Pinched Sciatic Nerve Pain
The sciatic nerve is the largest nerve in the human body and is a common source of pain. The nerve arises from the nerve roots of the fourth and fifth lumbar spine and the first three sacral nerve roots. The nerve roots coalesce to form the nerve within the pelvic cavity and exits deep to the large muscles of the hip and buttocks. From there it travels deep within the muscular layers down the back of the thigh to the knee where it divides into the common peroneal and tibial nerve branches. This nerve controls the major muscles of the posterior thigh and lower leg.
There are a number of conditions that can cause or contribute to sciatica such as:
- Lumbar disc herniations
- Arthritic degeneration
- Sacroiliac joint dysfunction
- Piriformis Syndrome and muscular compression syndromes
- Trauma
- Pregnancy
Most of these conditions requires diagnosis by a trained professional and the true cause will dictate the best treatment of the pinched sciatic nerve.
Arthritic degeneration of the lumbar spine and lumbar disc herniations are fairly common and can be treated conservatively in many cases but may ultimately require surgery in severe cases. The nerve roots from L4 and L5 contribute to the nerve and compression or irritation of these nerve roots can result in sciatica nerve pain. There have been some great advances in non-surgical treatments such as decompression therapy and inversion therapy.
Sacroiliac joint dysfunction can irritate the nerve roots as they practically lay against the inside surface of the joint within the pelvic cavity. Stretching and chiropractic care are the best treatment for this type of condition.
Piriformis syndrome describes the condition where the sciatic nerve is compressed by the piriformis muscle as it exits the pelvic cavity. The nerve passes beneath the muscle in most cases so any irritation or spasm of the muscle can irritate and compress the nerve. In about 15% of the population the nerve actually pierces the piriformis muscle making it even more prone to compression.
Trauma can initiate sciatic pain since any hard impact, like a fall on a hard surface, can injure the muscles and tissues of the hip and buttock and result in compression or irritation of the sciatic nerve.
Pregnancy is another common cause of sciatica nerve pain since the growing uterus puts increasing pressure on the nerve roots and nerve within the pelvic cavity. There are techniques and conservative measures that can help alleviate sciatica during pregnancy and ultimately most cases resolve with childbirth.