Sciatica is a term commonly heard used by family or friends. ‘My sciatic nerve is playing up’ or ‘My Doc told me I have sciatica’. But what exactly does this mean?
Essentially, whens someone says they have sciatica, they usually mean that they have pain that they have pain that is thought to be coming from their back and going into their leg or even down to their foot. The problem with this term, is that people use it for all different causes of pain in their backs, buttocks, or legs – which can get really confusing! It is important we explain what sciatica actually is.
We call this type of pain a 'referred pain’ – meaning pain that occurs somewhere else, such as in your calf muscle, but the actual problem is somewhere else, such as in your back. The wiring inside our body is not very good at knowing where pain comes from compared to our skin. If you closed your eyes and I touch your hand with a pin, you would know exactly where that pin was. But if I used the same pin and touched your heart, you might get pain in your neck or in your arm! How strange! This is because the wiring for the heart – crosses over with wiring ofthe skin of our neck and arm. And as our body is poor at working out where the pain is inside our body, it just tells us the bit it does know – the skin which is connected to it.
So, sciatica is essentially the same. The nerve can be pinched in your lower back, but it can give you really intense thigh or calf muscle pain!
When someone comes to see us at Resolve Pain and tells us that they have sciatica, we will always work out exactly what they mean to try and determine the causes of their pain if possible.
True ‘sciatica’ or‘radicular pain’ as we use in medicine, is when the sciatic nerve is pinched – usually at the level of the lower spine, and it causes a shooting, electrical type pain down the leg – usually to below the knee. It can cause the leg to‘ give way’ and can give unusual sensations in the skin such as pins and needles, or a feeling of crawling ants over the skin.
While pain that comes from the back and goes down the leg could be sciatica, we will usually try and help you work that out before we make a definitive diagnosis.
As the sciatic nerve forms from multiple nerves from your lower back, the pinching of thisnerve could occur at many different spinal levels and can even occur from tight muscles in the buttock region due to other causes or reasons.
The treatments offered for sciatica are often different to those for other reasons such aspain from your facets, discs, or ligaments around your spine. Radiological imaging such as CT scans or MRI scans may be used to help try and determine the site of this pinching – but be aware that the scans are often not accurate enough to always give us the answer! If only it was that simple…
There are many therapies for sciatica. The first therapies are always the least expensive and least likely to cause you harm such as exercises and movements to strengthen the spine, muscles and ligaments and try and reduce any ‘pinching’ of the nerve. Sometimes disc troubles such as a ‘bulging’ disc can cause this pinching – butin many cases these disc bulges can shrink back down on their own.
In more severe cases, we may consider medications, minimally interventional procedures such as injections around the nerve to try and ‘open up’ any pinch points, or in serious cases which are not resolving, we may refer you to some of our expert neurosurgical/spinal surgical colleagues for surgical options.
At Resolve Pain weare experts in helping people understand their pain and forming management plans to reduce your pain and aim to return you back to life enjoyment and work tasks.
Further information specific to you can be provided by your team at Resolve Pain. Some further general information is given below.