Sciatica

What is Sciatica?

One of the most famous nerves in the human body is the sciatic nerve. It is a compilation of nerves that initially exit the spinal canal throughout the lumbar spine and form the sciatic nerve at the lumbar plexus. From there it travels down the backside of the leg and branches off into different smaller nerves that control the muscles and sensations of the foot and leg. The term sciatica refers to radiating pain going down the leg and into the foot.

Sciatica is one of many radiculopathy disorders. That is when compression of the nerve changes the information between the body and the brain. The diagnosis of radiculopathy comes from a thorough history and examinations. Additional imaging may be necessary for the exact level of involvement for this disorder. Current literature is heavily supporting a 6-8 week period of conservative treatment before any other intervention. According to the review study performed by Valat and colleagues (2010): “There is good evidence that discectomy is effective in the short term. but, in the long term, it is not more effective than prolonged conservative care.”

Is it True Sciatica?

From our experience, when people complain of sciatic pain, many it is not true radiculopathy. This means that the pain they are experiencing is not due to compression fo the sciatic nerve. Rather, it involves the compression of the sciatic nerve at the level of the piriformis muscle. It is evident by the work of Natsis and colleagues (2014) that there is in large an anatomical variation amongst the population of the positioning of the sciatic nerve and the piriformis muscle. In some of the population the nerve lays above the muscle, in others it pierces the muscle and in some, it is found below the muscle. Depending on the anatomical variance, one might be more prone to sciatic nerve compression due to muscle tension in the piriformis muscle.

At PEAKiropractic we quickly identify the cause of your symptoms with a thorough examination and apply the appropriate treatment. Whether it’s true radiculopathy or piriformis syndrome, let us help you get out of pain and prevent this disorder from reoccuring.

See what our patients with low back pain say: click here

REFERENCES

Valat, J. P., Genevay, S., Marty, M., Rozenberg, S., & Koes, B. (2010). Sciatica. Best Practice & Research Clinical Rheumatology, 24(2), 241-252.

Papadopoulos, E. C., & Khan, S. N. (2004). Piriformis syndrome and low back pain: a new classification and review of the literature. The Orthopedic Clinics of North America, 35(1), 65.

Natsis, K., Totlis, T., Konstantinidis, G. A., Paraskevas, G., Piagkou, M., & Koebke, J. (2014). Anatomical variations between the sciatic nerve and the piriformis muscle: a contribution to surgical anatomy in piriformis syndrome. Surgical and Radiologic Anatomy, 36(3), 273-280.