Do you think you may have trapped a nerve in your leg? Are you feeling confused why you might have a pain going down the back of your thigh? Is it a severe either deep ache or stabbing pain in the butt? Do you might pinched a nerve causing your problem? I know so many questions to try answer.
If you can associate with some of those questions then you might have sciatica. Leg pain is a common thing to hear people complaining about. It can be either in their left leg or right leg.
If you are doing some online research for some pain relief tips or exercises you have come to the right page. Learn what is this condition so many people suffer with around the world everyday. I have looked at what you can do for sciatica pain relief treatment with some tips on basic sciatica exercises. Learn what treatment options you have and try out the 11 useful tips at the end to help yourself today.
What is Sciatica
Before you can get any pain relief you first need to have a better understanding of this type of pain.
It is a pinched nerve pain of the sciatic nerve. Sciatica is what lots of patients come into a chiropractor’s office looking for pain relief from a feeling of a trapped nerve in the leg.
Sciatica is not a diagnosis, but is classified as a symptom of a trapped nerve or pinched nerve. It doesn’t have an ICD10 code for medical billing.
The specific nerve that is trapped or pinched can be one of five nerve roots leaving the spine. Sometimes it can be the whole big sciatic nerve being irritated somewhere along its pathway as it travels down from the lower back to the ankle, foot and toes.
Medical Definition and Common Misspellings
It is a strange word that is not taught at school, but all adults know about it. I have seen common misspellings and pronunciations such as: syatic, siatic, cyatic, scatia, sciatic & siactica. The correct answer is it is spelt sciatica.
According to Wikipedia: Sciatica pain is a pain that runs down the back of the thigh at times extending below the knee into the calf muscle or ankle, foot or toes. The leg pain follows same pathway that the sciatic nerve supplies the leg. It can normally happens to women during pregnancy, healthy adults with disc problems or the elderly with degeneration and arthritis.
Here are two more official sciatica definitions:
Pain and tenderness at some points of the sciatic nerve, usually caused by a prolapsed intervertebral disk; sciatic neuralgia.
Any painful disorder extending from the hip down the back of the thigh and surrounding area.
The second definition is important “Any painful disorder extending from the hip down the back of the thigh and surrounding area“. Basically this means that sciatica can have be more than just an irritation to the sciatic nerve. It covers pain running down the back of the thigh for whatever reason.
Cadaver Dissection Video
I found this video of a cadaver dissection examination that shows you the relationship of sciatic nerve and the gluteal muscles.
Where The Nerve Starts and Ends
Did you know that the sciatic nerve is one of the major nerve’s in the leg (lower limbs) of our bodies? Follow me as I guide you along its travels through our bodies and where it can get trapped, pinched or damaged.
- This nerve is actually made up of 5 nerve roots exiting our spines. These nerve roots are from the L4-5-S1-2-3 nerves. This is the first place it can become trapped from a disc herniation.
- Together these nerves join into a rope like structure starting inside your pelvis.
- This nerve rope then leaves the pelvis by exiting through an anatomical landmark called the greater sciatic foramen. It is at this point in its travels that you can get a common cause of sciatic nerve pain called piriformis syndrome. This is because the piriformis muscle in the buttocks can compress the nerve.
- Our sciatic nerve can either pass over, under or directly through the middle of the piriformis muscle. It is different in different people and depends on what you were born with.
- This is also the site where I have seen getting a Vitamin B injection that has gone wrong.
- Once the sciatic nerve leaves the buttock region it then runs proceeds to run down the back of the thigh (hamstring muscle). It is at this point where the sciatic nerve then takes a major split to become the two other major nerves of the leg.
- It splits to now be called the: common peroneal nerve and tibial nerve. These are branches of the sciatic nerve.
- The common peroneal nerve and the tibial nerve then go to supply different parts of the front and side of the shin, calf muscles, ankle and finally the foot and its toes.
Just another interesting fact for you is that when there is sciatic nerve injury it is 6 times more likely to be the common peroneal side that is damaged. Think of a car accident where the knee slams into the dash.
Function of The Sciatic Nerve
We get all our skin sensation, motor muscle control and reflexes in the legs from this major nerve. It tells you if your foot is hot or cold.
Maybe while you were waiting in the doctors rooms you were looking at the posters hanging on the wall like the one of the dermatome anatomical chart and myotome nervous system charts below.
Conditions That Cause a Pinched Nerve in the Leg
Back pain conditions that can cause a problems to the sciatic nerve are:
- Lumbar disc herniation,
- Osteo-arthritis of the lumbar spine (spondylosis),
- Muscle spasm causing piriformis syndrome,
- Sacro-iliac joint dysfunction (SI dysfunction)
When Is It Not a Trapped Nerve
Not all episodes of leg pain come from a problem stemming from the spine. Other causes of leg pain can be:
- DVT clot pain in your leg or pelvis
- Pulled hamstring muscle
- Hip arthritis
- Knee arthritis
- Hip or knee Bursitis
Symptoms of Sciatica
The most obvious major symptom would be pain in the leg. However, the pain should be in the same area where the sciatic nerve supplies.
You may have sciatica if you have these symptoms:
- Pain in the buttock, usually only one side
- Pain down the back of the leg
- Pain around your hip
- Pain down the back of your thigh
- Pain in the lower leg and calf
- Weakness of your leg
- Buckling knee that gives way when standing up or walking
- Pins and needles in your feet or toes
- Numb feeling in the sole of your foot or toes
- Limp with walking
- Pain in your lower back when standing
Diagnosis of Sciatica
Remember sciatica is not a diagnosis. So some other condition is irritating the nerve. You need to find out that cause.
How to Test the Nerve
A healthcare professional, like a chiropractor or doctor, will be able to help find the cause after first asking lots of health questions and then a physical examination, including orthopaedic and neurological testing like the slump test.
Your sciatic nerve can be tested with deep tendon reflexes.
You can see how the patella reflex or knee-jerk reflex is controlled by the L2-3-4 nerve roots. The Achilles reflex or ankle-jerk reflex is controlled by the S1-2 nerve roots. You may have had the Babinski reflex test.This is why your doctor needs to test your reflexes with his reflex hammer, which people either love or hate the feeling.
The chiropractor might then use light touch or hard touch on different areas of your leg skin to see which nerve of the sciatic is being affected. You might find the sensation on the outside of your calf is numb or you can’t feel your big toe properly. This could be signs of a pressure on the sciatic nerve and is testing your dermatomes.
They probably also made you walk on your heels and toes. Maybe made you tense your toe backwards whilst they tried to push it down. These are neurological muscle tests of the nerve looking for lack of signal to the muscle.
Nerves are the way our brain can communicate, listen to and control what is happening to the body. You don’t want a pinched nerve anywhere in your body.
Do You Need To Get An X-Ray?
X-rays of your lower back or leg will not confirm sciatica. X-rays are not normally required, unless, your chiropractor or doctor feels there is another medical reason to explain where your pain is coming from. Unfortunately x-rays can only show what is happening at the bone and not show you the nerurological tissue like a nerve root leaving the spine near a lumbar disc.
Do I Need To Get an MRI Scan?
A magnetic resonance imaging (MRI) scan, is usually not an immediate necessity to help with the diagnosis. This is because a MRI scan is normally done when you have been referred for a surgical consultation with a neurosurgeon or orthopaedic surgeon in a hospital. They will need the scan to determine if you have a significant disc herniation or bulge that is pinching a lumbar nerve root at a specific level in your lumbar spine. They should also refer you for more another advanced nerve tests like a nerve conduction study to confirm the MRI report from the radiologist.
Other times a MRI scan is performed is if the doctor is worried why there is such a delayed time for pain relief or they are concerned of less common causes like infection or a cancer tumour etc…
Medical Treatment Options
Sorry I am repeating myself here, but please remember “sciatica is a symptom not a diagnosis“. It is only once you have being diagnosed with what is causing your sciatica will you be able to find out what all the best treatment options for you. This is why, I think, it is important to see a health care professional first.
The treatment advice for sciatica can vary from different doctors according to what they believe (diagnose) is causing your pain. It can range from:
- Physical therapy like Chiropractic, Osteopathy or Physiotherepay
- Exercises like yoga or pilates
- Rehabilitation exercises for the lower back
- Acupuncture or dry needling
- Over the counter pain meds like ibuprofen or voltarol (voltaren)
- Prescription neuropathic painkillers or general anti-inflammatories
- Epidural steroid injections or cortisone injections of the facet joints
- Spinal surgery like a discetomy, lumbar fusion or artificial disc replacement
Speak to your local doctor first before trying any self-treatment sciatica pain relief tips below.
Eleven Sciatica Pain Relief Tips
This guide is to try give you some hints and tips if you are struggling to control your pain levels. There are some basic to more advanced techniques and products to consider.
The lower back has a spinal natural curve called a lumbar lordosis. You can support the lumbar lordosis with lumbar support cushions or pillows in the small of your back. Use one of these recommended lumbar support for your lower back whilst sitting on the sofa, work chair and the car seat.
- Lumbar Belt Support
A lumbar support belt is an elasticated belt to support your lower back. The lumbar support belt is also known as a “kidney belt” in gym circles and can help some peoples sciatica. Using a lumbar support belt is not usually recommended in the long-term as it creates a psychological dependence on it.
- Keep Hydrated
Make sure you are drinking enough daily fluids, like water, because dehydration will lower your healing ability.
- Pain Killers
Your GP will be able to provide you with pain medication. You can also speak to a pharmacist for a basic over the counter sciatica medication to control your pain levels. Best to speak to your local GP or pharmacist about all the different options for pain relief medication.
- Inversion Traction Therapy
Did you know an inversion traction table at home to create low back traction and release the pressure on the sciatic nerve may potentially reduce your risk for spinal surgery from 78% to 28%. CAUTION must be advised when using inversion therapy on your own as home inversion traction hasn’t been conclusively shown to create substantial relief from discogenic back pain, but there has been some positive results. Speak to your current doctor first before trying any home inversion traction therapy.
- Avoid Intense Stretching
Trying to stretch the leg pain out of your leg could be stressing the trapped nerve more. The nerve is like a rope trapped at the spine. Any stretching must be gentle and controlled so not to stress the sciatic nerve further.
- McKenzie Exercises
Mckenzie exercises are a great for sciatica pain from a disc herniation or disc bulge. Putting your lower back into repeated extension helps the disc heal and can relieve the trapped nerve pain in your leg quickly. For this sciatica exercise check out “Bent Over with Lower Back Pain – Here’s the Reason Why“.
These pain relief tips are not exhaustive. However, the sciatica exercises might help guide you in other ways in getting some leg pain relief and sciatica pain relief today.
I hope you get some rest from your sciatica pain soon.