A Guide to Sciatica

One of the most common questions I get asked, by my clients is “is my back pain sciatica?”.  So I would like take some time to explain what sciatica or piriformis syndrome is.

Sciatica is the irritation of inflammation of the sciatic nerve, which runs from L3 down through your legs and feet to your toes, so its the longest (and widest) nerve in the human body.  The reason sciatica is called piriformis syndrome is that the piriformis muscle (which is in your bum) can compress the sciatic nerve.  Because in most people approximately  87% the sciatic nerve passes below the piriformis muscle, in approximately 13% people the sciatic nerve passes in part or entirely though the piriformis muscle.  So tightness in the piriformis muscle is a major cause of sciatica and this tightness can be exasperated by prolonged sitting.  Other notable causes are trauma to your lower back or your pelvis, a history of herniated disc in your lower back and some systemic diseases e.g. diabetes.

So how can you tell if you have sciatica or lower back pain? 

Sciatic is characterised by the presence of one or more of the following symptoms:

  • Constant pain in one side of the buttock or back of one leg.
  • Sharp or burning pain or tingling radiating down the back of your thigh.
  • Pain is worse when sitting for long periods of time.
  • Pain may be aggravated by sneezing, stooping or straining.
  • You feel that you want to slouch away from the effected side.
  • Possible pins and needles or parasthesia (numbness) down leg.

Sciatic pain can begin abruptly or can come on gradually and may vary from infrequent and irritating to constant and incapacitating.  While symptoms can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result.

The vast majority of people who experience sciatica get better within a few weeks or months and find pain relief with non-surgical sciatica treatment including massage. For others, however, sciatica pain from a pinched nerve can be severe and debilitating.

There are a few symptoms that may require immediate medical, and possibly surgical, intervention, such as progressive neurological symptoms (e.g. leg weakness) and/or bowel or bladder dysfunction.

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