Sciatica

Sciatica is not actually a specific diagnosis, but actually a symptom of another underlying cause. Sciatica refers to the pain that is produced in response to pressure on the sciatic nerve, which runs from your lower back (or lumbar spine) down to your buttocks, hip and lower limb.


Characteristics of sciatic pain:
- Pain that radiates from the lower back and down the leg; more common: to the knee; less common: to the foot and toes
- Pain that can be described as tingling or burning (rather than an achey pain) or numbness or weakness with lessened ability to move lower limb or toes
- Pain that is worse with sitting
- Pain that is only present in one leg (generally affects only one side of the body, not both)

Causes of sciatic pain:
As mentioned above, sciatica is the pain that is experienced due to an underlying issue. The most common causes of sciatic pain include: herniated lumbar disc, degenerative disc disease, isthmic spondylolisthesis, lumbar spinal stenosis, piriformis syndrome and sacroiliac (SI) joint dysfunction. Essentially, any of these listed diagnoses create pressure against the sciatic nerve. When the nerve is pushed or pinched by another structure, it causes an irritation of the nerve. Because nerves have pathways within them that send messages from your body to your brain and vice versa, your brain will register this irritated sensation as sciatic nerve pain. 

Other causes of sciatic nerve pain might include things such as pregnancy. With pregnancy, a woman's body can go through many changes and with the additional weight this can cause pressure to build up against the sciatic nerve. Fractures of the lumbar vertebrae due to traumatic injuries from car accidents or a fall or in response to a weakened bone from osteoporosis can also create issues along the sciatic nerve. In rare cases, a spinal tumor or infection might cause sciatic nerve pain.

Treatment of sciatic pain:
In some cases, sciatic pain can be temporarily relieved through the use of a hot or cold compress or with common pain medications, such as ibuprofen (Advil) or acetaminophen (Tylenol), those these options will not treat the underlying cause of sciatic pain. Since the cause of sciatic pain can be any number of things, it is best to make an appointment with your physiotherapist for a full assessment to determine the cause itself. You do not need a doctor's referral to make an appointment with a physiotherapist for sciatic pain in British Columbia. In some cases, you may also need to see a doctor for additional tests, such as diagnostic imaging. In the most severe cases, you may be referred for a surgical consultation. This is generally reserved for those experiencing extreme weakness in the lower limb(s) affected or for those with impaired bladder function due to irritation of the spinal nerves. 

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