(BlackDoctor.org) — Who would have ever thought that leg pain could be the symptom of a back issue? The body is a meticulous form, and what affects one system or attribute can become apparent in another.
Sciatica is commonly used to describe pain traveling in the distribution of the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. Branches of the sciatic nerve extend through the buttocks and down the back of each leg to the ankle and foot. Sciatica is a symptom caused by a disorder occurring in the lumbar spine. Here are the most common disorders that cause sciatica:
Trauma
Sciatica can result from direct nerve compression caused by external forces to the lumbar or sacral spinal nerve roots. Examples include motor vehicle accidents, falling, and injuries sustained during football or other contact sports. The impact may injure the nerves or occasionally fragments of broken bone may compress the nerves.
Lumbar Bulging or Herniated Disc
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A bulging disc is also known as a contained disc disorder. This means the gel-like center (nucleus pulposus) remains “contained” within the tire-like outer wall (annulus fibrosus) of the disc. A herniated disc occurs when the nucleus breaks through the annulus. It is called a “non-contained” disc disorder. Whether a disc bulges or herniates, disc material can press against an adjacent nerve root and compress delicate nerve tissue and cause sciatica. The consequences of a herniated disc are worse. Not only does the herniated nucleus cause direct compression of the nerve root against the interior of the bony spinal canal, but the disc material itself also contains an acidic, chemical irritant (hyaluronic acid) that causes nerve inflammation. In both cases, nerve compression and irritation cause inflammation and pain, often leading to extremity numbness, tingling, and muscle weakness.
Lumbar Spinal Stenosis
Spinal stenosis is a nerve compression disorder most often affecting older people. Leg pain similar to sciatica may occur as a result of lumbar spinal stenosis. The pain is usually positional, often brought on by activities such as standing or walking and relieved by sitting down. Spinal nerve roots branch outward from the spinal cord through passageways called neural foramina comprised of bone and ligaments. Between each set of vertebral bodies, located on the left and right sides, is a foramen. Nerve roots pass through these openings and extend outward beyond the spinal column to innervate other parts of the body. When these passageways become narrow or clogged causing nerve compression, the term foraminal stenosis is used.
Spondylolisthesis
Spondylolisthesis is a disorder that most often affects the lumbar spine. It is characterized by one vertebra slipping forward over an adjacent vertebra. When a vertebra slips and is displaced, spinal nerve root compression occurs and often causes sciatic leg pain. Spondylolisthesis is categorized as developmental (found at birth and develops during childhood) or acquired from spinal degeneration, trauma or physical stress (e.g., weightlifting).
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Piriformis Syndrome
Piriformis syndrome is named for the piriformis muscle and the pain caused when the muscle irritates the sciatic nerve. The piriformis muscle is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome develops when muscle spasms develop in the piriformis muscle, thereby compressing the sciatic nerve. It is often difficult to diagnose and treat due to the lack of x-ray or MRI findings.
Spinal Tumors
Spinal tumors are abnormal growths that are either benign or cancerous (malignant). Fortunately, spinal tumors are rare. However, when a spinal tumor develops in the lumbar region, there is a risk for sciatica to develop as a result of nerve compression.
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