Sciatica - You get one chance!
Tommy Conway, Chartered Physiotherapist and Director at OneHEALTH, Physiotherapy Clinic Tullamore.
Sciatica is a diagnosis that many people receive but they don’t know how they got it and what caused it. Everybody knows it is a severe painful condition and everybody knows at least one person that suffered from it. If you have pain running from your back, into your buttocks, down your leg and struggle to drive, sit and walk then you could have sciatica.
When I see my clients in clinic they often ask me “Will it stop me going for walks, am I able to do my usual day to day routine, do I have to live with this for the rest of my life?” They are scared they will have it for life but it is nothing to be scared of because it can be easily treated provided you know why you are having Sciatica.
What is Sciatica?
Before we get into it treating it, let's explain Sciatica. Your sciatic nerve is a nerve that goes from your Spine and down your leg and branches off into smaller nerves. Think of your Spine as a tree trunk, your sciatic nerve as a branch and the smaller nerves down your leg are like the twigs off the branch.
So, why am I having sciatica?
There can be two main reasons why you are having Sciatica;
Nerves are very sensitive and don’t like being irritated, that is why it causes pain and irritation down your leg. Understanding where your sciatic nerve is irritated and why will allow you to become pain free.
Why does it happen?
You are born with a lot of movement in the upper back and hips. When you start to lose mobility your body has to compensate for this loss of movement. Your lower back is stuck in the middle of these two moving pieces and when the movement above the lower back (Upper back) decreases the lower back will get compressed and take the load. The same thing happens when you lose movement below the lower back (Hips) the lower back will again get overloaded and start to make changes to your discs in your lower back.
These discs can then break down and form a bulge which starts to irritate the nerve resulting in severe pain. This is a severe condition that will make it hard to sit, sleep and especially drive the car. Most people want a quick fix and just to get rid of it but I think we have to start thinking about this differently.
With such a severe condition, there is no quick fix. You need to take this seriously and find out why it is happening, you need to figure out where you have lost the movement. If you don’t figure that out you will start on the road of it having one episode a year, twice a year and then a monthly occurrence, injections, operations, a long hard road ahead. Most people start down this hard road because they never ask the question: why has sciatica happened to me?
Here is why?
Your first episode of sciatica is a warning shot. What usually happens is the disc is not affected but the muscles around the disc are shortening and compressing the nerve. This can take 5-6 physiotherapy sessions to improve but this episode needs to be known as a warning shot and if you do not take it seriously the long hard road awaits.
Yes yes yes muscles can cause a nerve to be compressed, restrict movement and cause a lot of pain. Did you ever hear of a “crick in the neck”? Well that can happen at the lower back as well. The muscles of the hip and leg surround the sciatic nerve, picture 1 shows the sciatic nerve and the route it travels down the back of your body. In picture 2 you can see the nerve is not as visible now as the muscles of the hips and hamstrings start to cover it. In the third picture you cannot see the nerve at all because the muscles of the glute max which are closest to the skin fully cover the nerve.
You can now clearly see how if one of the muscles identified in picture 2 and 3 gets shortened and loses their ability to move freely it can cause a compression on the sciatic nerve. What I want people to take from this article is there is a reason for everything, there are clues throughout and starting at the warning shot. How you move now determines the potential damage in the future. I have sympathy for people who suffer from sciatica on a long term basis as sometimes the damage is severe. But to someone that gets it today try and remember this.
The warning shot is fired and you need to listen to it. Follow this link for your next best steps.
You can check to see if you have the movement in your upper back and hips that you should have. Download this FREE pdf to test it for yourself. And If you do great, if you don’t your lower back and sciatic nerve are going to be under pressure soon.
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