Are You Experiencing
Sciatica symptoms are generally described as a "pinched nerve" or nerve related leg pain. What could be causing this nerve pain? How can you tell if your sciatica is from Piriformis syndrome, a bulging disc, or another lower back condition? Most importantly, what can you do now to get out of pain?
What is Sciatica?
The sciatic nerve is a broad nerve that supplies both sensation and muscle control to the leg. It is comprised of the nerve roots from the spinal nerves L4 (fourth lumbar nerve) through S3 (third sacral nerve).
True sciatica symptoms are caused by the pinching of this nerve. In cases of true sciatic nerve compression, the nerve is pinched by a small muscle called the piriformis. In such cases it may therefore be diagnosed as
Despite this relationship between the sciatic nerve and the piriformis muscle, most often sciatica symptoms are NOT caused by piriformis syndrome.
Unfortunately the diagnosis of sciatica is only a general way of describing nerve related leg pain and does little more than describe the symptoms as opposed to designating the cause.
If this sciatica pain is not caused by piriformis syndrome, what is the cause? Sciatica symptoms are more likely to be related to low back conditions such as a
or in some cases can be related to
facet joint dysfunction.
In such cases it is the nerve root and not the sciatic nerve itself that is getting pinched.
Because nerve symptoms in the leg can be from a number of different sources, the best treatment will depend on the specific cause of the pain. Thus, the first step in determining an appropriate treatment plan is to get a specific and accurate diagnosis. If you have received this diagnosis, ask for a referral for physical therapy where the physical therapist can help determine the best treatment and exercise program for your specific condition.
In the mean time, a good place to start is to begin minimizing inflammation. If you do have pain, inflammation may be a component to your pain. Although you may not have any lower back pain, the cause of most leg symptoms stems from the lower back. For this reason, utilizing
to the lower back will be helpful to reduce local inflammation. Apply ice to the lower back 10 minutes at a time frequently throughout the day.
In addition, the use of over the counter anti-inflammatory medication (such as Advil or ibuprofen) can also be helpful to reduce pain and inflammation (consult your doctor regarding medications). It is important to note that in order for the medication to have an anti-inflammatory effect; it must be taken on a regular basis. Periodic use will help to relieve pain but do little to reduce the inflammation.
One of the keys to helping minimize sciatica pain is to pay attention to when the pain occurs. Most symptoms of sciatica follow a specific pattern. Based on that pattern, specific exercises and recommendations can be given.
For example: your sciatica pain increases when sitting, driving or bending. If this is the case your symptoms are being aggravated by lumbar flexion. To reduce your symptoms, positions of prolonged sitting and any bending should be avoided. To minimize flexion aggravated symptoms follow these lumbar extension exercises (the same exercises utilized for lumbar disc issues):
Lumbar Extension Exercises
If, however, your pain is aggravated with standing and walking (and relieved by sitting) your sciatica may be aggravated by lumbar extension. Walking and standing should be avoided and instead do more sitting. The treatment to minimize symptoms aggravated by extension are lumbar flexion exercises (similar to those given for facet or stenosis issues):
Lumbar Flexion Exercises
Note: be very cautious with hamstring stretch.
Sciatica symptoms are a common component to many lower back pain conditions and requires a thorough evaluation to determine the true cause. Seek assistance from a qualified medical professional and implement simple treatments to help you take control of your leg symptoms.
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