A buldging/herniated disc is a condition affecting a disc between two adjacent vertebrae of the spine.
Sciatica…Now that’s a real pain in the butt.
If I had a nickel for every time someone has told me that their sciatic is acting up….I would’ve definitely been able to afford that surf trip to Costa Rica.
The funny thing about sciatica is that it is a blanket term for a few different issues that can be the root cause of the pain felt. In general, a person would describe sciatic as any pain felt in the back or buttocks, which may travel down the back, outside or front of the leg.
Well let’s start from the top and work our way down.
The sciatic nerve is a largest nerve in the human body. It stems from nerve roots of our spinal cord. Specifically the lumbar and sacral spinal nerve roots. (These roots come together to form a nerve plexus outside of our spine and are responsible for providing the innervations to all of our motor and sensory dealings in our lower limb)
The sciatic nerve fibers unite and pass through, beneath or under the piriformis muscle. It then travels down our posterior thigh to the back of our knee when it splits into two separate nerves- the tibial nerve and common fibular nerve.
Approximately 90% of all sciatica pain is attributed to a buldging or herniated intervertebral disc. This leads to compromise of the nerve root. Other causes of sciatic pain include spinal stenosis, piriformis syndrome, SI joint dysfunction, spondylolisthesis, tumours, cysts, and other gnarly reasons.
I could go on for a while about each specific cause, so I will briefly touch on a few of the important ones.
A buldging/herniated disc is a condition affecting a disc between two adjacent vertebrae of the spine. With a herniated disc, there is a tear in the disc and the inner portion of the disc is protruding into the spinal canal. In both cases (buldge or herniation) they can affect the spinal cord or the spinal nerve roots. In general, most individuals have a disc buldge or two. However, they probably show no symptoms. Disc herniations are usually due to age-related degeneration of the disc, trauma, lifting injuries, or straining.
Spinal stenosis is a condition in which the spinal canal (the spaces the spinal cord runs through) narrows and compresses the spinal cord or spinal nerve roots. This narrowing can be caused by bone spurs, degeneration, inflammation, or herniated disc. This decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord that travel to the sciatic nerves. This condition most frequently affects older adults.
Piriformis syndrome is a controversial condition as it is very rare. In 17% of the population, the sciatic nerve runs through, or under the piriformis muscle rather than beneath it. When the muscle shortens or spasms due to trauma or overuse, it's thought to cause compression of the sciatic nerve. Compression of the sciatic nerve through the glutes, from sitting on a wallet or anything else that can cause a similar compression can also cause sciatic like symptoms. Piriformis syndrome causes sciatica when the nerve root is normal.
So, this is when I should cover my butt and say if you are have or are currently experiencing sciatic symptoms, you should go be checked by a health professional who is an expert of the musculoskeletal system. They will be able to determine the cause of your symptoms and get you on the road to recovery.
But because you’ve made it this far, I’ll give you some ideas on how to help yourself with sciatic pain.
A 2015 meta-analysis (basically, the bees knees in research) in the European Spine Journal, suggests that surgery may show better results than conservative care. However, surgery is invasive and can cause long-term complications (see my compensation pattern blog here). I’d suggest that conservative care is the first logical step in treating sciatic pain, if after 8 weeks there is no improvement then surgery could be an option. But again, all of this depends on the specific cause of your sciatic pain, as different root causes calls for different interventions.
What exercises could you be doing right now to help your pain?
Check out this video that gives a good basic routine for managing sciatic nerve pain: https://www.youtube.com/watch?v=wUOb0qA_w3I
I would also recommend adding in a glute and hip flexor stretch stretch like these ones 3 times a day for 30 seconds on each side:
Anyway, that’s the basic story on Sciatica. Go get yourself checked out by a musculoskeletal health practitioner who can provide you with a diagnosis and also assess any muscle imbalances that could be a contributing factor.
As always, if you have any questions, concerns or comments, please post them below or stop by Satori or the Richmond Olympic Oval and we can grab a tea and chat about it all. Check out my website! www.westcoastchiropractic.ca
Dr. Kristian Frantzen