Sciatica is the name for the symptom that many patients experience of burning, shooting pain following the pathway of the sciatic nerve, from the lower back to the buttocks and further down the outside of the legs and feet, sometimes all the way down to the little toe.
There tends to be a good deal of confusion and misunderstanding regarding the actual cause of sciatic pain. There are actually two entirely different syndromes that are implicated in Sciatica.
- The first is a radiculopathy of the lumbar spine. A radiculopathy is an irritation of the nerve at the the nerve root, where it first emerges from the spine. Common causes are disc herniation, misalignment of the spine, and degenerative disc disease. Frequently, the affect of the radiculopathy can be worsened by tension of the muscles surrounding the spine.
- The second syndrome that frequently leads to sciatica is far less easily diagnosed, and therefore more often overlooked. This is compression of the nerve further down its trajectory by muscles that the nerve runs through and next to. The most common muscle perpetrator is the piriformis muscle of the buttocks. In a significant portion of the population, the sciatic nerve actually runs directly through the piriformis muscle. In these people especially, tension or spasming of the muscle can lead to compression of the sciatic nerve, and thereby the associated sciatic pain.
Very frequently sciatica, even long standing sciatica, can be relatively easily addressed by acupuncture and a few simple exercises. The goal of treatment is to relax the stressed muscles that may be impacting the nerve, and remove inflammation from the nerve directly to reduce pain immediately. If the sciatica is caused by a radiculopathy, it will also be very important to strengthen the lower abdominal muscles to better support the back, and allow the muscles around the spine to loosen and relax.
Herbal medicine, topical ointments, kinesio taping, TENS therapy, cupping, and ultrasound therapy can also be effective adjunct therapies for treating sciatica.