Sciatica - It Can Be Nasty!
WHAT IS SCIATICA?
Sciatica is a symptom rather than a condition. It involves irritation and inflammation of the sciatic nerve, the largest nerve in the body, it's almost the diameter of your thumb!
The sciatic nerve originates in the lumbar spine by bundling together lumbar and sacral nerves (L4, 5, and S1-3). It courses deep through each buttock continuing down the posterior-lateral aspect of each leg and ends in the soles of the feet.
WHAT ARE THE SYMPTOMS?
Sciatica can vary in pain from a slight numbness, tingling sensation, to a deep dull toothache-like pain affecting the entire leg and foot. Acute sciatica can become relentless and severe enough to cause limping. Medication does not always relieve the pain. Some people even experience an electric shock-like feeling shooting down the leg!
Back pain is not always present but most often you feel sciatica in your buttocks. At times, it may skip areas so you might feel it only behind the knee or in the foot. Other times your only symptom may be a numbness in your foot.
Most sciatica is one-sided, affecting only one leg.
Typically sciatica is “insidious”, meaning it comes on gradually and not one specific event caused it to occur.
Excess pressure on the sciatic nerve causes sciatica. It is the result of an unbalanced spine and spinal muscles.
WHAT ARE THE CAUSES?
An unbalanced spine often takes years to manifest into sciatica. Poor postural habits causes wear and tear to the discs in your spine. Eventually, they start thinning. This is a condition and referred to as degenerative disc disease.
Degenerative discs come on slowly, you may not even notice your spine is slightly crooked. Eventually, the disc becomes thin enough to decrease the area (IVF) where the nerve exits the spine. Thin discs are often the cause of sciatica.
Sometimes the discs themselves become weak causing part of the disc to bulge or even break off. This is a herniated disc. Herniated discs can irritate and inflame the sciatic nerve. Disc herniations can occur anywhere in the spine but are most often found in the lumbar and cervical areas.
Of note: only one-third of disc herniations are symptomatic and are usually found as a secondary condition to something else.
Another cause of sciatica is a condition called Piriformis Syndrom. The piriformis is a small muscle deep in the butt, it lays on top of the sciatic nerve. The piriformis muscle is responsible for internal and external rotation of the hip. I believe it also helps to keep the sciatic nerve in its correct place, deep in the butt, for protection of the nerve.
In Piriformis Syndrom, the muscle gets so tight it puts pressure on the sciatic nerve, causing sciatica. It is a frequent complaint of runners. It can also be caused by sitting too much or having weak butt muscles.
If your butt muscles are weak, any sudden movement can cause the muscles to grab and stay tensed, increasing pressure on the sciatic nerve. Conversely, weak butt muscles may not engage at all causing excessive grinding to joints in the low back and hips.
Anterior Pelvic Tilt
An anterior pelvis occurs when you have too much curve in the small of your back. The excessive curve brings the joints in the lumbar spine closer together, closing down the room needed for the sciatic nerve.
(the one on the right shows an anterior pelvic tilt)
Some people have a "natural" anterior pelvis, but generally, it is due to an unbalanced spine, or excessively tight back muscles. It is often seen in obese people. They need to arch their low back to maintain balance.
The rapid "front-end load” during pregnancy can also put pressure on the sciatic nerve. This is similar to an anterior pelvic tilt.
WHAT CAN YOU DO ABOUT SCIATICA?
Here are some things to do for your sciatica:
- Keep the knee of the affected side higher than your hip. When sitting, place something under your foot to raise your knee.
- When lying in bed or hanging out on the sofa, put something under your knee to raise it.
- If you are a side sleeper, put a pillow between your knees with the bad side up.
- Sit with knee crossed, ankle on the knee, the bad side does the crossing (shown).
- Do the piriformis stretch (shown).
Slight downward pressure on up knee This is known as a "piriformis" stretch
- When driving, bring your seat closer to the steering wheel to raise both knees, as if you were sitting in a real “bucket seat.”
- Ice your buttocks.
It's all about attaining and maintaining good, balanced posture. Here are some images of typical posture we see every day. These are before and after pictures.
BUT WHAT IF IT ISN'T SCIATICA?
Did you know 93% of all Americans have experienced back pain, including sciatica, significantly enough to seek professional help? Most of this pain is NOT a result of an injury. Poor posture and postural habits cause most of the problems.
Here is a checklist of symptoms you should have checked by a professional:
- You get the “electric shocks” mentioned above.
- You feel sciatica on both sides.
- You have persistent numbness in your foot, especially if it affects your gait.
- Your sciatica continues to get worse.
- Your pain gets to the point where you can’t do the things you want or need to do.
- You notice changes in your bowel or bladder function.
HOW CAN PUREPOSTURE HELP?
The best way to deal with sciatica is not to get it in the first place. PurePosture can help with sciatica. By correctly aligning your spine so BOTH sides of your back share the load, equally, easing the pressure on the nerve.
PurePosture is an orthopedic tool designed to align your spine, fix your posture and solve neck and back pain. It really works!! Invest in PurePosture today!