Writer: BRAD WALKER | Outlet: Stretch Coach
What is Sciatica?
Sciatica is a name given to pain caused by pressure placed on the sciatic nerve. When a nerve is placed under pressure it sends out pain signals. It may radiate down the length of the nerve or be focused in a specific area. The muscles innervated by the nerve may or may not be directly affected.
What Causes Sciatica Pain?
Sciatica has several possible causes. Any condition that puts pressure on the sciatic nerve can result in pain in the lower back, buttocks and back of the leg. The pressure may come from vertebral discs, bones or muscles. The causes of sciatica pain may be acute or chronic. A traumatic event may result in injury to the lower back or hip area causing pressure on the sciatic nerve through misplaced bones, spasm of a muscle or inflammation from the injury.
Chronic causes of sciatica may be due to muscle imbalances, misaligned bones, or narrowing space in the vertebrae. There are four conditions that most commonly cause sciatica.
- Piriformis syndrome is one common cause and is the result of the piriformis muscle putting pressure on the nerve. This may be caused by misalignment of the pelvis and/or hip joint, which changes the position of the piriformis, placing pressure on the sciatic nerve. This misalignment is often caused by muscle imbalances.
- Herniated discs in the spinal column can also put pressure on the nerve. A herniation, or protrusion, of the disc can result from a traumatic event or from years of pressure from muscle imbalances.
- A third possibility is Spinal Stenosis, or a decrease in the space between the vertebrae. This reduced space compacts the nerve where it leaves the spinal column. The narrowing is often caused by compression on the spine due to muscle imbalances.
- The fourth cause is Isthmic Spondylolisthesis, which is a condition where the vertebrae slips or moves out of position, pinching or placing pressure on the sciatic nerve. This may be caused by a traumatic event or a chronic muscle imbalance.
Sciatica Pain Treatment
When sciatic nerve pain is caused by an acute injury the first step is to treat the injury. The R.I.C.E.R. formula (Rest, Ice, Compression and Elevation, followed by Referral) may be used for the first 48 to 72 hours. Reducing the inflammation caused by the injury will help reduce the pain. After the initial 72 hours heat and gentle massage may be used to warm and relax the muscles around the nerve. Once tolerated, some physical therapy or light exercise to improve the strength and flexibility the injured muscles may also alleviate some of the pressure.
Sciatica caused by a chronic condition requires a correction of the underlying problem that caused it in the first place. If it is caused by a bone displacement, then a correction or realignment of the bones will be required. If the pain is caused by a muscle imbalance the imbalance must be corrected. While the underlying problem is being fixed, non-steroidal anti-inflammatory medications can be used, along with ice, to reduce the pressure on the nerve caused by the inflammation. Later, ultrasound, massage and heat may also help to relax the muscles around the sciatic nerve, reducing the compaction on the nerve.
Correcting the underlying causes and taking the time to fully rehabilitate the muscles will help ensure proper healing. It will also reduce the chance of a chronic condition developing. Since the piriformis muscle is a common offending muscle it is important to work this muscle with physical therapy or strength and flexibility exercises. If the muscle remains tight and/or weak it will lead to additional problems in the future. Strengthening and improving the flexibility of the muscles of the lower back and hamstrings will also reduce the pressure on the nerve, as well.
Surgical intervention is rarely needed with this condition. It may be used to open the space for the nerve, but most people respond to rest and ant-inflammatory treatments within a few weeks to a few months.