What is sciatica? Is it from the hip or the back? What causes it? These are all questions that I’ve been asked several times in the last few weeks, so I thought I’d try to answer.
What is sciatica?
According to the medical dictionary, sciatica is “pain along the course of the sciatic nerve especially in the back of the thigh caused by compression, inflammation, or reflex mechanisms.” Or in layman’s terms, “pain in the lower back, buttocks, hips, or adjacent parts.”
In a literal manner of speaking, sciatica is a pain in the butt. The nerves from the spinal cord leave the lowest part of the spinal column, and then come together and the nerve comes down the back of the leg. The sciatic nerve is actually a large bundle of a lot of nerves, and is about the thickness of a pencil where it runs through the buttocks muscles. Sciatica can come from irritation of the nerve anywhere along its path.
Does the pain originate from the hip or the back?
Medically speaking, most of the time “sciatica” is actually pain coming from the lower back. The nerves may get pinched or irritated as they are coming out of the spine. The nerves then refer pain down the leg. Two common causes of this are a herniated disk or spinal stenosis.
Sometimes the pain can be caused by the sciatic nerve being pinched or irritated by the piriformis muscle. This muscle is deep, and it is below the gluteal muscle of the buttocks. The sciatic nerve courses right past this muscle, which is why the muscle can have such an impact on the sciatic nerve.
What are some of the risk factors for sciatica?
Some of the things that can increase the risk of having sciatic pain include:
- Age. As we age, our backs usually begin to go through some degenerative changes; this can lead to concerns such as herniated disks or stenosis.
- Prolonged sitting.
- Job. Anything that causes repeated motions can increase your risk. Activities that are particularly a problem include twisting, driving, sitting or carrying heavy objects.
Physical therapy treatment for sciatica is often very successful and focuses on a number of different areas. Exercises to address the cause of the problem, manual therapy to help with soft tissue mobility, and work on postures and positions with daily activities.
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