What is Sciatica?

Sciatica is a condition or a symptom that can be caused by other underlying factors. It is not a disease in itself. The sciatic nerve is a major nerve that enervates the legs, buttocks, and lower back. It is the longest single nerve root in the body. The origin of the sciatic nerve is in the spinal cord, from where it runs down to the lower back to send nerve endings down the lower limbs.

A pinching or pressure on the sciatic nerve causes pain that radiates down all the organs innervated by the sciatic nerve. This sciatic pain usually originates in the lower back, moving down the lower limbs.

Sciatica pain can be a frustrating condition because it affects simple activities. Activities, like sitting and walking, can cause pain thus reducing the quality of life. Sciatica pain follows the path of the sciatic nerve. So pain can start in the lower back and affect the hip down to the foot. That’s why you may have lower back pain.  This can combine with burning or tingling in your buttocks or leg. Below are the most common sciatica symptoms.

  • Lower back pain.
  • Pain in the buttocks or leg that’s worse when sitting.
  • Hip pain.
  • Burning or tingling in the leg.
  • Weakness, numbness, or difficulty moving the leg or foot.
  • Constant pain through buttocks.
  • Difficulty standing up.

Sciatica Pain Causes

Sciatic nerve pain arises when there’s pressure applied to the sciatic nerve. The most common cause of pressure is from bulging discs in the lower back pressing on nerves.  Other causes are tension through the buttocks and sitting on hard surfaces. Sitting on a wallet in the back pocket is a classic example.

How Many People Does Sciatica Affect in Canada?

In Canada, back pain is the third most common reason for outpatient visits to the hospital and contributes 25 per cent of total consultations. This pain is most often caused by sciatica.

Sciatica Causes and Symptoms

The most common cause of sciatica is when the sciatic nerve is pinched by a piece of the ruptured lumbar disc, which supports the lumbar vertebrae in the lower back.

However, there are some other causes of sciatica:

  • Slipped disc caused by undue stress or weight on the disc, causing one vertebra to slip over the one below it.
  • Spinal and disc degeneration due to age can make the pieces of bones and disc pinch on the sciatic nerve.
  • Arthritis can cause the discs and the surrounding soft tissue to get inflamed and painful, filling the vertebral space and pinching on the nerve painfully.
  • Other less common causes are built up trauma to the leg over time (like with athletes), tumours, infections that affect the lumbar spine, internal bleeding around the sciatic nerve and bone interference in the path of the nerve (like with a fracture or shift), causing irritation and pain.
  • Obesity and incorrect posture when lifting heavy things can contribute to the development of the condition.

The symptoms of sciatica are mostly pain related and include:

  • Pain from the lower back down to the legs and toes
  • The stiffness of the leg and loss of sensation in the affected limbs.
  • Sharp, pinching pain when standing or sitting.
  • As the condition deteriorates, loss of nerve function might lead to other neurological symptoms like inability to control bowel movement and loss of feeling in the lower extremities.

Sciatica and the anatomy

The nerves that are involved with sciatica form the terminal of the lumbosacral plexus: L4-L5-S1-S2-S3

How is Sciatica Diagnosed?

Physical examination will chronicle the range of movement and the sites of pain. That combines with a detailed medical history can help to pin down a diagnosis of sciatica. The most common neural tests in the clinic include:

  • Straight leg raise test
  • Crossed straight leg raise test
  • Slump test
  • Femoral nerve tension test

When a positive neural test combines with the description of pain radiating down one leg, this is usually enough for a positive diagnosis of sciatica.

Acupuncture Sciatica Pain Research

The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis

In 2015, twelve acupuncture studies on sciatica were reviewed involving 1842 participants. Results showed acupuncture more effective than conventional Western medicine for reducing pain intensity and increasing pain threshold.

Find Journal Article here Acupuncture for Sciatica Pain Research

More research is needed on acupuncture to be classified as an effective treatment for sciatica.

Acupuncture for Sciatica Questions

Within the positive research trials on sciatica, patients received a minimum of 2 acupuncture sessions per week. Many studies, however, gave daily treatment. The number of sessions varied from 6 acupuncture sessions to 40. See the numbers here.

It depends on the response to the acupuncture plus many other factors.

Within the initial session, a treatment plan will be arranged to aim for the best result for you.

No. However as a herbalist that has trained in Chinese medicine, often Paul will be thinking about herbs that have been traditionally used for sciatica.

Any treatment will be discussed as a part of your treatment plan.

Most commonly, a combination of acupuncture, massage, gua sha, linaments, herbal medicine is used to help with sciatica.

We may also discuss diet, exercise and home care.

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