August 14, 2018
Ever had a pain in the buttock that runs down the back of your leg? A pain that makes it uncomfortable to drive or sit for long periods? Chances are, you may be experiencing what is commonly called sciatica. While it is a very common ailment, the causes and treatments vary for each individual.
The truth is sciatica, medically referred to as radicular pain, is a symptom of inflammation of a spinal nerve that radiates down the sciatic nerve, which is the largest nerve in the body. This nerve serves the muscles in the back of your knee and lower leg and also provides feeling to the back of your thigh and the soles of your feet.
Inflammation and Sciatica
What people call sciatica can have a number of causes including a muscle inflammation, a herniated or bulging disc, bone spurs, spinal stenosis, or a slipped vertebra (called spondylolisthesis). Other less common causes can include a tumor or diseases such as diabetes.
One pain source is irritation from the piriformis muscle that connects the spine, which runs through the pelvis and connects to the top of the thigh bone. It is the muscle that moves the hip and allows you to swivel. If injured, the piriformis can swell and rub against the sciatic nerve causing irritation, resulting in pain radiating down the buttocks and leg.
Herniated Disc or Bulging Disc?
A herniated or ruptured disc is not the same as a bulging disc. A bulging disc also results from the same causes of a herniated or ruptured disc — age and wear and tear of the discs — which over time, can dehydrate and stiffen the disc cartilage. However, a bulging disc tends to flatten and extend out beyond the vertebra. If it extends far enough beyond the bone, it can rub against a nerve, causing pain.
Spinal Stenosis and Bone Spurs Can Cause Sciatic Pain
Spinal stenosis is a narrowing of the canal that runs through the vertebrae that surround the spinal nerves. Due to age, injury, or osteoarthritis, the bone grows, causing narrowing of the passageway for the nerves. This can cause the bone to rub against the spinal nerves, causing pain.
Bone spurs, medically referred to as osteocytes, are not actually pointy bones on the vertebrae; rather, they are an extension of a part of the bone. In the spine, bone spurs are usually caused by joint damage from osteoarthritis. In the case of the spine, the damage breaks down the cartilage on the ends of a part of the vertebra called the facets joints. The body tries to repair the damage by growing osteocytes on the facet joints, which can impinge on nerves exiting the spine and causing pain.
Spondylolisthesis Can Cause Sciatica
Spondylolisthesis (pronounced spon-dy-lo-lis-the-sis) causes sciatica when the vertebra slips forward over the vertebra below. Depending on the vertebra affected, the slippage can put pressure on the sciatic nerve root, resulting in sciatica.
Pinpointing the Cause of Sciatica Pain Is Critical
There are many causes of sciatica, but the common denominator for sciatica is irritation of the sciatic nerve that sets off an inflammatory response, which causes swelling of tissues. In the case of the sciatic nerve, the irritation can cause pain that extends along the nerve into the legs and even feet, which doctors call radiculopathy.
The key to successful treatment is pinpointing the cause of the pain. Your doctor will want to know when the pain started and where you feel pain. Other factors will include whether you feel pain in both legs, whether it stops at the knee, or if you are experiencing tingling in your feet. Your doctor will also ask if you have tried any home treatments.
In addition, you may need to undergo a physical examination and/or a neurological exam to determine if there is nerve damage. Imaging studies such as X-rays, CT scans, or an MRI may be needed to determine the best treatment for the exact cause of your sciatic pain.
At Healthcare Associates of Texas, we specialize in finding the optimal treatment for you. Our nerve specialists work with you to help manage your pain and find the best long-term therapy for your sciatic pain. Call our Appointment Line at (972) 258-7499 or contact us by email.