Sciatica! It’s just a trapped nerve…isn’t it?
Many, but not all, of my new “sciatica” patients, (by this I mean patients who have not seen me before) will on their initial first visit tell me, “I’ve trapped a nerve in my back” and now “I’ve got pain all the way down my leg” and for some they may even say “and I have this tingling type feeling in my toes”
It seems a reasonable self-diagnosis by the patient, after all, their uncle or neighbour had just the same pains and to be honest the self-diagnosis of a trapped nerve isn’t too far from the truth in many cases. But as an Osteopath and like my fellow healthcare professionals we will want to know what exactly is causing what the patient describes as a ‘trapped nerve’ because it is not always quite as simple as a ‘trapped nerve’
What exactly is the sciatic nerve?
Well it is the largest nerve in your body, about the thickness of an adult finger and you have two of them, one running down each leg to your foot. Each sciatic nerve is made of up five separate nerves, L4, L5, S1, S2 and S3 that are part of the lumbosacral plexus that is located in the lower part of your lumbar spine. It is when these five nerves come together that the sciatic nerve is formed.
So what is sciatica?
Sciatica is a term that is used to describe pain, ache or other neurological symptoms along part or all of the sciatic nerve. The pain / neurological symptoms are brought on by an irritation, inflammation or compression of one or more of the five nerves of the sciatic nerve. Sciatica may also be described as Lumbar Radiculopathy.
What does sciatic pain typically feel like?
This can be very varied and I would say the most frequent symptoms described by my patients are:
- A dull ache in the back of the upper leg which may or may not ache as far down as the foot.
- Sharp shooting, electric shock like pains that travel from the lower back to the buttock and leg and again which may or may not shoot as far down as the foot.
- A severe muscle type spasm pain in the buttock and leg which feels like the muscles cannot relax and again which may or may not go as far down as the foot. There would often be increased pain when bending or raising the leg.
All of the above symptoms may also include a tingling type sensation in the skin of the leg and most often in the foot and toes. Many people will also have some degree of lower back ache, pain and or stiffness.
The above are only some of the symptoms that I and other healthcare professionals typically hear from our patients. There are other symptoms and some much more rare symptoms that may include a loss of bowel or bladder control or a numb like sensation around your genital areas. These more rare symptoms may indicate a potentially serious injury or nerve compression and should be treated as a medical emergency.
The vast majority of causes of sciatic nerve compression are of spinal cause, such as a disc prolapse, often referred to as a ‘slipped disc’ but there can be non-spinal musculoskeletal causes of sciatica such as piriformis syndrome.
Take home message
Sciatica is a very common problem that is very rarely of a serious underlying cause and osteopaths, chiropractors, physiotherapists and your doctor are trained to help with treatment and to also spot when further tests should be carried out. Do not self-diagnose or just leave it, get it checked out just to be sure...it may not just be a trapped nerve!
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