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Conditions
Sciatica |
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The sciatic nerves are the largest in the human body
– they run from the base of the lumbar spine, on either side, through the buttocks
and down the back of the legs; they extend all the way to the feet. If the nerve-root
becomes compressed, pain is often experienced – not only in the lumbar spine, but
also radiating into the buttocks, hamstrings, and (occasionally) lower legs. The condition
is referred to as sciatica, and it’s very common.
Why does this happen?
The sciatic nerve can become compressed for a number of reasons. For example, the
following, underlying conditions (if present in the lumbar spine), can all lead to
sciatica:
Please note: the list is by no means fully inclusive. |
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The nerve itself has five roots on either
side of the spine – these are labelled according to the hole from which they exit the
spinal column, namely L4 and L5 (lumbar); S1, S2, and S3 (sacral). The five roots come
together to form the sciatic nerve – just below, and to the side, of S4 (shown
opposite).
Because the nerve is so big, and has so many roots, sciatic nerve root compression is
reasonably common (only one of ten possible roots needs to be compressed for sciatica to
develop). |
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| Note: despite the fact that the nerve root
is compressed, the pain can be felt anywhere along the entire nerve – from the lower
back, through to the buttocks, hamstrings, knees, and lower legs. This is due to a
condition known as referred pain (or radiculopathy), where the brain finds it difficult to
localise the pain. |
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How is it diagnosed?
The symptoms of the condition are relatively unique – whilst the level of pain can
vary, from mild to severe, it usually affects one side of the body only (not both), and
the pain often radiates through the buttock and/or leg. One or more of the following
symptoms may be present:
- Pain in the lower back.
- A constant pain in one side of the buttocks.
- Pain in the buttocks and/or leg that is worse when sitting.
- A shooting pain that makes it difficult to stand up.
- Burning or tingling (pins and needles)
down the leg.
- A numb feeling in the leg.
- Difficulty moving the leg or foot (in severe cases, the foot may drop).
As a result, sciatica is fairly easy to diagnose. However, determining which (or how
many) of the five nerve roots is compressed is more difficult – it requires a
thorough understanding, both of anatomy and referred pain; following on from this, the underlying
cause must be identified. In this respect, sciatica is quite a vague term – only a
trained individual will be able to give a full and accurate diagnosis.
Note: if your symptoms are severe you should generally consult an expert (for
example, by visiting our Spine Clinic). You may
have a slipped disc, or Cauda Equina
Syndrome (amongst other conditions), both of which require prompt attention. |
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What are the consequences for back pain?
The general symptoms are mentioned above. However, depending on the nature of the
underlying problem, you may experience other symptoms – at this stage, we recommend
that you either consult your doctor, or visit our Spine
Clinic. |
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What are the risk factors?
Because there are so many underlying causes, the risk factors for sciatica are many and
varied. However, up to 98% of all back pain is directly caused (or substantially
aggravated) by compression of the spine; as a result, compression (which itself is caused
by bad posture; injury; ageing;
hereditary conditions; and/or excess weight) is a primary risk factor in cases of
sciatica. |
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Can it be treated?
Yes. It follows, that if 98% of all back pain is either directly, or indirectly, caused by
compression of the spine, then decompression will solve many of the underlying
conditions (at the very least, it will make them asymptomatic – that is, the
underlying condition might still be present, but it’s improved to the extent that
symptoms are removed).
The type of treatment is obviously very important – some provide temporary
relief, others prove ineffectual, and some are actually detrimental to the
individual’s health. We believe that orthopaedic
medicine is the most appropriate form of treatment – the backrack™ will replicate most of the
methods used by a practitioner, but, for more serious conditions, you may wish to visit
our Spine Clinic in London.
For more details on the range of treatments available, please visit our section on Treatment. |
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