today, there are 3 common and not very serious reasons patients in my clinic typically present with ##sciatica, and a 4th less common, but a little more serious.
Anecdotally, one of the most common diagnoses that I see patients with #sciatica with is Sacroiliac (or SI) Syndrome. As already stated, the #sciatic nerve travels out the bottom of the spine & down the back of the #leg – in very close proximity to the SI joint. The SI joints are some of the most immobile joints in our body, however they do still require 2-3° to function properly. Loss of this very small amount of rotation predisposes tension along the ##sciatica nerve – which can be a cause of #sciatic #pain.
The second most common source I see is Facet Syndrome. A facet is the term given to the joints that connect our vertebrae (the bones of our spine) together. They exist right by the exit-way for the spinal nerves from our vertebral canal, to their target muscles. As such, local inflammation of a facet joint may also irritate the neighbouring spinal nerve root. Should facet syndrome arise at the L5 or S1 spinal nerves (two spinal nerves that constitute the #sciatic nerve), we have another recipe for perceived #sciatica.
The third frequent source of #sciatica #pain I see is from Piriformis Syndrome. The Piriformis is a very important muscle located deep to our gluteal (butt) muscles. It connects our sacrum (bottom of our spine) to our Femur (#leg bone), and is responsible for turning our hip/foot outward, or away, from our body. The #sciatic nerve passes directly underneath the Piriformis; should this muscle become hypertonic, or tense up, we can get a pinching on the #sciatic nerve – again producing ##sciatica.
The fourth #diagnosis to discuss is Disc Herniations. This is one of those diagnoses that many people worry frequently about at the first sign of back #pain, but are a lot less common than people seem to think. Our vertebral discs exist between our vertebrae, and given enough stress the possibility exists that they “herniate” backward and impinge directly onto our spinal nerves. If you’re having trouble visualizing this, picture biting into a sandwich or burger & having all the toppings push out the other side & fall on your plate – that’s a herniation.
So, what to do if you are experiencing #sciatica? If you’ve watch my videos or read other blog posts the answer should be obvious – seek an examination from a healthcare provider whom you trust. Should this healthcare provider give you the #diagnosis of “##sciatica”, ask them to explain what they believe is the cause of it. If you are not satisfied with their answer, or if they are unable to answer it, I highly recommend seeking a different healthcare practitioner.
In the meantime, a very simple screen you can do yourself at home is to MOVE. Move your lower body through a wide range of motions – forward, backward, side-to-side, twisting. If these movements either worsen or lessen your discomfort/#pain, it is very likely you have a musculoskeletal component. Therefore, a visit to either an evidence-based chiropractor (oh look, that’s me!) or physiotherapist would be most appropriate.
If your movement does NOT have an affect on your experienced #sciatica, it is possible that your complaint is more visceral in nature, and you should consider promptly visiting your MD.
Thanks for reading all; until next time!
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