I originally stated that this was going to be a 2 part series, but as I get into this I now realize this is a multi-part series. I could probably finish this in one blog but it might be 10 pages long and too much to handle in one sitting for both you and me.
So to recap in the first part I talked about
- The spine and its role in sciatica (very very important).
- The #1 cause of sciatica… Herniated discs.
- The #2 cause was the dreaded bulging disc.
The #3 cause of sciatica is a DEGENERATED DISC!
A degenerated disc is the result of wear and tear on the disc over time. With a degenerated disc what ultimately happens is the disc gets thinner and this makes the opening (where the nerve exits the spine) smaller. This causes a pinched nerve. So when the nerves being pinched are in the low back it’s the sciatic nerve that gets pinched. This is what we call sciatica.
The very process of disc degeneration of one disc, will lead to other discs in your spine degenerating. This is why we call it degenerative disc disease. It becomes a biomechanical issue, eventually the change in motion of one disc will increase the stress on other discs and over time they all start to break down (degenerate)!
I have seen it written 1000 times that disc degeneration is a normal occurrence, but I promise you it’s not normal. It’s as normal as a cavity. If you know why cavities develop and never do anything to prevent them and you get them, then it’s normal. If you do certain things to your spine and never do anything to fix the condition and continue to commit the same mistakes then degenerated discs are also normal.
The #4 cause of sciatica is Lumbar SPINAL STENOSIS!
We talked about the opening where the nerve exits the spine getting smaller in disc degeneration. Well, with stenosis the opening where the actual spinal cord is located gets smaller or narrower. So it’s similar to disc degeneration but the narrowing is deeper inside the spine. The narrowing will irritate the nerves even before they exit the spine. Stenosis incidentally is also related to wear and tear of the spine. Over time wear and tear will result in changes in the bone, overgrowth of ligaments and other soft tissues changes including disc bulges even disc degeneration.
As we talk about all of the causes of sciatica, it’s important to realize that they all have different names but ultimately they are all similar origin! This is important because the origin of these conditions is truly the reason for 99% of all back pain. I will talk a little about this in a future blog post because it is that important. The process is related to the stresses on the spine and the eventual break down of the spine and soft tissues.
Stenosis tends to be the hardest condition to fix but with some effort this condition also can be eliminated without drugs or surgery.
The #5 cause of sciatica is PIRIFORMIS SYNDROME!
The sciatic nerve as it exits the spine works its way down the leg. Right after it exits the spine it passes between a muscle (the piriformis muscle) and the bones of the pelvis. It’s at this point the sciatic nerve can be irritated. It’s known as piriformis syndrome because the piriformis muscle is the culprit. The symptoms of this will be similar to the above 4 conditions, pain down the leg. In all of these cases at times the pain can be severe. I have had sciatica in the past and I know it’s not pretty……
These conditions are all similar from the point of view that the origin of the break down is dysfunction. Each of the 5 causes has a specific treatment so it’s very important to know where the problem is located. Like any treatment the more specific the diagnosis the better the outcome with the treatment.