WHAT IS SCIATICA?
The term sciatica dates back to 1398 A.D., appearing to originate from the Latin word "ischiadicus" meaning "of pain in the hip" and from the Greek term "iskhiadikos" meaning "pain in the hips". The term sciatica usually describes pain that radiates along the path of a nerve from the back to the buttocks and leg. The discomfort can be minimal or disabling, and may be accompanied by tingling, numbness or obvious muscle weakness. Its term is general, but actually has a number of causes. It is important to know the right type of sciatica, in order to treat each one effectively.
SCIATIC NERVE PAIN
The sciatic nerve is actually five sets of paired nerve roots in the lumbar spine that combine to create the one sciatic nerve. Starting at the back (Lumbar Spine), the nerves merge, run under the buttocks, and downward through the hip area and into each leg.
LEADING CAUSES OF SCIATICA:
1. 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.
2. 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 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).
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.
5. 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.
6. 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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