What is sciatica? Many people experience it at some point in their life. Sciatica is characterized by stabbing pain radiating over the course of the sciatic nerve. It can feel like achiness running down the outside of the leg, a pinch in the hip area that shoots up into the back, numbness in the hip and leg, inability to balance.  We all know it doesn’t feel good.
Back pain is unfortunately a pain that we all experience at some point.  And it often lasts longer than expected because of the large number of functions the low back and pelvis muscles perform. It can be hard to find the “one” muscle that causes the dysfunction. Only looking at a textbook definition of sciatica will start the process of eliminating back pain but may or may not take away the pain.
One can experience sciatica if any of the spinal nerve roots in the low back are compressed. The nerves of the lumbar plexus (low back) can become compressed by a herniated disc, before they reach the sacral plexus, or through trauma such as a blow to the buttock where the nerve travels to innervate the hamstring. Nerve root compression is the case with “true sciatica”. Many people experience piriformis syndrome. This occurs when the piriformis, a lateral rotator of the hip- clamps down on the sciatic nerve and causes the pinched nerve sensation.
Sciatic Nerve
The sciatic nerve is the thickest and longest nerve in the body and supplies the entire lower limb except the middle portion of the front of your thigh.  It has branches that supply both sensation and muscle functions along the nerve pathways. The nerve originates at lumbar vertebra L4-L5 and the Sacrum S1-S3, courses down the back of the leg, and then divides into two nerves which then innervate the entire calf. The tibial branch (the tibia is the shin bone) innervates the back and medial side of the calf as well as the small muscles of the bottom of the foot. The common fibular branch (outside of the calf) innervates the front and lateral portions of the calf and the muscles that lift the toes and the foot.
Any injury or impingement of the nerve can cause either loss of motor function or sensation all along the lower limb. The flexors of the lower limb originate from the first four lumbar vertebrae L1-4 while the extensors originate from the last lumbar vertebra L5 and the sacrum S1-4.
Injury to the first part of the sciatic nerve can result in lower limb impairments.   The leg is rendered almost useless if the nerve is transected. The hamstrings are paralyzed and all foot and ankle movement is lost. If the nerve -tibial branch-is damaged at the knee then one will experience footdrop. The calf muscles become paralyzed and cannot point the foot and a shuffling gait develops. Because of its superficial location at the knee lying too long on your side on a firm mattress can also potentially cause foot drop.
Regaining balanced muscular strength will help combat sciatica along with some specific massage or manual therapy performed by a professional.  Lunges, squats, calf exercises, core training, stretching the back, abdomen, hips and legs are all great points to begin the recovery process. Be mindful of the pain however and don’t force yourself into greater pain and dysfunction. Keep in mind if your daily activities are not varied one can experience strength discrepancy between flexors and extensors of the lower limb. A well-balanced exercise regime will keep your muscles healthy and allow your joints to move freely.
