Sciatica: To be or not to be?

To be or not to be, that is the question! Sciatica is a word that gets thrown around a lot as a self-diagnosis. It’s a common term used for low back pain that travels down into the leg. But do you truly have sciatica? What is sciatica? We are going to discuss the differences between sciatica and those other conditions that can cause symptoms like sciatica.

First, lets define sciatica. The sciatic nerve starts in low back where the nerves exit the spinal column through the sacrum. These nerves that exit the sacrum form whats called the sacral plexus. As the nerves run down towards the glute they form one giant nerve, which is your sciatic nerve. This nerve travels down the back of the leg to the knee where it splits into the tibial nerve and the common fibular nerve. Now it’s important to note that this nerve passes under and close to the piriformis muscle, which sits under the glute max muscle. We will talk about this later.

Sciatica vs. Radicular Symptoms

So what are symptoms of true sciatica vs. radicular symptoms? True sciatic symptoms occur when you have pain that runs down the low back, into the back of your leg and into your foot along the nerves. Pain typically passes the knee joint which is a hallmark of this condition. If you have symptoms that do not cross the knee then you may be suffering from another condition such as a radicular symptom.

Sciatica Causes

Some of the causes of sciatica are disc herniation and piriformis syndrome. A herniated disc is when the disc material in between the vertebra comes out and starts to put pressure on the nerve. This can cause severe pain and travels down the leg. You can have numbness, tingling, weakness, foot drop or a combination of these. Another cause of sciatica is the piriformis muscle that we spoke about earlier. If this muscle goes into spasm it can contract and put pressure on the sciatic nerve causing the sciatic like symptoms. These two are some of the most common reasons to experience sciatica.

Other Causes of Sciatic Like Symptoms

Many people experience pain running down into the glute and leg but this doesn’t mean you have Sciatica. Again if the pain doesn’t cross the knee joint then chances are you don’t have sciatica. SI dysfunction (sacral iliac dysfunction) can be a cause of your pain. SI joint makes up your pelvis and this joint can cause pain that runs down the leg. This pain doesn’t cross the knee joint but can feel similar to sciatica.

Another condition that can cause sciatic like symptoms is myofascial pain or trigger points. The muscles and fascia in your body holds a ton of nerve endings and if your muscles go into spasm or contain trigger points it can cause pain to run down the back of your leg just like sciatica. Again the pain does not cross the knee joint and this is a hallmark of sciatica.

What should you do?

Having a consultation and examination done by a chiropractor is one of your best options. As a chiropractor I deal with this every day in the office and know the best ways to treat it. If it’s due to joint dysfunction or myofascial pain we have the tools and knowledge to treat these conditions and get you back to the pain free lifestyle you had.

Dr. Michael Barnard

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