Do you actually have sciatica?

Differentiating sciatica and referral pain from joints dysfunction or muscles

Sciatic nerve diagram
Source: Sciatic nerve2.jpg from Wikimedia Commons by K. D. Schroeder, CC-BY-SA 4.0

Do you get pain down your leg? Does your google search suggest sciatica?

Ever consider other structures that may be causing pain down your leg?

More often than not we get clients coming in to the clinic thinking they may be suffering from sciatica (entrapment of the sciatic nerve). However, is it common to find this is not the case.

Instead it is usually referral pain for either from muscle trigger points and/or joints dysfunctions in the low back or pelvis. 

Lumbo-pelvic girdle:

There are many structures that make up the lumbopelvic girdle, these include:

  • Pelvis (ilium, superior & inferior pubic ramus)
  • Sacrum (tail bone)
  • Lumbar (low back)
  • Gluteal muscle group (gluteus Maximus, medius and minimus)
  • Piriformis
  • Iliolumbar ligament

 

Differentiating sciatica and referral pain:

The aforementioned structures are a few examples within the lumbo-pelvic region that can potentially lead to pain and discomfort that refers down the back of the leg. To differentiate referral pain from actual sciatica we need to identify the referral pattern, in most cases the difference is that pain normally wont travel past the knee with other conditions, with the exception of the gluteals that can refer past the knee, however the path of the pain is noticeably different from that of sciatic pain. 

What is sciatica?

Entrapment of the sciatic nerve which sits deep under the muscles in our  buttocks is what causes the symptoms of sciatica. Sciatic pain will refer down the back of the leg, past the knee and down into the foot. The characteristic of the pain could be numbness, tingling and weakness in the leg of foot. With all neurousculoskeletal condition, these symptoms may vary between patients. However, to confirm true sciatic nerve entrapment there must be weakness to all the muscles the sciatic nerve innervates. So, it is always best to be throughly assessed by our chiropractor to get the right diagnosis and advice on your condition.

Marcus Ng explaining sciatica

Diagnosing Sciatica:

Correctly diagnosing your condition is important to create a specific treatment plan that would work best for you. However, all the condition’s mention above can significantly benefit from a combination of conservative treatment that may involve gentle manual adjustments, dry needling, soft tissue therapy and shockwave therapy.

In addition, to the hands on therapy it is important to prescribe a specific rehabilitation program to complement. For sciatic conditions, it is more important to recondition the sciatic nerve and decompress the areas of entrapment. Where as for the other conditions the focus is more on the resolving muscle imbalances or movement pattern dysfunctions to help unload joints and/or muscles.

This is where a qualified chiropractor is necessary. We are here to help guide and build a proper rehabilitation and treatment plan so that you can return to your daily activities or achieve your goals.  If you are experiencing any of the aforementioned conditions or would like to talk about your condition, contact Quay Health and we will be more than happy to provide information to help.

 

Post by: Chiropractor Steven Tran