The sciatic nerve has the distinction of being the largest and longest nerve in the body and when irritated, causes pain that elicits the familiar phrase, "oh, my aching back!"

The sciatic nerve is as wide as your thumb and runs from the lower back, down the buttocks, legs and to the feet. It's responsible for the painful condition referred to as sciatica.

When this nerve is compressed or strained, the resulting irritation can play havoc with everyday life. For example:

  • It's responsible for more lost days of work, other than the common cold.
  • Treating it can run into billions of healthcare dollars.
  • It can interfere with being able to carry out the simplest everyday duties without pain.

The symptoms help to establish the diagnosis easily because the ensuing pain has several distinctive characteristics:

  • It typically occurs on one side of the body.
  • The pain is often described as tingling, burning, pins and needles sensations, electric shock like feelings, hot and cold sensations, numbness and weakness in the leg or foot.
  • The classic symptom starts with lower back pain which runs through the buttocks, back of the thighs, and divides into two branches just above the knees. It continues to branch out into the calf muscle and all the way down to the feet.

Sciatic nerves were designed to transmit messages from the spinal cord to the legs to tell them to move. But when the sciatic nerve becomes compressed, irritated, or inflamed, the only message it transmits is pain.

A herniated disc, arthritis, a tumor, an injury or spinal infection are among a variety of causes for sciatica. Researchers in Finland have also discovered a genetic component that contributes to a predisposition for developing sciatica. So, don't be surprised if you find that it runs in the family!

However, one of the most common causes of sciatic pain involves a small, deep muscle called the piriformis. It is located beneath the gluteus maximus and in a certain percentage of cases; the sciatic nerve actually runs through the piriformis muscle. When the muscle contracts, it compresses the nerve causing irritation and pain.

There are other things that will cause the piriformis muscle to act up, for example, repetitive activityinvolving hip, back and buttocks can be intense enough to cause the piriformis muscle to swell up, creating pressure on the nerve.

Another common cause of sciatica is a herniated disc in the lower spine, which can pinch off or compress the nerve.

Other circumstances that can create compression on the sciatic nerve include the bony, irregular projections due to osteoarthritis or swelling that develops as a result of an injured ligament.

Even something as innocent as a man sitting on a wallet that happens to be in his back pocket, can put enough pressure on the piriformis muscle to cause problems.

Last but not least, weak hip and gluteal muscles will cause the piriformis muscle to become tight, compressing the nerve.  The best way to combat muscle weakness is by regularly participating in exercises for sciatica.

Available Treatments
Good News!!! Dr. James Wheeler III, an orthopedic surgeon in Marion, NC reports that "90% or more of sciatica problems resolve themselves". Surgery is considered only when a person becomes functionally disabled.

It's imperative to begin with professional help to properly manage sciatica. A neurological exam and, most likely, a peripheral vascular exam are needed to rule out any circulatory problems. Your doctor may prescribe an anti-inflammatory medication to relieve the pain temporarily and to reduce the inflammation. He may also recommend a sequence of 10 minutes of cold compresses or ice followed by stretching the hamstring group, piriformis muscle, and all the surrounding muscles.

Other treatment modalities for those managing sciatica might include physical therapy, biofeedback, extended bed rest, epidural steroid injections or nerve blocks.

Engaging in a regular exercise program that focuses on strengthening the postural and abdominal muscles and stretching the hamstring group, piriformis muscle and the other external rotators is a good first step.  A list of specific exercises for sciatica, found below, will help prevent sciatica and other disorders.

Here are a few suggestions that will help prevent sciatica if it is caused by prolonged sitting. 

  • Take a break from sitting by getting up and walking around once an hour.
  • When sitting, keep your feet flat on the floor and don’t cross your legs.
  • When sitting in a car, use a lumbar support or a rolled up towel or jacket, for back support.
  • Men, carry your wallets somewhere other than your back pockets so that you don't sit on them and unconsciously put pressure on the sciatic nerve.

Besides using proper body mechanics, correcting your posture throughout the day and avoiding prolonged sitting, there is one other important fact to keep in mind. It has been shown that individuals who are consistently improving their general fitness level, are less prone to suffer back problems and most likely will never utter those dreadful words, "oh my aching back!"  Clearly, exercise is a great way to prevent or manage sciatica.


Posted on March 26, 2014 .