Sciatica


Any person who has suffered the painful symptoms of Sciatica can quickly tell you just how poor their quality of life can be at times. The common symptoms of Sciatica include pain which may travel from the low back and through the buttocks, and sometimes down the back of the thigh. The pain is caused by a compression of the sciatic nerve, and depending on where it is being pinched, the pain may even reach the foot area. Sciatica may be extremely debilitating for some, and less so for others.
There are 4 major conditions that can create sciatic pain, and a person may be experiencing one or more of these conditions. It is important to note that muscular imbalances are a contributing factor in each case. It is easy to understand how this may happen, given the fact that the moment we are born, our bodies are subjected to the force of gravity. There are more than 600 muscles in the human body, and when some of them are tighter/unbalanced, then bones and joints will be under constant stress and uneven pressure. Due to our posture, the spine is greatly affected in this process.
Condition #1: Piriformis Syndrome. The piriformis muscle is located in the buttocks and the sciatic nerve passes under it. This muscle may be tighter on one side of the pelvis, and compress the sciatic nerve. The pain may remain in the buttock area, or travel down and across the lower thigh. The best treatment for this condition is ice therapy, stretching, and deep tissue massage.

Condition #2: Herniated disc: the disc between the vertebrae can bulge and put pressure on the sciatic nerve. The disc may herniate due to a trauma such as a car accident. It can also occur after years of uneven pressure placed on a spine which has an excess curvature due to muscular imbalances. See figure 1.Herniated discs are probably the most common diagnosis given for Sciatica. It is important to note that not all herniations or vertebral aberations produce discomfort, and therefore the sciatic pain may not be coming from this source.
Condition # 3: Spinal Stenosis: This is the narrowing of the spinal canal, which creates pressure and therefore pain. This can occur for several reasons, including being born with a relatively narrow spinal canal. Another reason could be that during the aging process, the ligaments between vertabrae can thicken and create a narrowing effect. Bone spurs may form in the vertebrae and narrow the canal. The best approach for avoiding pain in the person who suffers from spinal stenosis is to maintain a spinal curvature that is as close to normal as possible.
Condition #4: Spondylolistheses. This condition occurs when 1 vertebrae slips forward over the lower vertebrae. This condition usually occurs due to degenerative disease (ie. arthritis) and happens in the lower lumbar vertebrae (L4-5) where there is more curvature in the spine.
The treatment for Sciatica frequently responds favorably to home care, including ice therapy, stretching, and analgesics. Treatment should include massage therapy, physical therapy, and movement therapy. More aggressive yet is the option for cortisone injections or surgery, recommended by clinicians when other treatment has not met success. This may also be indicated for times when the compressed nerve causes significant leg weakness, or bowel/bladder incontinence.
The conditions leading to sciatic pain may be avoided if people considered their posture and muscular balance/flexibility as it lifts into the constant force of gravity. A simple example of how muscle imbalances are created is in the office worker, who spends a great deal of time in a sitting position. The hip flexors will be shortened, and the glute muscles will become weak and flabby over time. This will lead to postural dysfunction between the pelvis and the spine. The spine becomes less supported and therefore weak and prone to injury. This poor office worker picks up a heavy object and suddenly herniates a disc which possibly leads to Sciatica!