As the largest nerve in the body, the sciatic nerve starts in the lower back and extends down the back of the lower body and into the foot. In most cases, sciatica is felt down the body’s left side, and if left untreated, the sciatic nerve can become damaged, causing permanent symptoms.
Sciatica refers to a set of symptoms that involves sciatic nerve pain. Sciatic nerve pain can have a variety of causes, the most common of which are disc issues and/or the presence of certain spinal conditions. The last stages of sciatica can involve permanent damage to the sciatic nerve.
In order to understand how sciatica develops and affects the body, let’s start by exploring the nature of the sciatic nerve.
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As mentioned, the sciatic nerve is the largest in the human body; it originates in the lumbar spine (lower back) and extends down the back of the hip, buttocks, leg, and into the foot.
In most cases, sciatic nerve pain is felt down the body’s left side, but it can also involve the right side, and rarely affects both.
Sciatic nerve pain can be felt anywhere along the sciatic nerve’s pathway, which is extensive.
The sciatic nerve is considered a mixed nerve as it contains both motor and sensory fibers, which is why sciatic nerve issues can affect sensation and movement.
The spinal cord that runs through the vertebrae (bones of the spine) is a bundle of nerves, consisting of 31 pairs of spinal nerves, five of which are lumbar nerves, including the sciatic nerve.
The spinal cord works in tandem with the brain to form the body’s central nervous system, which is a complex communication network that facilitates brain-body communication.
While many people think of the term sciatica as a clinical diagnosis, it’s more accurate to think of it as referring to a set of symptoms with an underlying cause.
Sciatica involves sciatic nerve pain and/or irritation felt anywhere along the sciatic nerve’s pathway, which runs through the lower body.
Sciatic nerve pain is caused by the sciatic nerve being pinched, compressed, irritated, and/or impinged.
When a nerve is exposed to uneven pressure, it can radiate pain to different parts of the body, and cause other symptoms of nerve compression.
When a nerve is impinged, it means there is a loss of space for the nerve to function optimally within.
So now that we have defined the sciatic nerve and sciatica as a set of symptoms, what causes the sciatic nerve to become irritated?
Sciatica can have different causes, but among the most common are intervertebral disc issues and the presence of an underlying spinal condition such as spinal stenosis or scoliosis.
In order for sciatic nerve pain to be addressed effectively, treatment plans need to be customized and shaped around a condition’s underlying cause.
The most common cause of sciatica involves the intervertebral discs.
In a healthy spine, its vertebrae are stacked on top of one another in a straight and neutral alignment, and adjacent vertebrae are separated by an intervertebral disc.
The intervertebral discs are key to the spine’s optimal health and function because they have many important roles: acting as the spine’s shock absorbers, combining forces to facilitate flexible movement, giving the spine structure (adjacent vertebrae attach to the disc in between), and providing cushioning between adjacent vertebrae.
In most cases of spinal degeneration, it’s the discs that are the first spinal structures to start to deteriorate, so disc health can be the underlying cause of many spinal issues/conditions.
When a disc starts to deteriorate, it can become desiccated, and this changes its shape, which will also affect the position of adjacent vertebrae, and this can cause the spine to shift out of alignment, putting pressure on the area surrounding an affected disc.
If a disc becomes a bulging or herniated disc, this means that it is encroaching on space inside the spinal canal, which means the nerves within are being exposed to uneven pressure.
If a disc in the lumbar spine, where the sciatic nerve originates, is affected, it can irritate the sciatic nerve, causing sciatic nerve pain to develop as a result.
Spinal conditions such as lumbar spinal stenosis and lumbar scoliosis can also cause sciatica; the latter involves a narrowing of the space within the lumbar spine, putting pressure on the nerves within.
Scoliosis involves the development of an unnatural sideways spinal curve that also rotates, and if it develops in the lumbar spine, the unnatural spinal curve can expose the sciatic nerve to uneven forces and pressure, irritating it and causing a variety of symptoms.
Sciatica symptoms can vary from one person to the next and will be shaped by patient age and overall health, severity, and causation.
While some patients will experience natural improvement within a number of weeks, others will experience sciatica flare ups: periods when intense symptoms develop, and then abate.
Frequency of flare ups will depend on how severe the sciatic nerve pain is and its underlying cause.
Common symptoms of sciatica can include:
When a spinal nerve or section of the spine develops an issue, it’s most common that the area of the body located closest to the affected spinal section is going to be the most likely to feel its direct effects.
If sciatica is left untreated, the sciatic nerve can become damaged, and sciatica symptoms can increase in severity and become permanent, such as numbness in the legs and/or feet.
So when the sciatic nerve is irritated, the aforementioned types of pain can be felt throughout the lower body, including the hips, buttocks, lower back, legs, and feet.
If a nerve is irritated for long enough, it can become permanently damaged.
There are a number of treatment options for sciatica, and when treated proactively, the frequency of flare ups can be reduced as pressure is taken off the sciatic nerve.
The first step to effectively treating sciatica is determining its underlying cause, and when disc issues have caused sciatic nerve compression, irritation, and/or impingement, the health of the affected disc has to be improved.
Through condition-specific chiropractic care, disc health can be improved by addressing any areas of vertebral subluxation, using manual adjustments to encourage a bulging disc to reclaim its central position between adjacent vertebrae, and the disc’s inner nucleus to reclaim its central position inside the disc.
When a disc’s shape/height is restored, this means pressure on its surroundings is reduced, including nearby nerves.
As the discs don’t have their own vascular supply, they absorb nutrients needed for repair from their surroundings, so increasing circulation around an affected disc can also help improve its health and function, and this can be worked towards through physical therapy.
When an underlying spinal condition such as stenosis or scoliosis has caused the sciatic nerve compression, the spinal condition has to be addressed proactively as it is the underlying cause of the sciatic nerve pain.
Once again, condition-specific chiropractic care can work towards opening up space within the spine so the nerves within can function optimally, and it can also work towards restoring as much of the spine’s natural curves and alignment as possible so nerve compression is reduced as a scoliotic curve is reduced in size.
Sciatica doesn't have to be permanent, and the last stages of sciatica involve permanent damage to the sciatic nerve, but if its underlying cause is determined and proactive treatment is shaped around it, permanent nerve damage can be prevented.
Sciatica is a set of symptoms caused by compression, irritation, inflammation, and or impingement of the sciatic nerve.
The sciatic nerve originates in the lumbar spine and extends down the back of the hip, buttock, leg, and into the foot.
When the sciatic nerve is exposed to uneven pressure, it can’t function optimally and becomes irritated and/or inflamed, and this can cause a variety of symptoms felt anywhere along the sciatic nerve’s extensive pathway.
From radiating pain felt throughout the lower body to localized lower back pain, sciatica flare ups can range from mild and intermittent to chronic and debilitating.
The last stage of sciatica is permanent sciatic nerve damage, and if this happens, loss of sensation and motor control in the lower body can develop, as can incontinence.
Permanent nerve damage is just that: permanent.
Here at the Scoliosis Reduction Center, the goal of treating any nerve-related conditions is to preserve as much function as possible, while proactively working towards preventing further damage.
If the sciatic nerve is damaged, nerve pain can be chronic and severe, and treatment will be about symptom management, a large part of which will be pain management.
So if you, or someone you care about, is experiencing sciatic nerve pain, don’t hesitate to seek out professional help to determine its underlying cause so proactive treatment can be started immediately; this is the best way to avoid entering into the last stages of sciatica and permanently damaging the sciatic nerve.
