Sciatica? Possibly Not, But We Can Help!

The term “sciatica” is so well known, that often people overuse this term and apply it to any pain experienced in the lower back or back of the leg. Similarly, many people refer to their wrist pain as “carpal tunnel” or their elbow pain as  “tendonitis” , when in actuality, it may or may not be.  People do this because it is easier to describe their pain as a condition than to try to give reason to the pain they are experiencing. In many cases of neuro-musculo-skeletal pain, the cause can simply be tight muscles from exercise without complimentary stretching/treatment,  muscular weaknesses or overuse. 

Throughout my years as a Registered Massage Therapist (RMT), I have had multiple patients tell me right away that they are looking for treatment for “sciatica” but during intake and questioning I find out they have not had any assessment to confirm this from a health care practitioner. A proper history and physical exam is something we can offer at Choice Health Centre, and it important to decipher the best course of treatment. The good news is that Massage Therapy, Physiotherapy, Chiropractic and more can help define and alleviate most, if not all symptoms of lower back and leg pain, whether it is true sciatica or not. 

So let’s get into what sciatica actually is, what else your symptoms could be, and what health care practitioners can do to help you! 

Sciatic is defined as symptoms of an underlying condition that causes pain radiating along the sciatic nerve from the lower back, into the glutes and down the back of the leg. Sciatica can also present as numbness, tingling and/or weakness, and most commonly affects one side of the body. Sciatica itself, therefore, is not a diagnosis, rather a symptom, that can be caused by many different diagnoses.  The most common cause of sciatic symptoms is a disc herniation, and can also be caused by degenerating discs or spinal stenosis (the narrowing of space in your spine, causing pressure on nerves). Pregnancy, where the uterus presses on the sciatic nerve,  is another common cause of sciatica, but in most cases symptoms will go away within a few weeks of the baby being born. 

So if it’s not sciatica, what else could it be?

Piriformis Syndrome and Sacroiliac Joint (SIJ) Dysfunction are 2 common conditions that mimic sciatica, that could be the reason for lower back/gluteal pain.

  • Piriformis Syndrome is when the sciatic nerve is compressed by the piriformis muscle (in the gluteal region), causing pain and may cause tingling and numbness as well. With piriformis syndrome you are less likely to experience pain in the lower back. Piriformis syndrome is due to exercise (especially without stretching or treatment) that tightens or spasms the piriformis muscle, or from compression of the muscle by being seated for a long period of time (often seen with people who work at a desk, or do a lot of driving).
  • Sacroiliac Joint Dysfunction is defined as pain caused by abnormal movement (too much or not enough) of the sacroiliac joint. SIJ dysfunction causes lower back pain, and can also cause referral along the sciatic nerve, but is not originating from the nerve root itself. Causes of SIJ dysfunction may be pregnancy, sports/exercise, heavy lifting/lifting improperly and postural imbalances affecting the hip. 

What can we do to help? 

Getting regular treatment and remaining active are going to be key to your recovery. Seeing multiple practitioners such as a Physiotherapist (for stretching and strengthening specific muscles), a Massage Therapist (for loosening muscles and promoting circulation) and a Chiropractor (for spine and joint health), are the most common therapies to help with sciatica. Other therapies such as Acupuncture and Osteopathy are also known to help with sciatica symptoms. With any issue it is always good to also consult with your Family MD and work together with other health care practitioners.

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