If you’re experiencing back pain, there’s a good chance you’re also feeling pretty panicked. I mean, it hurts to stand up, sit down, or even lie in bed. And sciatica? Just the sound of that word is enough to make anyone cringe. But before you start Googling your symptoms and convince yourself you’re dying, take a deep breath and read this blog post. It just might put your mind (and back) at ease.
I often tell patients that sciatica is a dump collection of diagnoses. It means that there are maybe two dozen different things that could present with the complaints people usually label as “sciatica”. In reality, there are really a wide number of different conditions. It is important because unless you have a diagnosis that really gives you a solid treatment plan, it’s not a useful diagnosis.
What it really is just a complaint. Sciatica usually ranges from a minor muscle issue where it compresses or presses on the nerve. Or it could be something that will cause paralysis and loss of function. The chances of death or paralysis is exceedingly rare. You have a better chance of being struck by a meteor than having that catastrophic event where you’re really in danger.
What really happens
Most of the time, sciatica is anything that happens in the pathway of that nerve, between the limb and your brain. Anything could cause that same symptom. It could be something like if you’ve strained a muscle in your butt. The sciatic nerve runs right underneath that muscle. When that muscle is irritated, it will release irritants and inflammatory chemicals. It’s going to go into spasm and compress the sciatic nerve.
Any one of those things can cause that symptom. If we move up the chain of the sciatic nerve, you could have issues around where the nerve exits the spinal cord. For instance, if you have arthritis or if you have a slipped disc, those things are typically what people think of as sciatica.
It could also be something associated with the sciatic nerve. For instance, if any of the ligaments in your buttock or in your back get sprained, you can have the same kind of presence. Sciatica is often not that scary. In fact, most of the time it’s something very simple that just needs some minor adjustments or tweaking to figure out how to make it go away.
In my 17 years of practice, I have seen a few catastrophic events related to this complaint. It’s rare. I’ve had a patient come in, head hanging low, mopey and depressed. They think that they have this terminal condition in which they could end up being stuck sitting in a wheelchair for the rest of their lives. It’s not uncommon for people to think they’ll be the next victim or even imagine themselves in such an event.
Especially if we can see people in the early stages, we can identify the real root cause and start treatment plans that will help address and fix it. The symptoms can completely go away. When you come across one of these rare occasions – there is nothing more rewarding than knowing how much work went into preventing something bad from happening!
Some muscles can cause pain that feels like sciatica. The pain might be in different places depending on which muscle is causing the problem. For example, the piriformis, the tensor fasciae latae (TFL), and the gluteus minimus muscles can all cause pain that feels like sciatica. These are muscles that form from the bottom of the spine and extend through the buttocks down to the thighs.
These are all muscles that share nerve roots. Anything that goes off, like a loud alarm, will cause a chain reaction and your body won’t be able to tell where it’s coming from. This will cause pain that feels like it’s coming from a wider area. There are many different types of tissue injuries that can cause the feeling of sciatica which may include ligaments, joint capsules and tendons. But they’re not necessarily going to end up being catastrophic – a nerve root destruction.
A little bit of storytime
“I’m not sure what I was expecting, but it definitely wasn’t that,” my colleague said, staring at the patient in disbelief.
The woman had just walked out of the room on her own two feet, after having been in a lot of pain when sitting in her wheelchair. I couldn’t help but smirk a little; it was nice to see him being so impressed.
“What did you do?” he asked, looking at me with fascination. “Some sort of magic trick?”
I shook my head and explained how we’d figured out the source of her pain and gave her an injection to help relieve it. It wasn’t magic – just good old-fashioned medical care
She was able to just walk around and exclaim that her pain is so much better. She thought magic doesn’t happen all the time. It’s not magic how we make the pain go away – it’s science. But it just feels like magic to our patients when their pain diminishes or disappears altogether.
A lot of times it is going to be some cooperative work for both us doctors and the patient themselves – but it’s just, people just don’t have to live in that dire state of pain. We don’t want to live in that impression that it’s going to be a progressive problem that ends up with a disability.
In conclusion . . .
The term “sciatica” to me, is like degenerative disc disease. It’s not necessarily this catastrophic condition. But we all get the impression that it is because in rare instances, surgery is a necessity. So a lot of patients will come in, be frustrated thinking It’s incurable because the surgeon said there’s no surgery to fix it. The surgeon is trying to convey that this isn’t as bad of an event, which would require surgery. The patient comes away from the meeting thinking “If a procedure can’t fix me then nothing will.”
People may think there’s nothing that can be done when surgeons were just trying to emphasize one thing: “I can’t do a surgery to fix this, but there are other treatment sources available.” That is exactly what we are trying to convey too.
So, if you’re dealing with sciatica and feel like you’ve been told “there’s no surgery to fix it,” don’t give up hope quite yet. There are many other treatment sources available that may be able to help alleviate your pain. And if you’re curious about what those might be, we would love to chat with you! Schedule a discovery call today and let us help you start feeling better.
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DISCLAIMER: The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional
