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Sciatica
Sciatica is a set of symptoms including pain that may be caused by general
compression and/or irritation of one of five nerve roots that give rise to the
sciatic nerve, or by compression or irritation of the sciatic nerve itself. The pain
is felt in the lower back, buttock, and/or various parts of the leg and foot. In
addition to pain, which is sometimes severe, there may be numbness, muscular
weakness, and difficulty in moving or controlling the leg. Typically, the
symptoms are only felt on one side of the body.
Although sciatica is a relatively common form of low back pain and leg pain, the
true meaning of the term is often misunderstood. Sciatica is a set of symptoms
rather than a diagnosis for what is irritating the root of the nerve, causing the
pain. This point is important, because treatment for sciatica or sciatic symptoms
will often be different, depending upon the underlying cause of the symptoms.
The first cited use of the word "sciatica" was registered in 1450.
Causes of sciatica
Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or
sacral nerves S1, S2 or S3, or far less commonly, by compression of the sciatic
nerve itself. When sciatica is caused by compression of a dorsal nerve root
(radix) it is considered a lumbar radiculopathy (or radiculitis when accompanied
with an inflammatory response) from a spinal disc herniation (a herniated
intervertebral disc in the spine), or from roughening, enlarging, and/or
misaligning of the vertebrae (spondylolisthesis), or degenerated discs. Sciatica
due to compression of a nerve root is one of the most common forms of
radiculopathy.
"Pseudo-sciatica," which causes symptoms similar to spinal nerve root
compression, is caused by the compression of peripheral sections of the nerve,
usually from soft tissue tension in the piriformis or related muscles (see
piriformis syndrome and see below).
Spinal disc herniation
Main article: Spinal disc herniation
One cause of sciatica is a spinal disc herniation, pressing on one of the sciatic
nerve roots. The spinal discs are composed of a tough spongiform ring of
cartilage (annulus fibrosus) with a more malleable center (nucleus pulposis).
The discs separate the vertebrae, thereby allowing room for the nerve roots to
properly exit through the spaces between the L4, L5, and sacral vertebrae. The
discs cushion the spine from compressive forces, but are weak to pressure
applied during rotational movements. That is why a person who bends to one
side, at a bad angle to pick something up, may more likely herniate a spinal disc
than a person falling from a ladder and landing on his or her back. Herniation of
a disc occurs when the liquid center of the disc bulges outwards, tearing the
external ring of fibers, extrudes into the spinal canal, and compresses a nerve
root against the lamina or pedicle of a vertebra, thus causing sciatica. This
extruded liquid from the nucleus pulposus may cause inflammation and swelling
of surrounding tissue which may cause further compression of the nerve root in
the confined space in the spinal canal.
Sciatica can be caused by tumours impinging on the spinal cord or the nerve
roots. Severe back pain extending to the hips and feet, loss of bladder or bowel
control, or muscle weakness, may result from spinal tumours. Trauma to the
spine, such as from a car accident, may also lead to sciatica.
Spinal stenosis
Main article: Spinal stenosis
Other compressive spinal causes include spinal stenosis, a condition wherein
the spinal canal (the spaces through which the spinal cord runs) narrows and
compresses the spinal cord, cauda equina, and/or sciatic nerve roots. This
narrowing can be caused by bone spurs, vertebral dislocation, inflammation, or
herniated disc which decreases available space for the spinal cord, thus
pinching nerves from the spinal cord that travel to the sciatic nerve and irritating
them with friction.
Piriformis syndrome
Main article: Piriformis syndrome
In 15% of the population, the sciatic nerve runs through the piriformis muscle
rather than beneath it. When the muscle shortens or spasms due to trauma, it
can compress or strangle the sciatic nerve beneath the muscle. This cause of
sciatic symptoms is piriformis syndrome. This may be the major cause of
sciatica when the nerve root is normal.
The risk of self-inflicted sciatica has increased in recent years with the fashion
trend of lower-hanging trousers as well as lower-positioning of the pockets. For
instance, sitting on a wallet for prolonged hours every day can cause
self-inflicted sciatica. Symptoms of numbness and/or pain behind the knee cap
are associated with this form of sciatica.
Sacroiliac joint dysfunction
Another cause of sciatic symptoms is sacroiliac joint dysfunction. Unhealthy
postural habits, such as excessive time sitting in chairs, and sleeping in the fetal
position, along with insufficient stretching and exercise of the relevant
myofascial areas, can lead to both the vertebral and soft tissue problems
associated with sciatica.
Trigger points
Main article: Trigger points
Another source of sciatic symptoms is active trigger points of the lower back
and the gluteus muscles. In this case, the referred pain is not consequent to
compression of the sciatic nerve, though the pain distribution down the buttocks
and leg is similar. Trigger points occur when muscles become ischemic (low
blood flow) due to injury or chronic muscular contraction. The most commonly
associated muscles with trigger points triggering sciatic symptoms are: the
quadratus lumborum, the gluteus medius, the gluteus minimus, and the deep hip
rotators.
Pregnancy
Sciatica may also be experienced in late pregnancy, primarily resulting from the
uterus pressing on the sciatic nerve, and, secondarily, from the muscular
tension and / or vertebral compression consequent to carrying the extra weight
of the fetus, and the postural changes inherent to pregnancy.
-Wikipedia Encyclopedia
Sciatica is a set of symptoms including pain that may be caused by general
compression and/or irritation of one of five nerve roots that give rise to the
sciatic nerve, or by compression or irritation of the sciatic nerve itself. The pain
is felt in the lower back, buttock, and/or various parts of the leg and foot. In
addition to pain, which is sometimes severe, there may be numbness, muscular
weakness, and difficulty in moving or controlling the leg. Typically, the
symptoms are only felt on one side of the body.
Although sciatica is a relatively common form of low back pain and leg pain, the
true meaning of the term is often misunderstood. Sciatica is a set of symptoms
rather than a diagnosis for what is irritating the root of the nerve, causing the
pain. This point is important, because treatment for sciatica or sciatic symptoms
will often be different, depending upon the underlying cause of the symptoms.
The first cited use of the word "sciatica" was registered in 1450.
Causes of sciatica
Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or
sacral nerves S1, S2 or S3, or far less commonly, by compression of the sciatic
nerve itself. When sciatica is caused by compression of a dorsal nerve root
(radix) it is considered a lumbar radiculopathy (or radiculitis when accompanied
with an inflammatory response) from a spinal disc herniation (a herniated
intervertebral disc in the spine), or from roughening, enlarging, and/or
misaligning of the vertebrae (spondylolisthesis), or degenerated discs. Sciatica
due to compression of a nerve root is one of the most common forms of
radiculopathy.
"Pseudo-sciatica," which causes symptoms similar to spinal nerve root
compression, is caused by the compression of peripheral sections of the nerve,
usually from soft tissue tension in the piriformis or related muscles (see
piriformis syndrome and see below).
Spinal disc herniation
Main article: Spinal disc herniation
One cause of sciatica is a spinal disc herniation, pressing on one of the sciatic
nerve roots. The spinal discs are composed of a tough spongiform ring of
cartilage (annulus fibrosus) with a more malleable center (nucleus pulposis).
The discs separate the vertebrae, thereby allowing room for the nerve roots to
properly exit through the spaces between the L4, L5, and sacral vertebrae. The
discs cushion the spine from compressive forces, but are weak to pressure
applied during rotational movements. That is why a person who bends to one
side, at a bad angle to pick something up, may more likely herniate a spinal disc
than a person falling from a ladder and landing on his or her back. Herniation of
a disc occurs when the liquid center of the disc bulges outwards, tearing the
external ring of fibers, extrudes into the spinal canal, and compresses a nerve
root against the lamina or pedicle of a vertebra, thus causing sciatica. This
extruded liquid from the nucleus pulposus may cause inflammation and swelling
of surrounding tissue which may cause further compression of the nerve root in
the confined space in the spinal canal.
Sciatica can be caused by tumours impinging on the spinal cord or the nerve
roots. Severe back pain extending to the hips and feet, loss of bladder or bowel
control, or muscle weakness, may result from spinal tumours. Trauma to the
spine, such as from a car accident, may also lead to sciatica.
Spinal stenosis
Main article: Spinal stenosis
Other compressive spinal causes include spinal stenosis, a condition wherein
the spinal canal (the spaces through which the spinal cord runs) narrows and
compresses the spinal cord, cauda equina, and/or sciatic nerve roots. This
narrowing can be caused by bone spurs, vertebral dislocation, inflammation, or
herniated disc which decreases available space for the spinal cord, thus
pinching nerves from the spinal cord that travel to the sciatic nerve and irritating
them with friction.
Piriformis syndrome
Main article: Piriformis syndrome
In 15% of the population, the sciatic nerve runs through the piriformis muscle
rather than beneath it. When the muscle shortens or spasms due to trauma, it
can compress or strangle the sciatic nerve beneath the muscle. This cause of
sciatic symptoms is piriformis syndrome. This may be the major cause of
sciatica when the nerve root is normal.
The risk of self-inflicted sciatica has increased in recent years with the fashion
trend of lower-hanging trousers as well as lower-positioning of the pockets. For
instance, sitting on a wallet for prolonged hours every day can cause
self-inflicted sciatica. Symptoms of numbness and/or pain behind the knee cap
are associated with this form of sciatica.
Sacroiliac joint dysfunction
Another cause of sciatic symptoms is sacroiliac joint dysfunction. Unhealthy
postural habits, such as excessive time sitting in chairs, and sleeping in the fetal
position, along with insufficient stretching and exercise of the relevant
myofascial areas, can lead to both the vertebral and soft tissue problems
associated with sciatica.
Trigger points
Main article: Trigger points
Another source of sciatic symptoms is active trigger points of the lower back
and the gluteus muscles. In this case, the referred pain is not consequent to
compression of the sciatic nerve, though the pain distribution down the buttocks
and leg is similar. Trigger points occur when muscles become ischemic (low
blood flow) due to injury or chronic muscular contraction. The most commonly
associated muscles with trigger points triggering sciatic symptoms are: the
quadratus lumborum, the gluteus medius, the gluteus minimus, and the deep hip
rotators.
Pregnancy
Sciatica may also be experienced in late pregnancy, primarily resulting from the
uterus pressing on the sciatic nerve, and, secondarily, from the muscular
tension and / or vertebral compression consequent to carrying the extra weight
of the fetus, and the postural changes inherent to pregnancy.
-Wikipedia Encyclopedia
Texas Spine And Sports Therapy Center PLLC
Dr. B. Atencio D.C
1500 West 38th Street, Suite 38 (Near Seton Hospital)
Shoal Creek Professional Building
Austin, Texas 78731
512-219-8999
Austin's Back And Neck Pain Specialist. We help patients live pain free lives
without invasive surgery.
Dr. B. Atencio D.C
1500 West 38th Street, Suite 38 (Near Seton Hospital)
Shoal Creek Professional Building
Austin, Texas 78731
512-219-8999
Austin's Back And Neck Pain Specialist. We help patients live pain free lives
without invasive surgery.
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