One of the most common diagnosis for low back and leg pain is sciatica. Unfortunately, we find that many people who come to us for help who were given this diagnosis, do not truly have sciatic symptoms. The intention of this article is help educate and make you more aware of what is truly causing your symptoms and how to find relief with a long-term solution.
Far too many people are afraid to get back to the sports, work outs and activities they love because of this diagnosis. We’re here to help you understand more about your symptoms to gain knowledge and confidence that you can get back to your desired lifestyle and goals. Read through our comprehensive article and let us know if you need more help with your specific symptoms. We’re here to help active gym goers and endurance athletes who are frustrated from “sciatic” symptoms and want to finally get back to their routines without limitations.
What is Sciatica?
Sciatica, can be the irritation to the sciatic nerve. This nerve, which runs from the lumbar spine all the way down to the foot, is irritated. This irritation causes symptoms such as burning, tingling, numbness and progressive weakness throughout the nerve ending.
Sciatic symptoms can be caused by compression of the sciatic nerve at different points along the pathway. The two most common are are the exit from the spinal cord and the piriformis. At the spine level, compression of the associated disc (shock absorber between vertebrae) can compress the nerve root as it exits the spinal column. The common location is in the pelvis area. The piriformis muscle, which connects from your femur to your sacrum (tailbone), can become hyperactive and compress the nerve as it passes behind the muscle.
Regardless of the location of the compression or irritation, the neurological symptoms associated with sciatica can impair an individual’s ability to sit, bend forward, squat and even sleep at night. Symptoms trace along the nerve pathway, as seen from the image above.
Why it is Commonly Misdiagnosed
The pelvis complex is well….complex. Along with your spine, you also have the scarum AND hip joints involved with every movement. Because of this, many times “sciatica” symptoms may travel a similar path of the sciatic nerve but are not coming from it. For example, muscular dysfunction can cause referral pain in the pelvis are and down the leg. Below is a chart used to demonstrate the referral pathways of trigger points (or unhappy, dysfunctional muscles). The same knots you experience in your neck happen in any muscle and are particularly active within the 3 gluteal muscles.
You can see from the chart that when we look at the glute medius in particular the red area demonstrates where people had experience numbness, tingling, and radiating pain. Sound familiar? This is why in our experience, MOST people do not have sciatic nerve irritation and rather have muscle dysfunction or imbalances.
How Do I Know Where It’s Coming From?
First thing first, if your symptoms are persistent enough to disrupt daily activity then you should have it assessed by a movement expert. That does NOT mean you need imaging! The only time imaging should be the primary assessment is if you are having quick progressing weakness, loss of sensation and loss of bowel and bladder control. If you do not have that then identifying the source more conservatively will save you money, frustration and most importantly, time.
A simple test you can do to help determine if it is your hip area is below:
With this test, you can determine that if your symptoms are present during hip rotation, then you have a hip joint/muscles problem. If this does not make your symptoms worse, then there is still further assessment to be done. It’s recommended at this point to reach out to a movement specialist who can give you more information based on a thorough examination.
How Do I Begin to Get Relief?
There are 2 things that will help you on the path to relief and return to activities: mobility and muscle reprogramming. We want to reduce the stress and irritation to the impacted structures and tissue, and then reprogram muscles to fire correctly. This can be achieved by performing mobility work followed directly by motor control drills to reinforce the change in movement we desire.
Below are a few drills we commonly use to decrease irritation and then reprogram movement to initiate return to full activities pain-free.
What You Need to Do Right Now To Get Better
First thing is to assess the severity of your symptoms. If there is nurological problems, as described above then you need immediate attention and imaging. If your symptoms are not creating these issues, then perform our test to help determine the root cause. Following, performing the mobility and muscle reprogramming drills pain free would need to be initiated.
If these steps are provided relief but it is not consistent, or symptoms are affecting daily life and reduction in work outs and training, then it is recommend to be assessed by a specialist. If you are in the Raleigh-Durham area, you can schedule your free discovery consultation with Dr. Campbell or one of our other specialists to help give you pertinent information to help you decide the best solution for you.