What exactly is sciatica?

An online search of “sciatica” yields over 25 million plus results in about 0.52 seconds. The Mayo Clinic and WebMD are the first to rank, no surprise there. They are the first choice among readers who are researching about medical conditions, often times to learn about their own condition. Within moments, the reader can learn about the condition, it’s symptoms and causes, and common treatments. The reader is also left, however, with an overwhelming amount of information that makes it difficult to put the data into context...in other words, difficulty in applying the information as it pertains to them.

Sciatica is a term that is most accurately associated with back pain that radiates into the lower extremity. It is a condition where a nerve root is affected by pressure from the lumbar disc, typically from swelling or inflammation which then causes an effect to the sciatic nerve. Not all back pain leads to sciatica, and not all radiating pain is sciatica. Here’s why…

Lower back pain has multiple causes that involves different anatomical components which are compounded by one’s history. The spine is a series of bones that rests on fluid filled discs, its balance controlled by the abdominal muscles. If the disc is inflated (from swelling or inflammation), the stack can become unbalanced and put pressure on the adjacent nerves. There are many bony prominences around the spine that over the course of time and with chronic trauma or untreated pain syndromes may develop bone spurs. These bone spurs are correlated often with degenerative changes that take place with osteoarthritis, often causing spinal regions to develop stiffness and connective hardening over time. These are just a few examples of spinal pain that may not always produce symptoms into the lower extremity like sciatic nerve pain.

In the hip and pelvic region, there are muscles like the piriformis, hamstring and gluteals that can also place pressure on the sciatic nerve, which may cause pain into the leg. Nerve endings that live in and around the hip joint can be irritated by a deteriorating cartilage inside the hip joint. This syndrome can mimic sciatica but is rather a hip disorder.

There can also be a shortened hamstring or calf muscle from sitting for long periods. These muscles can become adaptively shortened. Muscle shortening is not just tight, but has adapted to a contracted state due to inactivity or lack of use. Tight muscles, on the other hand, can be stretched and restored (usually), but shortened muscles require some sort of stretching intervention that is often painful but necessary to return a normal length.

The internet is a double edged sword, providing access to information in abundance, but unfiltered and often out of context. The reader is left with a shotgun approach to learning and has to discern what is or isn’t important. There is a reason why a systematic learning process is necessary to filter the massive amounts of information available, the kind of information that leads to real options and resolution.

Dr. Adrian Pujayana has been providing drug-free solutions for health and wellness to adults, athletes, and youth since 2000 through his private practice at Family Chiropractic Center of South Pasadena, a place for strength training and nutrition based health care.