At Bureta Physiotherapy we see a number of people being referred with or complaining of “sciatic pain”. A percentage of these presentations do have true sciatic pain but large number actually have pain in a similar distribution but arising from other structures.
What is true sciatic pain?
The typical presentation of sciatic pain is that of pain radiating from the lower back into the buttock and down the back of the leg (usually one) at times all the way to the ankle. The quality and intensity of pain can vary greatly from a mild ache to an excruciating sharp or burning pain. Other symptoms that can accompany pain are areas of numbness or weakness in the leg or foot and in severe cases loss of bowel and/or bladder control.
What causes sciatic pain?
Sciatica most commonly occurs when a herniated disk, bone spur in the spine or narrowing of the spine compresses part of the sciatic nerve. This causes inflammation and causes symptoms along the nerve pathway down the leg.
So what else can cause similar pain?
There are a number of structures that can cause pain that is often misdiagnosed as sciatica…
- Muscular trigger points – several muscles in the lower back and buttock commonly refer pain into the buttock and leg and can be surprisingly painful. These tend to give a deep achy type pain and can be secondary to a lower back injury.
- Joints of the lumbar spine – Between every level of your spine there is a small joint on each side called a facet joint. When inflamed, facet joints will also cause pain to radiate into the buttock and at times, upper thigh. This is different to sciatic pain however as the sciatic nerve itself may not be affected at all.
- Upper hamstring tendon – The upper hamstring attachment into the sitting bone of the pelvis is another cause of pain easily confused with sciatica. When this tendon becomes overloaded it can cause buttock and thigh pain and become very uncomfortable especially in sitting.
What should I do if I think I have sciatic pain?
The vast majority of sciatic pain as well as similar pain arising from other structures can be managed conservatively by your physiotherapist at Bureta Physiotherapy. They can perform specific tests to correctly diagnose the source of your pain and form an appropriate management plan with you to reduce your symptoms, achieve your goals and prevent similar episodes from occurring in the future. Your Physiotherapist can also arrange an x-ray or referral for review by a Specialist if necessary.