Often times people who are suffering with either back pain, pain in the leg or a combination of both will call the office and say they have “sciatica”. This has become a catchall phrase but does not really tell the doctor what is actually wrong with their back or leg.
Our lower spine has nerves that branch off and head down the legs. Some of these nerves go to the thigh, others into the groin region while others make their way all the way down to the leg to the foot. This bundle of nerves is called the sciatic nerve. Anything that irritates or insults these nerves can be called “sciatica”.
Knowing the pattern of the pain, or where the pain travels to (the ankle, the knee or the top of the foot etc.) allows the doctor to understand where to begin the examination. If the nerves are irritated into the upper leg region, this would lead the doctor to begin the examination at the upper lumbar spine area. If the pain goes down the leg into the back of the ankle, this would be an indication to check the lower lumbar region. Like wise for any number of pain patterns.
The sciatic nerve may also be irritated from a muscle in the buttocks. Often times this occurs with weight lifters, blue-collar workers and other people who use their hips and body doing strenuous activities. The sciatic nerve may also be impinged in the lower leg, at the knees or anywhere else along its course down the body. Finally the nerve may be affected in the lower back as well as in the leg, creating what is commonly called a “double crush syndrome” meaning the nerve is injured in more than one area.
When a patient conveys this information verbally the doctor may begin to focus in and locate the causes of the “sciatica“, which as mentioned above could be many. Some of the causes of sciatica may be an injured disc (slipped, bulging, herniated), arthritis, taught lumbar musculature, sacroilliac joint issues, lumbar facet syndrome…..as well as a few others.
The point being made is that sciatica is a blanket name for anything affecting the sciatic nerve. Reasons for these symptoms must be identified as the cause has many layers and many diagnoses. There is no single “treatment for sciatica” rather sciatica is a red flag to any practitioner that something is assaulting the nerve, a clear and concise diagnosis needs to be made and treatment that falls within the parameters of the diagnosis will get the patient out of pain and back to pre-injury status!