What is sciatica pain? In this post, I am going to discuss sciatica pain, what causes it and talk about my personal experience. If you have heard this term before, aren’t quite sure what it means, or if you suffer from sciatica, I hope you will continue reading.
Do you have pain radiating down your leg? Sciatica is pain that travels along the pathway of the sciatic nerve. Sciatica is not a diagnosis, but a term for pain along this path. Before I get too far, I want to take a look at the spine and explain how all these pieces fit together. In this post, I am going to have a pretty high-level discussion, and I want to try to explain this in simple terms.
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The spine consists of different regions, cervical, thoracic, lumbar, and sacral. Cervical refers to the neck area; thoracic is the upper and mid-back, lumbar is lower back and sacral is the bottom of the spine.
The image above shows the makeup of the spine. The vertebral body, or vertebrae, are the bones that make up the backbone and protect the spinal cord. The discs are there to act as shock absorbers, to keep the bones from rubbing against each other. The discs are made up of a tough outer layer and a soft, gel-like interior. You can also see the nerves.
Discs are designed to be flexible and sturdy to allow for movement and absorb pressure, which cushions the vertebrae (bones in your spine) from actions we do every day.
Discs consist of three parts, Annulus fibrosis, the sturdy exterior material, nucleus pulposus, the inner gel-like substance, cartilaginous endplates; this connects the disc to the vertebrae.
Imagine the discs are like the cream filling between Oreo cookies and sit between each vertebra in the spine. When a disc is damaged, the gel-like center, or cookie cream filling, can leak out, and press up against a nerve and cause pain.
The Sciatic nerve
Five nerves make up the sciatic nerve. These five nerves come together at the piriformis muscle (a muscle deep in your butt) and form the sciatic nerve. The sciatic nerve runs right underneath, or through the piriformis muscle. This nerve is about as big around as your finger.
The sciatic nerve is the largest nerve in the body. It runs from the lower spine, on the right and left side your body, through your butt, down the back of your leg all the way to your foot. The sciatic nerve connects the spinal cord with leg and foot muscles.
As the nerve travels down the back of each leg, it branches out and provides motor and sensory functions to the legs and feet. The sciatic nerve branches off at the behind the knee into two nerves, the peroneal and tibial nerves. The peroneal nerves go through the outer part of the knee and down to the upper foot. The tibial nerve continues down to the heel and sole.
The sciatic nerve has a big job, as it supplies the legs with feeling, strength, and reflexes. This nerve also connects many of the muscles in your leg (including, but not limited to hamstrings, outer thigh) with the spinal cord. When the sciatic nerve is injured or irritated, it can lead to problems, like weak muscles, or in my case, tingling in my leg. I have had tingling or numbness in my outer calf, ankle, even all the way to my toes.
Different types of pain come from sciatica symptoms, meaning you might feel pain in different areas of your lower body, like your butt, hamstring, calf, ankle or toes.
Pain can range anywhere from annoying to debilitating and also the length of time you be in pain will vary on factors like the degree of injury. It’s hard to say precisely how long you will be in pain.
One of the biggest things people think about when it comes to sciatica is leg pain.
What causes sciatica?
The causes of sciatica vary; common conditions that can cause sciatica are a lumbar herniated disc, degenerative disc, or spinal stenosis. There are other conditions as well, but this is a sample of some common ones. The piriformis muscle can wreak havoc on the sciatic nerve as well and cause sciatica-like symptoms, but, a spinal problem causes sciatica.
Degeneration means that a disc is losing hydration which makes the disc harder and more susceptible to tearing or cracking. When the disc loses its flexibility, it can become more vulnerable to herniation. Degeneration happens as we age and also just good old wear and tear on the body.
With a herniated disc, the gel-like interior leaks through the hard, outer area and pushes against the nerve root (a nerve root is a nerve that leaves the spinal cord and branches out to other areas of the body). The medical term for a pinched nerve is Radiculopathy.
Disc degeneration makes the discs more susceptible to damage, like tearing or cracking. If this happens, the gel-like center can leak out and contact the nerve. Damage to the nerve can cause sciatica or pain along the nerve channel.
If you lift something heavy, twist your lower back, or make some other motion that put stress on the discs, you may end up with a herniated disc. It doesn’t have to be a traumatic movement or injury that can lead to a herniated disc. You can step off of a curb, or bend over to pick up a load of laundry and these things can happen.
The herniated disc goes by many names, including, slipped disc, bulging disc, ruptured disc, or sometimes you will hear people call it a pinched nerve since the disc space is pushing against the sciatic nerve.
People use these term interchangeably, although there are some differences. With a herniated disc, the gel-like interior is not contained within the disc, as the outer part of the disc has a tear or crack allowing the gel-like fluid to leak out. With a bulging disc, the interior fluid is still contained, no gel has leaked out. The disc is literally bulging and pushing against a nerve.
Stenosis means “narrowing or constricting space.” Stenosis is the narrowing of the spinal canal, meaning there is less space in the spinal canal where nerves travel.
With lumbar spinal stenosis, the nerve roots are compressed and can demonstrate symptoms of sciatica. A bulging or herniated disc can cause stenosis since the disc protrudes out of the spine, this has now narrowed the free space in the spinal canal.
Often, as was my case dealing with stenosis, leaning forward provides relief. I hobbled around leaning on my kid’s shoulders or a shopping cart.
I have had back problems since my late 20’s. In 1999 I underwent back surgery after months and months of pain. I had previously tried physical therapy, injections and nothing was working for me.
My pain level with sciatica has been minor to freaking unbearable. I have had trouble sleeping or finding any comfortable position sitting, standing, or laying down. Not being able to dress myself kind of sucked the life out of me.
I have had pain so severe that I didn’t know if I would be able to make my 45-minute commute to work or not. Then get to work and barely make it from my car to my desk.
In late 2015 I was doing things at the gym that I had no business doing, given my history of back trouble. I ended up with a herniated disc, which put me in stenosis, and a sprained SI joint. This time I went to see a very highly recommended chiropractor.
My chiro visits were multiple times per week, and I was dead set against having surgery again. During this time I was dealing with stenosis, and I was not able to stand upright, bent over about 30 degrees. Like I said, getting around was tough, relying on my kids and shopping carts.
Finally, I was upright, after months of treatment and my trusted inversion table.
My chiropractor pushed me to work on building, and maintaining muscle in my core, but also my whole body. One way to help sciatica is to strengthen your core, which will help support your spine.
If you are suffering from sciatica, of course, you should make sure you are working with a doctor or other healthcare provider.
Things that have worked for me are:
Check out the links above my other posts for more information. Depending on your condition, you may not be able to use an inversion table or workout. So some of these posts are great for prevention. Again, you should talk to your doctor before you begin an exercise or treatment program.
I hope this post has given you a better understanding of sciatica. I know there are a lot of people who deal with this and also people who don’t realize what shooting pain down the leg means. Let me know if you have any questions or comments. I will get back to you as soon as I can.
I would love to get some feedback. Do you deal with lower back or leg pain? Do you know someone who does?