Sciatica or sciatic neuralgia is a commoncondition in which one of the spinal nerve roots of the sciatic nerve is compressed resultingin lower back, buttock and leg pain. Sciatic nerve is a large nerve derived from 5 spinalnerve roots: L4, L5, S1, S2 and S3. It runs from the lumbar spine through the buttockdown the leg and the foot on the posterior aspect. There is one sciatic nerve on eachside of the body. Typically, only one side of the body is affected.A typical sciatica pain is described as a sharp shooting pain in the lower back, downthe buttock, thigh and leg on one side of the body. There may also be numbness, burningand tingling sensations. The pain can get
worse with sitting, moving, sneezing, or coughing.The patterns of pain depend on which nerve root is compressed, and follow the dermatomedistribution. The most common cause of sciatica is a herniatedspinal disc. The spinal disc is a soft elastic cushion that sits in between the vertebraeof the spine. With age, the discs become rigid and may crack, the gellike center of thedisc may protrude out and become a herniation outside the normal boundaries of the disc.Disc herniation presses on the nerve root as it exits the spine.In majority of the cases the condition resolves by itself after a few weeks of rest and conservativetreatment. Pain relief, nonsteroidal antiinflammatory
drugs and muscle relaxants may be prescribed.Stretching exercises and physical therapy may be recommended.Surgery may be needed if the pain doesn’t go away after 3 months or more of conservativetreatments. The herniated disc may be removed in a procedure called discectomy. Or, in anotherprocedure called laminotomy, part of the bone of the vertebrae may be cut to make room forthe nerve.
Piriformis Syndrome versus Sciatica Animation
Piriformis syndrome is a neuromuscular conditionwhere the piriformis muscle one of the deep gluteal muscles presses on and compressesthe sciatic nerve causing pain, tingling and numbness in the buttock area and down thepath of sciatic nerve to the thigh and leg. Sciatic nerve runs UNDER the piriformis muscleand may be irritated when the muscle is too tight or shortened due to spasms. Piriformissyndrome is to be differentiated from sciatica which shows similar symptoms but has differentcauses. Diagnosis is commonly done by EXCLUSION ofsciatica. Because sciatica usually associates with compression of sciatic nerve roots bya herniated disc, sciatic symptoms in the
ABSENCE of spinal disc herniation are indicativeof piriformis syndrome. Causes and risk factors of piriformis syndromeinclude: Anatomical abnormality of the nervemusclerelation. Some people are more likely to get piriformis syndrome than others. Tightness or spasm of the piriformis muscle due to overuse injury. This commonly happensin sport activities that put pressure on the piriformis muscle such as bicycling, runningwithout proper stretching, or any activity that involves repeated movements of the legsperformed in sitting position. Treatment options include: Stretching exercises, massage, avoidance
of causative activities. Antiinflammatory drugs, muscle relaxants for relief of symptoms. Physical therapy that strengthens the gluteus maximus, gluteus medius, and biceps femorisis usually recommended to reduce strain on the piriformis muscle.