Updated: Aug 29, 2021
As the summer blossoms and the weather heats up, the call to outdoor work becomes too much to ignore. Gardens beckon, yard work bellows, and the backyard entices us to straighten, clean and tidy what’s been left to grow disheveled the previous months. But in a mean twist of fate, the bending, lifting and twisting that go hand-in-hand with pruning, raking and weeding set us up for a potential painful fall. They form the perfect storm for sciatica. See, as we neglect the outdoors, we often neglect to maintain our bodies, too. Virtual hibernation through long, cold months has a tendency to focus our attention on comfort, not fitness. As we step out into summertime’s beauty with work on our minds, we can find much to do and a core and spine that are not up to the task. As a result, injury can occur. You might find yourself grimacing as your back twangs, gingerly nursing an ailing, failing leg, or scared to move because the pain *screams*… But before jumping to the conclusion its sciatica, it’s important to understand what this condition is, what it can mean, and why people — including health experts — often can this diagnosis wrong. What is the sciatic nerve?
Sciatica involves, as its name suggests, irritation of the sciatic nerve. This incredible piece of biological architecture is the largest, thickest nerve in the body. At its widest, it’s around the size of your thumb! The sciatic nerve is large because it’s formed by numerous nerves that join together. It’s a little like a watercourse. When smaller tributaries feed into a river, it becomes bigger, stronger and more nourishing. The sciatic nerve is made up of nerve roots from the lower lumbar spine and from the tailbone. Together, they form this mega-nerve. Sciatica causes: Two common reasons this condition develops There are two common reasons for the development of sciatica; an intervertebral disc disorder and excess piriformis muscle tightness (hypertonicity). Intervertebral disc damage As we have already mentioned, the sciatic nerve is made up of nerves from the spine. Damage to one or more of the discs of the spine, where these contributory nerves exit, can harm the nearby nerve and so affect the downstream sciatic nerve, too. This can cause sciatica. This is a conclusion that is often reached by health professionals; sciatica as a result of a spinal problem. We have had many patients consult with us for this diagnosis. Yet, for some the diagnosis is incorrect. Instead, the true cause is piriformis syndrome. Piriformis syndrome The sciatic nerve exits from the pelvic, where it can travel under, over, or through the piriformis muscle; an important muscle in the buttock. When this muscle becomes too tight, it can compress and irritate the sciatic nerve, causing the symptoms of sciatica. This might occur because of trauma, injury, or sitting for long periods. Yes, the latter often happens over a long, cold winter. However, it might also be in response to a “stuck” or subluxated sacroiliac joint (SIJ). The piriformis muscle commonly tightens when this joint doesn’t function as it should. But, sciatica is not just caused by compression… While compression is the most understood cause, two other factors play important roles; inflammation and what’s called “neural sensitization,” an overly reactive nerve. We must deal with all three, as we do at our practice, to form an effective sciatica pain treatment. But before we discuss treatment… Sciatica symptoms: What are the telltales signs? How can you tell if you might have sciatica? There are specific sciatica symptoms to look out for. The article, Diagnosis and treatment of sciatica, described these as:
- Pain in one leg that is stronger than the accompanying low back pain - Pain that radiates down to the foot or the toes - Numbness and tingling into the same area as the radiating leg pain - A straight leg raise (SLR) test that increases leg pain (the SLR involves sitting with a straight spine, both knees bent, with feet on the floor. The knee of the sore leg is then slowly straightened. This stretches, and so stresses, the sciatic nerve. In sciatica, it is painful) - Symptoms that are limited to involvement of the sciatic nerve only
Piriformis syndrome can be accompanied by: - Ongoing pain in the buttock and the hip - Pain in the buttocks that is worsened by movement of the hip - An increase in pain when getting out of bed - Trouble sitting for extended periods - Exquisite tenderness in the middle of the involved buttock (near the sciatic notch)
Sciatica symptoms: When to worry? Sometimes, pain will remedy itself with time. Although, appropriate treatment will usually ease discomfort and speed recovery. But back pain and tingling into the leg warrants investigation. And there are times when examination cannot wait. Rarely, what might be dubbed sciatica is instead due to malignancy, a condition called cauda equina syndrome, or another illness. If you have any of these symptoms, seek prompt professional advice: - Fever - Unexplained weight loss - Weakness of the leg; a leg that gives way - Numbness around the saddle area - Loss of bowel or bladder control or sexual function Barring these… If you have sciatic pain, how can you find relief? Our top 4 sciatica pain treatment tips
1. Visit a Chiropractor The best place to start is with a professional diagnosis. The term sciatica is now common, which has lead to some confusion. The presence of back and leg pain does not mean the sciatic nerve is involved. Many patients report that their “sciatica is acting up,” but, on investigation, the pain is due to another cause. For example, the sacroiliac joint might be inflamed and sore, but no leg pain is present. The back can seriously hurt, but the diagnosis is one of SIJ dysfunction not sciatica. As determining the exact source dictates appropriate treatment, you must know the cause. Otherwise, you’re throwing darts in the dark. The likelihood of hitting a treatment bullseye is nigh on impossible. Consulting a Chiropractor will identify the correct diagnosis, rule out red flags (or dangers), and provide a considered treatment plan. Chiropractic care can then restore healthy motion, improve joint and muscle function, and calm inflammation by causing “the mediators of inflammation to present a normalization response.”
2. Reduce piriformis muscle spasm Muscle spasm hurts. As you’ve learnt with piriformis syndrome, it can also compress and inflame the sciatic nerve and trigger sciatica symptoms. Stretching, massage, and remaining active can help. Piriformis stretch: Stretching regularly can help to reduce the tension in the piriformis muscle. To perform: Sit on a chair. Cross one leg over the other so its ankle rests on the other knee. Sit upright. Keeping your spine straight, bend forward from your hips until you feel a stretch through the buttock of the raised leg. Hold for 30 seconds, relax, repeat three times. Your current pain level will determine where your raised knee falls. Do not force it down. Perform only within tolerance. You should feel a stretch, not a pain. Note: If you are advised that a piriformis stretch requires you to lay on the ground, ignore it. Getting up and down from the floor when you have sciatica is not easy and can trigger pain. This seated option works beautifully and allows you to stretch within pain limits. Massage: Depending on pain severity, you may wish to try self-massage or seek professional care. Relaxing the piriformis muscle through manual therapy can be a wonderful, therapeutic approach. Being active: Sitting for an extended period increases your risk of piriformis syndrome. If you work in an office, opt for a sit-stand desk. Personally deliver a message rather than send an email. Get up and move around often.
3. Develop stronger core stabilization Have you ever wondered why your core is so important for your health? Imagine how a car would perform with a dodgy chassis… Or how difficult it would be to walk a mile with one high heel on, the other off… Or what would happen to your home if the foundations weren’t level. The body’s core — the muscles of the abdomen and back that connect your spine and pelvis — is responsible for stability during rest and motion. They allow effortless movement, ideal posture, and protect the function of the musculoskeletal and nervous systems. Because of this, developing strong core stabilization may help you to avoid painful sciatica symptoms in the future. 4. Calm inflammation Research has shown that inflammation plays a crucial role in the development of pain, including sciatica. So, any sciatica pain treatment worth its salt ought to calm the inflammatory process. How can you calm inflammation? Manage stress Follow an anti-inflammatory diet Receive regular Chiropractic care Use essential oils Opt for massage therapy To find our more about how these steps work, read our article, The 3 Powerful Secrets You Must Know to Reduce Inflammation, Naturally. As you head back to your post-winter yard with secateurs, shovel or rake in hand, pause for a moment. Ask yourself, is your body ready for work? How can you reduce your risk of injury, particularly the unpleasant experience of sciatica? Is it time to strengthen your core, to stretch tight muscles, to ensure your joints work just as they should? If you’re unsure, it’s time to book your appointment with us. An ounce of prevention is worth a pound of sciatic pain.
Disclaimer: This Website offers advice designed for educational purposes only and is not intended to replace the advice, treatment, or diagnosis of a healthcare professional. We recommend consulting with a registered health professional before implementing any advice.