Sciatica

Sciatica
Sciatica (often misspelled as "syatica" or "psyatica") is
pain that results from irritation of one of the sciatic
nerves (one on the right and one on the left), and includes
pain in the hip and buttock area that may extend partially
or all the way down the back of the leg to the foot. The
sciatic nerves start out as smaller nerve roots that branch
off from the lower part of the spine. The component nerve
roots come together in the pelvis to form the sciatic
nerves. Each sciatic nerve then extends down the back of
each thigh and divides into two parts below the knee and
the two halves continue down the lower leg to the foot.

While there are several possible causes of sciatica, by far
the most common source of sciatic nerve irritation is a
bulging or herniated disc in the lower lumbar spine. A
damaged disc may bulge into the opening where one of the
nerve roots exits the spine on it's way to join other nerve
roots as part of the sciatic nerve. The bulging disc may
create direct nerve pressure, and/or may trigger
inflammation and swelling, which can also cause pressure on
the nerve. When this occurs, pain and other symptoms may
be felt part along the course of the sciatic nerve,
starting in the buttock area and possibly running down the
leg, sometimes all the way to the foot.

In addition to bulging discs, sciatica may be caused by
bone spurs projecting into the nerve openings. Sciatica
may also be caused by direct injury to the sciatic nerve
after it leaves the pelvis, such as can occur with an
impact or heavy pressure applied just behind the hip joint.
Rare sources of sciatica can include spinal tumors, which
can compress sciatic nerve roots as they exit the spine.
Another rare cause of sciatica is a cyst or tumor that
compresses the sciatic nerve in the hip or knee area.

Not every buttock or leg pain that people think is sciatica
is acutually sciatica. True sciatica (sciatic nerve
irritation) is usually felt mostly in the back of the leg
(not the front or side of the leg). Symptoms of true
sciatica are described by various people as stabbing,
burning, tingling, numbness/heaviness, or like an electric
shock. Even symptoms that meet the desciption of sciatica
though are not always due to actual sciatic nerve
irritation.

One common condition that closely mimics sciatica is caused
by knots of contraction called trigger points in a muscle
called the piriformis. The piriformis muscles are located
on either side of the lower buttock area, running from the
upper thigh bone to the edge of the sacrum (the triangular
pelvic bone that is at the base of the spine). In addition
to causing symptoms that mimic sciatica, tightness in the
piriformis muscle may also cause true sciatic irritation,
because the sciatic nerve actually runs through the center
of the piriformis muscle in some people, and can be
compressed by excessive muscle contraction.

Trigger points in other muscles in the buttocks and upper
thigh can cause referred pain in the side of the leg that
may be mistaken for sciatica as well. Bear in mind that
both true sciatica and piriformis syndrome typically
produce symptoms in the back of the leg. Symptoms in the
side or front of the leg are usually due to problems other
than sciatica.

Treatment of sciatica is usually associated with treating a
bulging disc. The first line of treatment is usually an
attempt to reduce inflammation to reduce pressure on the
nerve bymeans of oral medications. If oral medications
fail, steroids may be injected in the area of the disc
bulge in order to provide more potent anti-inflammatory
effects. Depending on the case, other forms of treatment,
including physical therapy, chiropractic, massage,
acupuncture, and new methods of treatment such as spinal
decompression may be used. In some situations, surgery may
be recommended as a last resort.

Most episodes of sciatica will resolve within a period of
several weeks with or without treatment, but due to the
severity of the pain typically involved, most people with
sciatica will seek out treatment. Unfortunately, due to
misconceptions by doctors and patients alike regarding the
nature of sciatica, the necessary steps to prevent a return
of sciatica are usually not taken. So, even though most
people do recover from a bout of sciatica, nearly all will
eventually have problems again at some point. Even
sciatica sufferers initially treated successfully with
surgery will often have future problems with sciatica.

The good news is that with awareness of how to manage
sciatica and a little bit of effort dedicated to
prevention, most people can avoid ongoing long-term
sciatica problems. The challenge is simply to making
people aware of the necessity of a "management" versus
"cure" approach to sciatica and getting them to
follow-through with preventive exercises and other
self-care techniques.

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Dr. George Best has been treating patients with sciatica
and piriformis syndrome for over 15 years. To educate the
public on the importance of the proper management of
sciatica and how to prevent long-term pain and disability,
Dr. Best has produced a free ebook and online video program
on Sciatica and Sciatica Exercises. For more information,
visit:

http://www.SciaticaSelfCare.com .