The diagnosis of sciatica can be misleading. The original intent was that sciatica was a diagnosis given to people with irritation of their sciatic nerve, a large nerve that passes through the buttock area. The reality is that there are many different problems that can create “sciatic” pain.
The pain patterns associated with sciatica may include the lower back, buttocks, tailbone, hip, back or side of the leg. May extend into the foot and may be associated with numbness or tingling. That’s a lot of areas and the way people present in the clinic varies dramatically.
What causes sciatica?
Problems that can cause sciatic pain include but are not limited to:
· Sciatic nerve compression by the muscles in the buttock region
· Spinal disc herniation compressing a nerve root
· Gluteal or deep hip muscle spasm or trigger points
· Lower back muscle spasm or trigger points
· Lumbar joint dysfunction/ facet syndrome
· Sacro-iliac joint dysfunction/ SI syndrome
· Poor blood circulation to the legs (vascular claudication)
· Nerve compression by bone spurs (neurogenic claudication)
Some of the causes on this list aren’t due to nerve compression. Pain spreading into the leg can sometimes be due to pain referral from muscle or joints and not always from nerve irritation.
Using the term “sciatica” as a diagnosis is similar to using “headache” as a diagnosis. You still need to determine the actual cause.
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