Sciatica Nerve Pain: What You Need to Know to Treat Scatica

We've been seeing this a lot in the clinic and there's a lot of misconceptions, a lot of misinformation that throws people off course and ultimately keep them in a pain cycle. Generally speaking, when patients come into my office, they think anything in the back and/or any pain traveling down the back of the leg is considered sciatic pain. Our goal is to provide you with so you can actually figure out the pain for yourself and if necessary, go get it fixed.


The sciatic nerve is one big nerve. It's about the thickness of our index finger or our middle finger. It's very thick and it's a collection of all the nerves that exit our lumbar spine. There are five lumbar vertebrae in our low back and they all come into one plexus before they turn into one big nerve that goes down through the top of the pelvis and under the sciatic notch before continuing down the center of the back of the leg where it ends at the bottom of the foot. So with this, we see the first two spots where we get a lot of impingement, the plexus, and the sciatic notch.


The lumbar plexus is where all the nerves coalesce and create the sciatic nerve and the sciatic notch is where the nerve exits from the pelvis, these two spots tend to be the number one areas where we have compression of the nerve, which ultimately going to give us that nerve pain. The nerve pain you're going to experience is different for every individual but there are some typical symptoms to look out for.


Typical sciatic nerve pain, a textbook-like pain would be pain on the bottom of the heel, in the form of a sharp shooting, lightening-like, pain down the back of the leg when the nerve is compressed. But that's not the only way that we get that pain. Nerve pain can be any type of pain but typically we notice it in the form of tingling, burning, numbness, dull ache, and weakness. So if we're getting any of these types of pains down the back of the leg, then we need to address the issue as soon as possible. These pains typically get brought on when bending forward, sitting with legs crossed and/or for prolonged periods of time, stretching the hamstrings, and engaging the glutes ineffectively, among other things.


This leads us to the most common form of nerve compression we see in the clinic, a double crush injury. This occurs when there is at least two points of compression on the nerve causing symptoms. For example, this could be coming from the spine/plexus, and another directly at the sciatic nerve, which could be that there in the form of a really tight muscle in our hamstring. This hamstring deficiency may be from an obvious old hamstring injury that caused scar tissue to proliferate over time or could be from repetitively loading (ie. Sitting), regardless of the reason why there is a shortening of the muscle-related to compression of the nerve. Relieving these symptoms would be predicated on decompressing the nerves, something we will get more into later on.


I hope by now you are understanding that sciatica pain is not one size fits all, like most things it affects individuals differently based on multiple factors. So this nerve, this big guy in the back of the leg governs the sensation of our skin, it tells our muscles what to do, it tells the lymphatic structures and the vasculature how appropriately nourish an area. Nerves in general are ultimately going to connect everything and help those individual parts to communicate more efficiently. Regardless of what we decide to do for your personal plan in the office, our main goal is to decrease the stress around the nerve. That relief is going to come in three specific forms, soft tissue manipulation to lengthen the tight muscles, chiropractic manipulation to restore motion and decrease stress around the joints, and finally to bring it all together – corrective exercise.


We know that we need to decrease the stress on the muscles so it stops compressing the nerve because as that nerve gets compressed, it's going to lead to pain. These tight muscles will directly restrict the motion of the joints as well. This stress is easily relieved with a chiropractic adjustment something that directly affects joint motion. And then the third and most important part of treatment is that we need to learn corrective exercises to engage the motions that have been lost due to the dysfunction. For example, if we lack rotation in the pelvis and/or torso, that's going to put a lot of stress on those nerves. That's going to cause a buildup of scar tissue in areas that could potentially pinch on those nerves. And overall, it's going to reinforce bad habits and potentially even bad movements. We need to do is correct that dysfunction before it proliferates into an issue, not only will corrective exercises get us out of the pain cycle, they are also used to prevent this pain from coming back once it's gone.


Sciatica - we know where it is, how it affects the body, and what our options are when we need to address the issue. I hope this helps answer any questions and provides some direction on your health journey. If you need any more information, or you have any questions. Feel free to call the front desk at Head 2 Toe Spine & Sports Therapy and we help the best we can.