What is causing the pain running down your leg?

What is causing the pain running down your leg?

What is causing the pain running down your leg?

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What is the Sciatic Nerve? Can it be Compressed? 

We’ll start with the sciatic nerve itself and where it comes from. As you might have read, a  number of nerves leave your spine and join together to form the sciatic nerve. The sciatic nerve  runs from your lower back through your hip and buttock region down the back of your thigh  before branching off towards your foot. 

Now, in very rare cases a problem can occur at the roots of the sciatic nerve (the roots being  where the nerve exits the spine). This problem might be that the nerve has become  compressed by a herniated disc or in even rarer cases a malignancy or infection. This  compression causes the nerve to become irritated, triggering inflammation and sometimes  severe pain down the back of the leg below the knee, along the course of the nerve.  

The Good News 

The good news is that a disc issue such as a bulging disc, slipped disc or herniated disc is very  rarely the cause of a person’s radiating pain down their leg. There is a lot of misinformation  spread about the intervertebral discs in our spine. They are often portrayed as fragile structures  that are waiting to burst upon an awkward movement, when in reality, they are incredibly  robust strong structures that can withstand huge amounts of force.  

What is so confusing about sciatica? 

Today sciatica is used more as an umbrella term. The term ‘sciatica’ is often used by people  who have experienced an episode of back pain along with pain that travels down the back of  their leg. This is not technically correct. In the vast majority of cases, this should be called  referred pain, not sciatica. ‘True sciatica’, also known as radicular pain is due to a compression  or irritation at the nerve root.  

Simply put, low back pain and referred pain down the leg is common but this is rarely due to a  compression at the nerve root.

So, if my Sciatic nerve is not compressed by a Disc, What is causing the pain  running down my Leg? 

As mentioned, it is very common for people to experience low back pain and pain running  down from their buttock into the back of their leg. This pain is most commonly experienced due  to something called somatic referred pain. 

Let’s briefly explain referred pain. Referred pain is when the pain you experience in one part of  your body (down your leg in this case) is caused by the signal of pain in another part of your  body (lower back muscles). 

We have a vast network of nerves throughout our body that make up the nervous system. The  muscles in our lower back can often become tight, sore and even go into spasm. When this  happens, our nerves carry the signal of pain from the muscles to our spinal cord and up to the  brain. However, our vast network of nerves work closely together and there is very often  communication between nerves in adjacent areas. Therefore, there is communication of the  painful stimulus between the nerves around our back muscles and the nerves that travel down  to supply the muscles and skin in our legs.  

Other common examples of referred pain include people with hip arthritis that experience pain  in their knee, or people with neck pain that begin to feel pain in their shoulder region. 

How Can Exercise Help My Back and Leg Pain? 

Firstly, when you exercise you allow your back and leg muscles to contract and relax. In this way  exercise can help release the tension in your back muscles. Secondly exercise encourages blood  flow and oxygen to the nervous tissue. This helps to calm your nervous system down and  reduce the constant signal of pain being sent from your muscles.  

What Else Could Be Causing The Pain Down My Leg? 

There is a number of other issues that can cause people to experience pain down the back of  their leg. These issues range from tendon issues such as the hamstring tendon that inserts into  the back of your pelvis, to issues around the hip joint and muscles. These other possible causes  will be ruled out during your physiotherapy assessment. 

When Does Sciatica Require Surgery? 

As mentioned there are very rare cases when a problem is occuring at the nerve root. This  problem may be due to compression of the sciatic nerve roots by a herniated disc. People that  experience severe leg pain from this cause can experience some shorter-term relief with  surgical intervention. A suitable candidate for such a surgery may include someone with all of  the following: 

  • Very severe raging leg pain that is far worse than their back pain 
  • Pain is constant and unrelenting 
  • Sharp shooting pain 
  • Experience their symptoms below the knee 
  • Severe numb patches down their leg 
  • Severe weakness in their legs  
  • No relief from exercise  

If you would like any further information on sciatica or any pain or injury reach out to us info@painandperformanceclinic.ie

Gemma Brophy

Gemma Brophy

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