A Pain In The Butt, Literally - A Series On Sciatica - Part 2

In the first part of this series on sciatica, the question, "what is sciatica?" was posed, and then answered. In this second part, the question, "how does it happen" will be answered? This is in an effort to educate the public as to why the term sciatica is used so often, specifically in chiropractic, orthopedic and primary care settings.

Sciatica, as answered in part 1, is an inflammation or irritation of the sciatic nerve. In order to understand how does it happen, one must first understand the anatomy of the region. The sciatic nerve is a large, tortuous nerve that is comprised of nerve roots at the L4 - S3 vertebrae. The nerve roots come together to form a "superhighway" nerve that supplies nearly the whole of the skin of the leg, the muscles of the back of the thigh, and those of the leg and foot (see picture to left).

Nerve roots joining to form the sciatic nerve

Once you understand how large a nerve it truly is, and how far ranging the distribution is, it becomes a little clearer as to how irritation of the nerve can lead to problems as far away as the foot. When an intervertebral disc is "bulging," or "herniated" it implies that the center portion of disc has been pushed out the back of the disc. When this occurs, the bulge or herniation (see below) pushes or compresses against the nerve root that will later join with other nerve roots to form the sciatic nerve.

Just as when you compress anything, transfer from one side to another becomes more difficult. Think of a plastic bag that is inflated. Then compress the middle and try to transfer air from one side to the other. Because of your compression, transfer is made increasingly difficult, even impossible. A nerve operates in the same fashion. When compression occurs, signals that travel back and forth, in addition to the blood flow within the nerve becomes more difficult. Compression can take many forms including pain, altered sensation such as pins and needles, tingling or shooting sensations, and weakness. Herniations and bulging discs are the primary mechanisms by which sciatica occurs, but there are other causes as well, including but not limited to muscle tightness within the hip, bone spurs on vertebrae, spinal stenosis, tumors and even pregnancy.

Images of herniated & bulging discs

If you experience any of these symptoms, make sure you schedule an appointment with Dr. Donohue at Rehabilitation & Spinal Care of Rockford. The office is accepting new patients and can provide relief of this condition and these symptoms. Call (815) 394 0309.

A Pain In The Butt, Literally - A Series On Sciatica

The refrain is familiar, so much so that the question has become standard in the orthopedic health care setting. "Doctor, the pain travels down my leg when I......sit, stand, drive, golf.....what can you do?"

We've all heard the term Sciatica in some form or fashion. Whether it's an important player on your favorite team, your parent, you or somewhere in the news, the word is increasing in usage. But what exactly is sciatica? How does it happen? Why does it happen? Most importantly, what can be done about it?

Those answers, and trust me, there are answers, can be found in a variety of places including the internet, anecdotally or through medical research. But really, the best wealth of information will come from your doctor, a specifically a specialist in spinal or orthopedic disorders.

Sciatica, as people who have suffered from this condition, is an irritation of the sciatic nerve itself or the nerve roots that eventually join together to form the nerve. The sciatic nerve is the largest nerve that supplies sensation and motor function to the posterior gluteal region, back of the thigh, back of the calf muscle and into the foot. Irritation anywhere along the pathway can cause pain up and down the leg, leading to loss of sensation or even the ability to move the leg. It is important to note that sciatica is not a diagnosis, but rather a specific symptom that leads to a diagnosis. Fortunately, sciatica tends to occur on only one side of the body.

If you are experiencing any altered sensation, tingling, numbness, pain or pins and needles in either of your legs, do not hesitate to call Rehabilitation & Spinal Care of Rockford and schedule an appointment to be seen by Dr. Mike Donohue.

Sciatica And The Use Of MRI

In patients with sciatica, there is little relief with conventional therapies. The problem is usually treated effectively with physical therapy, manipulation of the sacroiliac joint and stretching. At Rehabilitation & Spinal Care of Rockford, the symptom of sciatica is a complaint that is commonly described as a sharp, shooting pain that travels down the posterior part of the thigh, into the calf and sometimes into the foot.

The use of MRI is an essential component of any orthopedic, chiropractic or physical therapy based medical practice in the diagnosis of a wide-range of conditions. However, the use of MRI should be judicious based on both the cost and benefit of the information obtained, as a recent study found.

The sciatic nerve travels down both legs

A Medpagetoday.com article noted that "follow-up MR [Magnetic Resonance] images obtained among patients treated for sciatica found no discernible benefit for the repeat imaging study." For patients with sciatica, obtaining an MRI is usually indicated, but this study found that there was no benefit in obtaining a follow-up MRI following treatment. Following one year of treatment, the study found, "disk herniation could be seen on MRI in 35% of patients who reported clinical resolution of the symptoms and in 33% of those whose symptoms persisted." Essentially, the symptoms of sciatica are present in both those who have discernible disc herniation and those without discernible disc herniation at similar levels.