Sciatica neuralgia, or Sciatica, is a common medical condition in which there is a disruption in the function of the sciatic nerve, typically due to inflammation or compression of the nerve.
The sciatic nerve is a peripheral nerve bundle, which arises from the lower lumbar and sacral nerve roots, and runs through the pelvis, and into the back of the legs. The sciatic nerve is responsible for carrying sensory and motor signals to and from the muscles of the thigh and lower legs.
Sciatica neuralgia can present with a number of different symptoms, with pain being the most common symptom. Pain is often experienced unilaterally within the lower back and can radiate down the posterior thigh into the lower leg. Buttock pain is frequently experienced with sciatic neuralgia as well.
Other common symptoms include numbness and tingling along the nerve distribution, which is primarily in the posterior aspect of the thigh and into the lower leg. In the most severe cases of sciatica, motor function is severely impaired.
The sciatic nerve is comprised of the common fibular nerve and the tibial nerve. These nerves carry the motor function needed to generate ankle movements, such as the ability to tiptoe or lift a foot off the ground. An Impaired sciatic nerve and motor function can result in difficulty walking. Atrophy can result in these muscles due to impaired or absent sciatic nerve innervation.
Mechanism of injury for sciatica neuralgia can be sudden or gradual onset depending on the cause. A common cause of sciatica is due to lumbar disc herniation at the level of L4-L5 or L5-S1. Click here to watch a video to get a visual of the spine anatomy that can help your understanding of sciatica neuralgia. This can be due to improper lifting mechanics, or a sudden twist or forward bending of the lumbar spine. In this case, the disc compresses the sciatic nerve. Gradual onset of sciatica neuralgia can occur with degenerative disc disease of the lumbar spine, in which bone spurring of the facet joints of the lumbar spine can compress the sciatic nerve. In more rare cases, entrapment of the nerve can result in the piriformis muscle, in a condition known as Piriformis syndrome. In this condition, the piriformis muscle can tether the nerve due to its proximity anatomically.
While the term “sciatica” is often defined by a set of symptoms, diagnosis often requires an MRI to determine the cause. Furthermore, EMG or nerve conduction studies can be included to further assess neural functioning. The cause determines the course of treatment. Typically, a mild to moderate case of sciatica is treated conservatively with Physical Therapy, medications, and injections. Physical Therapy may prescribe a battery of stretches and exercises to improve soft tissue mobility, and improve movement patterns that may be causing the exacerbation of symptoms. In moderate to severe cases, surgical intervention may be required. If you are looking for an exercise to help stretch your sciatic nerve, yoga may be a good alternative.