LEAH VERSTEEGEN, DPT
Sciatica is a term that is widely used to refer to pain that seems to be spreading or radiating into the back of the hip and sometimes down the leg. Where does this pain come from?
Technically the term 'sciatica' means that the sciatic nerve itself is the source or cause of the discomfort, but that is not always the case. The sciatic nerve is a thick nerve that courses through the buttock area and is formed from a combination of several nerve roots that originate in your low back and sacrum.
The nerve roots from the lumbar spine that are a part of the sciatic nerve are L4, which exits between the lowest two vertebrae in your back, and L5 which exits between the last vertebrae and the tailbone. Other nerve roots that make up the sciatic nerve are S1-S3 which all exit from the tailbone or sacrum.
What this anatomy tells us is that sciatica often stems from irritation of a nerve root at one of these levels and not necessarily from just the sciatic nerve itself. The pain that you are feeling in your buttocks or down your leg could be originating from inflammation or stiffness in your low back just above your tailbone. It could also be from inflammation of the sciatic nerve itself as it courses through stiff or thickened musculature in the buttock region, but this is less often the source of the symptoms.
To effectively treat sciatica, it is important to determine the underlying cause of your symptoms. Are they coming from the sciatic nerve in the hip, from the nerve roots in the low back, or from a combination of the two? Why is there inflammation, tension or stiffness in your hip or low back? Are there other structures, such as tight hip flexors or loss of mobility in the upper spine, that are contributing to the symptoms?
Once the true underlying cause of your sciatica is identified then you can choose the correct exercises, mobility work or stretches to help treat the cause of the symptoms and not just chase the symptoms themselves.
Don't let sciatica prevent you from having fun and definitely don't settle with the thought that you 'just have to live with it'. It can be treated with simple daily movement when done with the correct intention and aimed at the structures that are the true source of the problem.