Back pain is one of the most common ailments when a patient visits a doctor. One of the most common causes of back pain is irritation of the sciatica nerve commonly called sciatica.
The sciatica nerve exits the spinal cord from five different places in the lower back. These then come together to form the sciatica nerve.
The nerve then passes down through your gluteal (butt) region and continues down the back of the thigh. It next goes to the lower leg and into the foot and toes.
Sciatic pain can occur at any place along this trajectory or even along the entire pathway if severe.
Where X-rays or an MRI may help determine the cause of the sciatica, simple orthopedic tests at the doctor’s office can many times identify the cause of the problem. One such test is to have the patient lean forward.
If this motion exacerbates the pain, the problem is likely an intervertebral disc problem in the lower spine pushing on one of the five branches of the sciatica nerve as it exits the spine. How this works is simple.
When you lean forward, the intervertebral discs are squeezed between the vertebrae and pushed posteriorly. If the disc is damaged or herniated, this movement makes the disc press against the nerve causing pain .
Another test (known as Kemp’s tests) is to have the patient lean back and then rotate the torso towards the side that is painful. These two motions decrease the size of the space the nerve has as it exits the spine.
When you are in your sixties (or older) you are usually about two inches shorter than when you were in high school. This is due to the discs getting smaller over time and it is the discs which provide space for the nerves to exit the spine.
When there is less space, the nerve becomes compressed causing pain.
Unfortunately, drugs tend not to work very well treating sciatica. Acupuncture and chiropractic can help with less severe cases. Surgery is required for more severe cases.
