Sciatica is caused by pressure on the sciatic nerve. The pressure can be from bones or from muscle. Most often it seems to be muscle. The good news is the pressure can often be removed from the sciatic nerve without surgery.
Sciatic nerves are really large.
They are about the thickness of your index finger and run from the lower part of your spine through the bony hip area. The nerves pass through thick muscles in your buttocks, one on each side.
The gluteal muscles are the powerful muscles in the back of your hip (your buttocks). One of those muscles–a deeper one–is the piriformis. The piriformis muscle can be a cause of the nervy pain in your hip and/or leg. When it is, it is often called “pseudo-sciatica.” (Pseudo means false.)
If the nerve is being compressed by the spinal bones, it is true sciatica.
Nerves don’t like pressure regardless of whether it’s from bones or muscles. They like to be able to move freely, without pressure. When nerves are pressed on they cause symptoms–pain or nervy sensations.
As is usual with most physical pain, muscles are often at the root of sciatica. Your piriformis muscle can cause pressure on the nerve if the nerve passes deep to it (behind.)
A few unfortunate folks have a variation in their anatomy that allows the nerve to pass directly through a “split” piriformis muscle. They tend to have a lot of pain but fortunately it’s not a common situation.
When the problem is caused by actual pressure from a spinal bone, you have to wonder why. Sometimes it could be a bone chip–a piece of bone which broke or was actually pulled off by tight muscles. In that case, surgery may be the only option to remove the pressure from the nerve. Fortunately, this is not a common problem, either.
When your muscles get “out of balance”–some stronger or weaker than others–you are setting the stage for pain. When you were a liitle child, your muscles were “balanced.” You were always using ALL of your muscles and that’s why they were balanced.
Over time, most of us stop using all of our muscles and begin using only sixty or so on a regular basis. That’s why when you do work that you don’t usually do–like raking perhaps–you say, “I discovered muscles I didn’t even know I had.” They were always there; you just had stopped using them.
If you compare your posture with the perfect posture of most little children, you can start to imagine why you have pain. Look at that little head held right over his body. Where is your head?
Look at that little spine with it’s perfect curves in the lower back behind the waist and in the neck. How are your curves in comparison? Too much? Too little?
If you have lost or over-exaggerated (sway back) your lower back curve, there’s a good chance that your muscles are causing pressure on your sciatic nerve at some place along the way. It could be the muscles near your waist or in your gluteal region.
The good news is that bodies heal all the time.
If you can get to the root of your pain and get rid of the CAUSE of it, you’ll have a good shot at becoming pain-free.
Treating only the symptom is like putting a bandaid on a cut or taking an aspirin for a headache. It doesn’t change the cause of the cut or the cause of the headache. You want to get to the root.
Do you know why less back surgery is done now than used to be done?
Because so often the surgery didn’t address the CAUSE. It only was chasing a symptom–the pain–and after the patient healed from the surgery, the pain was still there.
You have a smart body. It wants to be well. It just needs a little help from you right now to get rid of your sciatic pain.
