Sciatica is commonly characterized as mild to severe pain which radiates along a single or both legs, caused by the impingement or compression of the nerve roots in the lower back. Various types of injuries or conditions affecting the lumbar spine can result in symptoms of sciatica.
Sciatica is often referred to as radiculopathy, a medical term utilized to describe symptoms of pain, tingling sensations, numbness and weakness in the arms or legs as a result of nerve complications. If the nerve issues occur along the neck, it’s called a cervical radiculopathy. Because sciatica affects the lower back, however, it is called a lumbar radiculopathy.
Beginning at the back of the pelvis, or sacrum, the sciatic nerve is paired with five sets of nerve roots which then runs from the lower back, under the buttocks and down through the area of the hips and into each leg. Nerve roots are a great part of the body’s entire nervous system, functioning by transmitting pain and sensation to the different parts of the body. Radiculopathy can frequently develop when pressure is applied to the nerve roots as a result of an injury or condition, such as a herniated disc or a bone spur in the lumbar spine.
Causes of Sciatic Nerve Pain
An array of spinal injuries or conditions can cause sciatic nerve pain or sciatica. The 6 most common include:
- a bulging or herniated disc
- lumbar spinal stenosis
- trauma or injury
- piriformis syndrome
- spinal tumors
Lumbar Bulging Disc or Herniated Disc
A bulging disc along the lumbar region of the spine is identified as a contained disc disorder. This occurs when the gel-like center of an intervertebral disc, known as the nucleus pulposus, remains contained within the tire-like outer wall of the disc, known as the annulus fibrosus.
A herniated disc occurs when the nucleus pulposus ruptures through the annulus fibrosus and it is identified as a non-contained disc disorder. Regardless if an intervertebral disc bulges or herniates, the structures of the disc can add pressure against the adjacent nerve roots, compressing nerve tissue which can lead to symptoms of sciatica.
However, the complications associated with a herniated or ruptured disc can be worse. While a herniated disc can cause the impingement or compression of the sciatic nerve and its nerve roots, the substance released by the disc itself is made up of hyaluronic acid, a chemical irritant which can also cause inflammation along the structures surrounding the disorder. Nerve compression or impingement, followed by pain and inflammation can often lead to tingling sensations, numbness and muscle weakness along the extremities.
Lumbar Spinal Stenosis
Spinal stenosis is a nerve compression disorder which most commonly affects older adults. When spinal stenosis develops along the region of the lumbar spine, it could cause symptoms similar to sciatica. Generally, the pain associated with the disorder will manifest due to physical activities, such as standing or walking, and it can be relieved by sitting down or resting.
Nerve roots found along the spine branch out from the spinal cord through passageways consisting of bone and ligaments known as the neural foramina. Located on the left and right sides and between each set of vertebrae, is the foramen. The nerve roots pass through these openings and extend outward beyond the spine and through to other parts of the body. However, when these passageways become narrow or clogged, leading to the impingement or compression of the nerves, it’s referred to as foraminal stenosis.
Spondylolisthesis is a disorder characterized when a single vertebra in the spine slips forward over an adjacent vertebra. When a vertebra is displaced, it could ultimately lead to the compression of the spinal nerve roots, causing symptoms of sciatica. Spondylolisthesis is considered a developmental disorder, meaning it is found at birth and may develop during childhood, although it can also occur due to the degeneration of the structures of the spine, due to trauma from and injury or as a result of physical stress from lifting weights.
Trauma or Injury
Sciatica can also be caused as a result of direct compression or impingement of the nerves due to direct trauma or injury to the tissues and other structures surrounding the lumbar or sacral region of the spine. These circumstances include: automobile accident injuries, slip and falls, and/or sports injuries from contact sports such as football. The force of a direct impact can damage or injure the nerves and, occasionally, fragments of broken bones may also add pressure to the complex network of nerve roots along the spine.
Piriformis syndrome is identified by the painful symptoms which manifest when the piriformis muscle irritates the sciatic nerve. The piriformis muscle is located along the lower region of the spine, where it connects to the thighbone and provides the function of rotation to the hip. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome occurs when the piriformis muscle spasms, adding pressure against the sciatic nerve. This syndrome can often be difficult to both diagnose and treat due to the lack of X-ray or MRI findings.
Although rare, spinal tumors are abnormal growths which can be either benign or malignant, cancerous. When a spinal tumor develops along the lumbar region of the spine, there’s a risk that it could potentially cause the impingement or compression of the nerve roots, leading to symptoms of sciatica. If you believe you may have sciatica, contact your healthcare specialist. The first step toward relieving pain is a proper diagnosis.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Chiropractic and Sciatica
Sciatica is identified as a group of symptoms rather than a single injury or condition. Low back pain is common among a variety of individuals, but when symptoms of numbness and tingling sensations are accompanied with pain and discomfort, there may be unnecessary pressure being placed against the sciatic nerve. Sciatic nerve pain or sciatica can occur due to a variety of factors and chiropractic treatment can help relieve the symptoms. Chiropractic care is a safe and effective treatment option available for restoring the health of the spine and reducing sciatica symptoms.