Everybody has heard of sciatica. Most people have either had it, think they’ve had it, or been told they had had it at some point in their life. But what exactly is it?
The Sciatic Nerve
At the base of you spine (lower back), you have 5 vertebrae known as your Lumbar Vertebrae. Each of these are numbered L1-L5. Between each of these vertebrae, you have a nerve that exits the spinal cord and travels down into the leg.
These 5 nerve roots join together forming 2 main nerves down into your leg – the sciatic nerve and the femoral nerve. The sciatic nerve travels down posteriorly the back of the leg, and the femoral nerve travels more anteriorly (the front).
What is Sciatic Pain?
The nerves progressively branch off as they travel down, and supply the muscles and skin in your leg. If these nerves become trapped, compressed or irritated, then you may experience pain, tingling and numbness in various parts of your leg.
These referred patterns are called dermatomes, and although a tingling big toe or calf may not mean much to you, it tells your therapist a significant amount about the source of the problem.
Where can the nerve get trapped?
The nerve can become irritated anywhere from your spinal cord to your foot. Pain typically travels downwards from the site of the problem. A true ‘trapped nerve’ is where the nerve root is compressed as it leaves the vertebral foraman, and can be due to disc prolapse, facet joint issues, or arthritic changes.
The nerve can then become compressed in the buttock region, particularly by the piriformis muscle – in some people the nerve travels through the muscle making them more susceptible to ‘sciatica’ if they develop tension in the muscle.
People performing hamstring stretches incorrectly can irritate the sciatic nerve. Either this, or a hamstring tear, can result in tethering of the nerve making it sensitive and irritable.
So have I got sciatica?
Sciatica has become a household name for nerve pain in the leg. People like labels for problems, especially when they go to the GP. Sciatica has become an umbrella term for any type of back/nerve related pain. It is good enough for your attention seeking Facebook posts, but not always entirely accurate.
My GP diagnosed it as sciatica?
GP’s are general practitioners and musculoskeletal injuries such as back pain are not their forte. An experienced physiotherapist or sports therapist can assess your low back and symptoms in depth and give you a more accurate diagnosis/explanation than your GP.
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Do I need a scan?
The majority of people with back pain and/or referred neural symptoms do not require a scan. Your physiotherapist or sports therapist will advise you if they feel a scan is necessary. If it was felt necessary, they would generally write to your GP to ask them for the scan, or refer you privately (approx £600). Other than the cost, the difference is privately will usually be done within 48hrs, whereas an NHS scan can take 4-6 months.
An x-ray will only show the bones of the spine and pelvis. It won’t show the nerves and muscles, whereas an MRI would be more appropriate for this.
Having back problems?
If you are having back pain or ‘sciatica’, or know someone who is – get in touch and book an appointment with one of our experts.