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What REALLY is Sciatica?

bulging discs

By: Jason Makoutz, DPT

Have you ever heard of sciatica? It’s quite for a patient to come into the clinic saying they are suffering from sciatica. However, in most cases, this is NOT actually what’s going on with them. The term sciatica tends to be thrown around and not many people have a true understanding what it is and what is actually causing their symptoms. If you were to google your symptoms: pain that goes down my leg to my feet, numbness and tingling in my leg Dr. Google would tell you that you have sciatica. Unfortunately, Dr. Google is not a licensed Dr. and often gets the diagnosis wrong.

What is True Sciatica?

True sciatica is actually an anatomical anomaly where the sciatic nerve runs through (or pierces) the piriformis, a muscle in the hip. When this muscles gets aggravated, it also aggravates the sciatic nerve, which causes the aforementioned symptoms. This anatomical anomaly is quite rare. Therefore most people who complain of sciatica are not actually suffering from this condition.

Common Signs and Symptoms of Sciatica

  • Pain in the buttock
  • Pain that radiates down the leg
  • Numbness/tingling/burning in the buttock and down leg

If it’s not Sciatica then what is it!?

More often then not if a patient says they are having sciatica, it is actually what’s called lumbar radiculopathy. A lumbar radiculopathy is when a nerve coming from your spine down your leg is irritated. It may even be the sciatic nerve, but the source of the problem is coming from the spine rather than your hip area.

Common Causes of Lumbar radiculopathy

  • Herniated discs
  • Spinal stenosis or the narrowing of the space in the spine where the nerves travel
  • Bone spurs or excess growths on bones often causes by bone on bone friction

Common Signs and symptoms of Lumbar Radiculopathy

  • Pain in the back, butt and down leg
  • Numbness/tingling/burning in the back, leg

Why does this differentiation matter? Because the treatment for sciatica and the treatment of someone with lumbar radiculopathy are different so it’s important for a trained professional like a physical therapist to fully assess you and determine the true cause of your discomfort and symptoms.

Common Treatment for Sciatica

  • Soft tissue mobilization to the hip muscles
  • Self-Trigger Point Release
  • Glute strengthening
  • Core strengthening
  • Functional/Dynamic strength training

Common Treatment for Lumbar Radiculopathy

  • Determining positional preference to centralize symptoms
  • Lumbar soft tissue mobilization
  • Joint Mobilization to spine
  • Glute strengthening
  • Core strengthening
  • Functional/dynamic strength training

Though it may seem like semantics to most people, there is a subtle but important distinction in the way true sciatica vs lumbar radiculopathy is treated.

Don’t wait to let the pain progress and affect your daily activities, work, sleep or chores. Seek help right away. Physical Therapy is an effective, conservative way to relieve your sciatica or lumbar radiculopathy and help you return to the activities you enjoy doing pain free. At Loudoun Sports Therapy Center, one of our Doctors of Physical Therapy will take you through a thorough evaluation to determine where the pain is coming from and how to treat it. They will talk to you about your daily activities and what leisure/work activities you’d like to get back doing. That could be anything from sleeping through the entire night pain free to returning to running or even gardening. We will be able to get you out of the vicious cycle of pain.

Jason’s Quick Sciatica Routine

  • Tennis Ball Trigger Point Release
  • Piriformis stretch
  • Bridges
  • Clams
  • planks

If you or someone you know has experienced or is currently experiencing any of these issues or just have general aches or pain, call our office today at 703-450-4300. We can evaluate you and determine what steps you need to take to return back to your pain free life! CLICK HERE for more on how physical therapy can help you.


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