The sciatic nerve is the largest nerve in the body and pain coming from it is called "sciatica." The sciatic nerve starts in the low back from three levels (L3, L4, and L5) and combines into one big nerve that travels through the buttocks and down into the leg. If you have low back pain that shoots down your leg, there's a good chance the sciatic nerve is affected.
The pain from it can be excruciating. You may find that you can barely walk, or that your foot or toes are numb or tingling. The pain shooting down your leg may feel like a hot poker, or you may find you can't put any weight on your leg. The muscles in your buttocks or leg may twitch uncontrollably, or spasm into hard rocks.
Is there anything you can do to get some relief?
Sciatica SymptomsMost people with sciatica say that they have low back pain that is worse on one side, with pain that shoots down to their buttock, the back of the knee, or all the way into the foot. The further down your leg the pain goes, the more parts of the nerve are affected and the more time it will take to get the pain to resolve.
The pain can range from a dull ache that diffuses down the buttock all the way to an "electrical" feeling shooting down the leg to the foot.
There may be muscle weakness in the foot that goes along with it, and sometimes patients tell me they feel like their foot is dragging, especially when going up curbs or stairs.
It's often difficult to switch positions, either from laying down to sitting or sitting to standing, and if the sciatica is severe enough you may feel like you have to support yourself on your thighs as you try to stand up.
The pain may come from the nerve roots (for example the L4-L5 disk can herniate and put pressure on the nerve as it exits the spine) or muscle tightness in the buttocks. Since the sciatic nerve travels through the Piriformis muscle in the gluteal region, tightness here can compress the nerve and send pain all the way down the leg. An orthropedic and neurological exam (standard practice in my office) can determine where the problem starts. Obviously they'll need to be treated a little differently.
Other Things That Cause Sciatic Pain
The piriformis muscle runs from the center of your lower spine, runs behind the glutes and attaches to the outside of your hip bone (on your femur). It can get tight or spasm from overuse (from walking or running) or, ironically, from underuse (sitting at a desk all day).
Piriformis syndrome will also have pain that shoots down the back of the leg, but the pain may feel more spread out over the back of the leg. If you move your leg out from your body and turn your toe outward, you may get some relief from pain. That motion relaxes the piriformis muscle and takes the pressure off the sciatic nerve. If this is causing your pain, it's relatively easy to correct with some simple chiropractic adjustments and stretches and exercises.
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