- Bulging or Herniated Disc
A bulging disc is also known as a contained disc disorder. This means the gel-like center (nucleus pulposus) remains 'contained' within the tire-like outer wall (annulus fibrosus) of the disc. A herniated disc is more severe and occurs when the nucleus breaks through the annulus. It is called a 'non-contained' disc disorder. Whether a disc bulges or herniates, disc material can press against an adjacent nerve root and compress delicate nerve tissue and cause sciatica. The consequences of a herniated disc are worse. Not only does the herniated nucleus cause direct compression of the nerve root against the interior of the bony spinal canal, but the disc material itself also contains an acidic, chemical irritant (hyaluronic acid) that causes nerve inflammation. In both cases, nerve compression and irritation cause inflammation and pain, often leading to extremity numbness, tingling, and muscle weakness.
- Spinal Stenosis
Spinal stenosis is a nerve compression disorder most often affecting mature people. Leg pain similar to sciatica may occur as a result of lumbar spinal stenosis. The pain is usually positional, often brought on by activities such as standing or walking and relieved by sitting down. Spinal nerve roots branch outward from the spinal cord through passageways called neural foramina comprised of bone and ligaments. When these passageways become narrow or clogged causing nerve compression, the term foraminal stenosis is used.
- Spondylolisthesis
Spondylolisthesis is a disorder that most often affects the lumbar spine. It is characterized by one vertebra (Bones of the Spine) slipping forward over an adjacent vertebra. When a vertebra slips and is displaced, spinal nerve root compression occurs and often causes sciatic leg pain. Spondylolisthesis is categorized as developmental (found at birth, develops during childhood) or acquired from spinal degeneration, trauma or physical stress (i.e. weightlifting).
- Trauma
Sciatica can result from direct nerve compression caused by external forces to the lumbar or sacral spinal nerve roots. Examples include motor vehicle accidents, falling down, football and other sports. The impact may injure the nerves or occasionally fragments of broken bone may compress the nerves.
- Piriformis Syndrome
Piriformis syndrome is named for the piriformis muscle and the pain caused when the muscle irritates the sciatic nerve. The piriformis muscle is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome develops when muscle spasms develop in the piriformis muscle thereby compressing the sciatic nerve. It may be difficult to diagnose and treat due to the lack of x-ray or MRI findings.
- Spinal Tumors
Spinal tumors are abnormal growths that are either benign or cancerous (malignant). Fortunately, spinal tumors are rare. However, when a spinal tumor develops in the lumbar region, there is a risk for sciatica to develop as a result of nerve compression. This is why it is important to follow up with your medical doctor first, prior to initiating any type of treatment, to make sure the cause is identified.
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1 Sciatic Nerve
2 Sacrum
3 Hip Bone
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If you think you may be suffering from sciatica, see your medical doctor first and ask for a referral to a qualified specialist in your community. The first step toward relieving pain is a proper diagnosis. The real trick to getting rid of your Sciatica is in the process of testing, evaluating, and then appropriately treating the problem. Beware of treatments that only make you feel better temporarily. Merely masking the symptoms only helps in the short term and ultimately prolongs your pain. This “quick fix” type of treatment may make your situation even worse. Seek out a qualified medical professional who specializes in neck and back disorders that can adequately get to the root of the problem.
Tim Weyant, MS PT received his Masters Degree in Physical Therapy and is the owner of Aspen Rehabilitation in Coral Springs. Aspen Rehabilitation offers a comprehensive Spine Rehabilitation Program. A licensed staff therapist can be easily reached for questions or comments at (954) 341-7875 or Contact the Referral Help Line |
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