Understanding Sciatica: What is Sciatic Nerve Pain or Radiculopathy?

by coachz on September 4, 2009

Neck pain, back pain, and sciatica or sciatic nerve pain (also known as lumbar radiculopathy) affect millions every year. It is estimated that between 80% and 95% of adults will experience back pain and/or sciatica at some point in their lives. This is the third article in a series on sciatica, its symptoms, its causes, and the treatment strategies for dealing with the underlying causes. I hope you find it useful.

Sciatica: Symptom or Condition

In the previous two articles in this series we’ve discussed some of the reasons why we experience sciatic nerve pain or sciatica. In this article I would like to jump back just a bit and discuss the symptoms associated with sciatica, explain just why we experience this type of pain, and some of the other basic issues often faced when we experience it. Naturally, as you know by now if you’ve read my previous articles and watched my videos on sciatica, sciatic nerve pain is an expression of a condition and not the problem in and of itself. An example of this might be the pain you feel when you burn yourself. The burning sensation is a signal that your skin has been exposed to heat, the pain is not the problem, although it may be at that particular moment, it is a signal that your skin is too close to the flame. The same is true of sciatica. Sciatic nerve pain is a signal that something is wrong at some point along the sciatic nerve, usually but not always at the nerve root, where the nerve exits the spinal canal, and it is that condition which needs to be addressed. In the previous two articles, we discussed several of the reasons why a back, leg, and at times ankle and foot pain sufferer may experience sciatic nerve pain. We will now discuss the symptoms associated with the condition and where they emanate from.

Sciatica: Getting to the Root of the Pain

The sciatic nerve is the source of the pain signal we refer to as sciatica, usually the result of what is called a lumbar radiculopathy. The radiculopathy is primarily an irritation or compression of a lumbar nerve root at L4-5 or L5-S1, affecting the nerve just as it exits the spine either to the left or the right. However, sciatica may be experienced as the result of aggravation or damage to the spine and/or spinal nerve roots as high up as the second lumbar vertebrae and as low as the third sacral nerve (remember the sacrum is a primary curvature and fused). The location of the pain, weakness, and/or numbness associated with sciatica will depend in large measure on exactly where the irritation, compression, and/or damage is located on the spine.

Sciatica: The Sciatic Nerve

The sciatic nerve is the longest and largest nerve in the body. The nerve may be as big around as your big toe or thumb at its broadest point and is actually a combination of five nerves. The nerve roots, exiting the spine on both the left and right sides, generally between the fourth lumbar and third sacral vertebrae, come together and form the sciatic nerve on the anterior (front) surface of the piriformis muscle (at the rear), and fuse to become the sciatic nerve, one large nerve that travels from the piriformis down the back of the leg, branching into two separate nerves behind the knee, becoming the peroneal and tibial nerves. We will discuss the piriformis muscle and the piriformis syndrome in a future article. Interestingly, many sciatica sufferers experience pain behind the knee, particularly after driving for extended periods. We will discuss ways of dealing with this condition while driving in a future article, as well. The peroneal and tibial nerves continue to radiate down the leg, into the ankle, heel, and toes; and, this is why many sciatica sufferers have pain, numbness, and tingling radiating into the feet and toes.

The Sciatica Nerve: Function and Effect

The sciatic nerve is responsible for strength, sensation, and reflex action in the hips, thighs, lower legs, feet, and toes. When irritated or compressed, the sciatic nerve will cause pain, tingling, numbness, burning, loss of strength, and a loss of reflexes In the worst cases, sciatica will create a debilitating and disabling level of pain and loss of sensation. In its mildest forms, the pain expressed may seem like nothing more than a pulled muscle or an ache behind the knee. However, in any of the above manifestations or pain expressions, it is important to get to the “root” of the problem before more permanent and/or intractable pain and disability becomes a reality. While there are distinctions between radicular pain, meaning true sciatica, and other types of leg pain, whatever the ultimate diagnosis may be, any sort of pain of the lower limbs, particularly pain radiating down the back of one of both legs and causing numbness, tingling, and a loss of sensation should be examined right away to make sure nothing serious is going on.

Sciatica: Treatment and Prognosis

There are exercises and stretches sciatica sufferers can do to ease and in many cases eliminate the pain completely, but if the pain is ongoing and acute, a medical practitioner should be consulted. In the next article we will discuss degenerative disc disease and how it may express itself as sciatica; and, how it may be avoided. Ultimately, regardless of the etiology or cause of the pain (e.g., degenerative disc disease, herniated disc, etc.) sciatic nerve pain may be a signal of a serious condition. A medical specialist, preferably a neurologist or an orthopedic surgeon should be consulted to rule out a more serious issue before embarking on any sort of exercise regimen or treatment program. The prognosis for most sciatica sufferers is quite good, provided action is taken to eliminate the chance of a more serious condition being to blame for the pain, and an intelligent program of treatment, to include stretching and exercise, is initiated early…and the 5 contributory factors are addressed (see previous videos and articles for the “5 factors”).

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Professor John P. J. Zajaros, Sr., The Bad Back Guy
Skype: johnzajaros1

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