All About Sciatica

spinal stenosis

What is Sciatica?
Sciatica is a medical term used to explain symptoms that develop when the Sciatic nerve is compromised. Pseudo sciatica, which is the most common, occurs when the sciatic nerve is compressed by the Piriformis (bum) muscle. True sciatica occurs when one of the sciatic nerve roots is compressed when it exits the spinal column.

Symptoms of Sciatica
Regardless of the type of Sciatica you have the symptoms are the same. These symptoms include but are not limited to pain in the low back, buttocks and down the back of the leg. Numbness and tingling are also common symptoms and they follow the same pathway. Weakness can develop anywhere along this pathway because there is an interruption in the sciatic nerve transmission.

Anatomy of Sciatica
The sciatic nerve is the longest and largest nerve in your body. Five sets of paired nerve roots combine to create it, and it's about the diameter of your middle finger. The sciatic nerve starts in your low back, which is called your lumbar spine. The nerve roots are at the L4 and L5 vertebrae (the 'L' means lumbar, and the numbers indicate the level of the vertebra where it is in your back). The sciatic nerve also travels through your pelvic region (sacrum).

In most people, the sciatic nerve runs under the Piriformis (bum) muscle, which moves your thigh side to side. From there, the sciatic nerve descends through the buttocks and the back of the thighs. Behind your knee, smaller nerves branch out from the sciatic nerve and travel down to your feet.

How is Sciatica caused?
Pseudo Sciatica is caused by a tightening of the Piriformis muscle on the Sciatic nerve. The nerve passes under the Piriformis muscle and in some cases it passes right through the muscle tissue. Exercise, pregnancy, weight gain and posture can create a tight Piriformis muscle.

True sciatica is caused from a variety of conditions: disk bulging or herniation, Degenerative Disk Disease (DDD), spinal stenosis and pregnancy.

How to test for Sciatica
There are a variety of tests used to diagnose this condition. The first step is to go through a history of symptoms and activities with the client. Muscle and neurological tests are then done. An Xray, CT Scan or MRI might be needed depending on the initial findings.

How to Treat Sciatica
Pseudo Sciatica is easily treated by massage therapy. Usually in one treatment you will notice a dramatic improvement in your symptoms. Some home care exercises are prescribed and if you follow them you should have no more symptoms.

True Sciatica responds extremely will to spinal decompression treatments. This is performed on a special table. The treatment schedule depends on your specific symptoms and cause. What needs to be done with disk bulges/herniations is that the disk material needs to be absorbed back into the disk and this requires taking the pressure off the disk. This is why spinal decompression is so effective. It is essentially traction targeted to your specific condition.

I highly suggest trying it out and talking with Mike Dixon RMT. He has had over 20 years of clinical experience and he has been teaching spinal orthopaedics for over a decade. He has also written two books on spinal manipulation.