Saturday, September 28, 2013

Sciatica - Back, Leg and Calf Pain


If you are feeling pain in your back, leg and calf, the chances are you are suffering with sciatica. Before I go any further however, it is important I stress that sciatica is a descriptive term and not a diagnostic one. Anyone who is feeling pain anywhere from there back, through their buttock and down the back of their leg could be said to be suffering with sciatica.

However, the most important thing to establish is not that you are suffering with sciatica, but rather what is causing your sciatica. Two or three different people could be presenting with the same signs & symptoms, yet each of their causes may be different.

The sciatic nerve is formed from the nerve roots L4-S3 which leave the lower part of the back. It then passes through the buttock region, down the back of the leg and then, via its branches, to the tips of the toes. If the sciatic nerve is being aggravated, either from its origin in the lower back or as it passes through the buttock and down the back of the leg, it has the potential to cause pain (as well as other signs & symptoms such as pins & needles, numbness and weakness).

The causes of sciatica can be numerous as I mentioned above. Nevertheless, the main culprits tend to be:

1) A prolapsed disc: A prolapsed disc will tend to pinch on the nerve roots which form the sciatic nerve as they leave the spine itself. If this 'pinching' begins to aggravate and inflame the nerve, pain will result. This pain could be felt anywhere from the low back itself, down your leg to the tips of your toes.

2) Facet Joint Irritation: As the nerve roots leave the spine, they can also be pinched or aggravated by the facet joints of the lower back. If a facet joint in the lower back is aggravating the nerve roots, once again pain may be felt anywhere from the low back itself, down your leg to the tips of your toes.

NB. It is important I note here that although a prolapsed disc and facet joint irritation may aggravate the same nerve roots which form the sciatica nerve, as well as produce very similar (in some cases identical) signs and symptoms, the treatment given would almost be opposite to each other. Therefore it is imperative the correct diagnosis is obtained.

3) Muscle Imbalance: This is where tight and/or weak muscles allow too much stress to be placed across the sciatica nerve. A more specific stretching and strengthening exercise programme would need to be prescribed for this problem. If your pain is starting in the buttock region, there is a fair chance muscle imbalance is the main cause. A tight piriformis muscle is a very common cause of sciatica which starts in the buttock region.

The good news is that sciatica can nearly always be treated conservatively with an appropriate advice and exercise programme, whichever of the above 3 may be causing your pain. If treated correctly sciatica can be treated and resolved 100% without any need for surgery. It is just knowing what to do and when to do it which is the critical factor.

For further information on how to treat sciatica, so my article How Do you treat sciatica?

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