Sciatica – Causes of leg pain

Sciatica is the name given to pain caused by compression or irritation to the sciatic nerve, which runs from your lower back all the way down your legs.

Symptoms are often depended on the severity of the compression to the sciatic nerve, the pain you experience can be anywhere from mild to excruciating. If th compression is more server or continues it can block the circulation inside the nerve itself. This often presents as pins and needles which can progress into numbness in the affected areas. Leg weakness can develop as the sciatic nerve fails to switch the muscles on to create resistance.

Sciatic pain is often worse in the buttocks and legs and may only be mild in the lower back.

If you experience loss of sensation in the saddle region between your legs or/and loss of bladder control you should call for an ambulance(999).

Causes of Sciatica

Your spine has cartilage discs which are layered like an onion. Prolonged flexion by sitting poorly or lifting heavy loads with your back flexed delaminates the spinal discs and this leaves them prone to cracks/tears. The disc has a ball of fluid which may bulge as layers in the disc are torn and the fluid tries to escape. This bulge can press on the sciatic nerve.

Some other causes of sciatic symptoms

Piriformis syndrome. The piriformis muscle passes over the sciatic never like a strap. So a very tight piriformis may compress the sciatic nerve.

Narrowing of the spinal canal with injury or age.

Tumor or spinal growth in the spinal canal (where the nerve passes).

Infection in the spine
Injury to the spine, or the surrounding muscles and ligaments
Cauda equina syndrome

Sciatica Treatment Options

Treatment usually involves a postural assessment, lower back assessment and hip assessment along with neurodynamic testing. In some cases, a foot posture assessment maybe necessary.

Postural and bio mechanical faults can be retrained to help remove load off the disc. Hands on techniques can be used around the hips and lower back to reduce tension in the area to reduce compression on the nerve. Acupuncture can be used to release muscle tension and inhibit pain. Gentle lower back mobilizations can reduce stiffness in the spine. And physiotherapy exercises can be used to correct muscle imbalances and add stability to the spine. It is also important to receive advice about posture and lifting techniques to help prevent symptoms reoccurring. If symptoms appear work related a ergonomic assessment may be helpful to limit future episodes.

In some cases (the minority) spinal surgery may be indicated after scan results and consulting with your surgeon. Surgical procedures can remove the compression depending on the structures involved and symptoms. Surgical options depend on the results of scans and testing.

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