Need help figuring out what is causing your sciatica pain? In this video blog, we go over the three main causes of sciatica pain.
Disc Herniation
So to begin with, let’s look at the number one cause of sciatica pain which would be a herniated disc. A lot of patients ask me: what is a herniated disc? To help answer this, let’s look at this model:
This model right here shows a section of the low back. The back is made of blocks called vertebra. Between each vertebra is a spinal disc. The disc acts as a gel-like shock absorber for the spine. So it takes a lot of stress out of movements such as heavy lifting and bending. Off to the side of the disc are spinal nerves. These nerves go downward to form the sciatic nerve that goes into the legs.
What a herniated disc is, is when gel-like substance from the disc bulges out and pinches a nerve. A pinched nerve then causes sciatic pain that goes down into the leg, foot, and possibly even into the toes. Somebody that has a herniated disc would have a lot of difficulty and pain with movements such as bending from the waist. Think trying to tie your shoe or put a sock on. Also, there’s a lot of pain while coughing and sneezing.
Piriformis Syndrome
The second cause of sciatica pain is due to piriformis syndrome. We call this ‘pseudo-sciatica’ since true sciatica comes from a pinched nerve in the back. However, people that have piriformis syndrome tend to have a lot of sciatica-like symptoms such as pain, numbness, and tingling in the back of the thigh, calf and foot. Let’s take a look at what causes it:
The piriformis is a small muscle that lies deep to the buttocks and the sciatic nerve runs right below this muscle. In this image, you can see the piriformis muscle starts at the base of the spine at the sacrum, (that’s the funny looking segment with the tiny holes) and attaches towards the thigh bone. What this muscle does is helps with rotating the hip and turning the leg and foot outward.
Since the sciatic nerve runs deep to the piriformis, you can imagine it getting sandwiched and pinched by the swelling of this muscle due to injury or a spasm. This is very common with runners and overuse injuries. Patients that I see with piriformis syndrome tend to have a lot of pain after sitting for long periods of time, because this tightens the piriformis muscle which then starts to pinch on that sciatic nerve. So think any long periods of running, walking, those type of activities usually will cause pain down into the glutes, buttocks, and down into the leg.
Spinal Stenosis
The final cause of sciatica pain is due to spinal stenosis, which is when the areas where the spinal nerves travel narrow, and become closed off.
Think of a canal where a spinal nerve travels through that is becoming smaller and smaller, until it’s so small it starts to pinch the nerve and cause shooting pains down the leg. So think about a big wide opening in which the nerve is able to travel through right here going into a smaller spot, in which it gets pinched causing pain down into the leg. Spinal stenosis is more common in people over the age of 50, due to build up of osteoarthritis and bone spurs.
People that suffer from spinal stenosis tend to have pain while standing up straight, especially after sitting for a long time. Standing and walking for long periods of time also tend to cause pain. Generally, I notice patients having to lean forward when they walk since it’s too painful to stand up straight.
St. Joseph, MI Chiropractic Center — Dr. Michael Rowe
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