Sciatic pain or sciatica is a typical complaint that people will come into the clinic with, and what they usually mean by that is they have pain somewhere in their back or going down their leg.

It’s important to remember that sciatica or sciatic pain is really not a diagnosis but a set of symptoms by which people describe pain. So it’s very important to be assessed by a physiotherapist to determine where the pain is coming from because it could come from a number of different structures.

If we have a look at the lumbar pelvic spine, we have the vertebrae which are these bones over here. And the lumbar spine is comprised of the last five vertebral segments.

This is our sacrum or tailbone and these are the two hip or pelvic bones with the hip joints sitting on either side over here. And five of these nerve roots will join together to form the sciatic nerve, and we have one on each side one on the left and one on the right.

So because sciatica is a complaint which can affect any of the five nerve roots comprising of the big sciatic nerve, it’s very important for your physiotherapist to assess each one of these levels to determine what the cause might be.

So depending on where that nerve is becoming either irritated or compressed, we could have symptoms which mimic or are described as sciatica. They can be things like numbness or tingling going down the leg or into the foot, difficulty in controlling the muscles supplied by those nerves, pain, or uncoordination.

And so there are four common causes of sciatica. One might be a disc which in laymen’s terms is called a slipped disc. Really it’s a herniated disc in which the disc tissue gets torn and that can push on a nerve root.

The second could be something called spinal stenosis which is compression around the central part of the nerve inside the spinal column. The third most common cause is something called spondylolisthesis which is a big word that means one vertebra has slipped forward on another.

The last most common cause of sciatic pain is something called piriformis syndrome. The piriformis is a muscle which runs through the pelvis from the sacral bone onto the hip bone. So as the sciatic nerve traverses this part the piriformis muscle can compress that sciatic nerve and that can give you pain further down.

Because we know that sciatica is a set of symptoms, rather than an actual diagnosis, it’s important to get an assessment by a physiotherapist experienced in dealing with sciatica to be able to accurately determine where the pain is coming from.

Typically when you see your physiotherapist he or she will do an assessment which consists of a subject of evaluation during which a number of questions are asked to determine the history of your pain and probable causes followed by an objective examination where your physiotherapist will use a variety of physical tests to put stress or lowered on various structures that could be responsible for the pain. An example of this would be a straight leg based test or stress tests of the lumbar spine joints to determine if they are at fault.

If you as a patient are complaining of pain in your buttock, lower back, or leg especially if that pain travels from the lower back down the leg or you’re experiencing symptoms of tingling, numbness, pins and needles, or you’re having trouble controlling the muscles in your lower back and leg, it’s very important to see a physiotherapist today to determine the causes of this pain.

You may visit a physiotherapist for information on what is, conditions, side effects, symptoms and treatments related to sciatic pain, back pain, lower back muscles and intramuscular therapy.

Presenter: Gordon Bohlmann, Physiotherapist, Vancouver, BC