So you think you have sciatica?

What is sciatica?

Sciatica means you have pain along some part of the sciatic nerve. The sciatic nerve is the longest nerve in the body, coming out of the lumbar and sacral parts of the spine. It travels through the buttock and down the back of the leg into the heel and foot (technically it gets some other names down there, but it's all part of the same big bad nerve).


​​What isn't sciatica?

Some patients will tell me they have sciatica, but then point to part of there leg that isn't related to the sciatic nerve.  Leg pain doesn't necessarily mean sciatica. If the pain is on the side front, or doesn't go below the knee, it might not be the sciatic nerve. Those are often sacroiliac joint issues.

What causes sciatica?

​The sciatic nerve exits out of the lumbar spine. It can get irritated by abnormalities there including

• Bulging discs
• Herniated discs
• Degenerative joint disease (formerly called osteoarthritis) in the spine
• Spondylolisthesis (one lumbar vertebra moves way forward in relation to the other one above and/or below it)
• Spinal subluxations (chiropractic term)

BUT...it can also be aggrevated by the PIRIFORMIS MUSCLE. In layman's terms, that's a muscle in your butt and the sciatic nerve passes right under it (in most people). The piriformis muscle can either become too tight or too loose and that will trap the nerve creating the pain. For a small number of people the nerve passes through the muscle. 

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A word about discs

When MRI's first came out a lot of low back pain and sciatica was blamed on the disc. There was a study done in the 1990's showing that people without back pain and without sciatica have abnormal discs. In other words, just because you have an abnormal disc doesn't necessarily mean that's what's causing your sciatica. Nor does it mean that you have to have surgery.  

I have a very high success rate of treating sciatica (or what patients initially thought was sciatica) in my practice. If you do need another type of healthcare provider,  I will refer you to someone else. Look for part 2 of my blog on sciatica and the unique ways I treat it. ​

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