What is sciatica?

 

The term “sciatica” gets thrown around quite often to describe any combination of ‘pins and needles’ sensation, burning, or shooting pain that travels down the leg. As a blanket term ‘sciatica’ can accurately describe this cluster of symptoms rather easily, which may explain its over use. It is important to therefore make the distinction that although ‘sciatica’ may involve shooting pain down the leg, not all shooting leg pain is ‘sciatica.’

 

Sciatica

 

True Sciatica

True sciatica involves pain travelling down the length of the leg as a result of the pinching or strangling of nerves stemming from the back. This can be a result of a disc herniation, degenerative changes (compressed discs, osteoarthritis) or stenosis (canal narrowing) of the spine. In all of these cases, the important structures of your back – the nerves that exit the spine, or the spinal cord itself – are being compressed. When nerves are compressed it can result in shooting or burning pain, or a ‘pins and needles’ sensation that will travel down the leg – usually in the distribution of the sciatic nerve, thus  the term ‘sciatica.’

 

Pseudo-sciatica or referred pain.

 

There are other processes that can mimic the symptoms of sciatica without being sciatica.

  1. Piriformis syndrome
    1. The sciatic nerve running down the leg lies directly underneath the piriformis muscle. A tight (hypertonic) or spasming piriformis can compress and irritate the nerve causing shooting pain down the leg.

 

Piriformis Syndrome

Piriformis syndrome

 

  1. Sacroiliac Joint Dysfunction
    1. The sacroiliac (SI) joint is located between the sacrum (the large bone at the bottom of the spine) and the pelvis. This large joint is easily irritated and can cause shooting pain down the leg when inflamed. Usually SI joint pain will shoot no further than the knee, and involves greater discomfort of the hip and glute.

SI joint Referral Pattern

 

 

Muscle pain referral

    1. Muscles that become overused have a tendency to tighten. This is a protective mechanism that allows the muscle to continue to be overused without constantly straining itself. Tight muscles are prone to knots or trigger points. If these trigger points progress, they can actually cause referral pain to elsewhere in the body. Trigger points in the glutes, and muscles of the hips can cause referral pain that shoots down the leg.

 

Glute Trigger Point Referral Patterns

 

What should I do?

 

If you have shooting pain down your leg, it is best to have your symptoms evaluated by a trained musculoskeletal professional such as a chiropractor or physiotherapist. During your exam we will be able to diagnosis the root cause of your discomfort and provide you with an appropriate treatment plan.

More times than not, shooting pain down the leg is a result of pseudo-sciatica and not true-sciatica. In either case, these symptoms can be treated effectively with a variety of services.

 

What are your treatment options?

 

  • Spinal Decompression – Helps to open up joint spaces and relieve pressure and tension around important structures of the spine.
  • Chiropractic care – Hands on therapy that allows for manipulation of the joints to encourage proper function and movement.
  • Physiotherapy – Hands on therapy designed to mobilize, and then strengthen weakened areas that may be contributing to your dysfunction.
  • MRT (Muscle Release Technique) – Pin and stretch technique that allows for the release of dysfunctional or tight muscles.
  • Acupuncture (w/ or without electric stimulation) – Insertion of sterile needles into designated areas to allow for improved blood flow, muscle tension relaxation, and nerve stimulation when coupled with electric stim.
  • Soft tissue therapy (massage) – Hands on therapy designed to help relax bothersome soft tissues that have become tight/tense over a period of time.
  • Exercise prescription and rehabilitation – Active care where the patient will complete a series of exercises under the supervision of a trained professional and is expected to continue with certain at home exercises to maintain progress.

** Treatment plans will be designed by your healthcare provider and may include several of the options listed above depending on your situation and severity of your condition.