Introduction
The sciatic nerve originates from the sacral plexus and comprises spinal nerve roots from L4, L5, S1, S2, and S3. It is the longest and largest nerve in the human body. It can be measured as large as 2cm at its thickest point. The sciatic nerve originates from the lower back at the lumbar spine and sacrum and comes out from the hip’s greater sciatic foramen. Then it travels beneath the piriformis muscle and extends down from the back of the thigh to the popliteal fossa at the back of the knee, where it divides into two branches: the common peroneal nerve and the tibial nerve. The tibial nerve continues its journey from the back of the knee and terminates at the ankle’s inner side, called the tarsal tunnel. It provides motor function to the muscles such as gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor hallucis longus, and flexor digitorum longus. At the tarsal tunnel, the tibial nerve divides mainly into the medial and lateral plantar nerves, which supply the sensory and motor function to the sole of the foot. For the common peroneal nerve, it wraps around the head of the fibula at the knee and branches into the superficial and the deep peroneal nerve. The superficial peroneal nerve mainly supplies the motor function of the outer side of the leg muscles and the sensations of the outer side of the leg and the dorsum of the foot. The deep peroneal nerve mainly supplies the motor function of the front side of the leg muscles.
Therefore, the sciatic nerve supplies all the motor and most sensory functions in the leg and feet. Also, the sciatic nerve provides motor function to the back of the thigh.
Causes of Sciatic nerve lesion:
- Fractures of the bones in the lower extremities, such as the pelvis, femur, tibia, fibular head, and ankle.
- Dislocations: Hip, knees, and ankle.
- Compressions: Piriformis syndrome, tarsal tunnel syndrome, Morton’s neuroma
- Compression from an external source: splint, crossing the legs, prolonged squatting,
- Trauma.
Common symptoms of Sciatic nerve lesion:
Sciatica Treatments:
Since sciatica can happen anywhere along the sciatic nerve pathway from the hip to the foot, finding the cause and origin of the sciatic nerve pain is crucial. Look for your local physiotherapist and ask the physiotherapist to assess your lower extremities comprehensively to find the cause of sciatica. The assessment can include observation & palpation, active & passive joint mobilization, and specific orthopedic tests such as the straight leg raise test, piriformis test, and bowstring test can be used to determine the cause of sciatica. Also, dermatome, myotome, and joint reflex tests can be used to determine the specific nerve root that might have contributed to the sciatic nerve pain.
Depending on the cause of sciatica, your physiotherapist will make a tailored treatment plan that targets the origin of your sciatic nerve pain. The treatment can include the following:
- Deep tissue manual therapy/deep tissue massage releases muscle tension that might have compressed the sciatic nerve.
- TENs machines can block nerve pain.
- ESTIM(electro-muscle stimulation) can prevent muscle wasting/atrophy.
- Stretch and strengthening can help achieve optimal muscle health.
- Shockwave therapy can soften the tissues that might have a compressive force on the sciatic nerve. Also, the acoustic energy can bring more blood to the treated area for an accelerated healing process.
- Therapeutic ultrasound can accelerate healing and relax the tissue and muscles accompanying the sciatic nerve.
The chiropractors can help you realign your pelvis by performing a spinal adjustment to optimize the sciatic foramen position so the sciatic nerve can pass through smoothly. Also, realigning the pelvis can help you achieve muscle balance in the hip region to minimize the compression of the sciatic nerve from the muscular origin. Also, chiropractors can assess your gait to determine any biomechanic fault that might have contributed to the sciatic nerve pain and compression while walking and running. A chiropractor can prescribe custom-made insoles or functional orthotics to help you correct your gait abnormalities.
Learn more from our experienced Chiropractors and physiotherapists in Oakville, who can help you with your Sciatica. Visit Kefi Wellness Centre, the top-rated physiotherapy and rehabilitation clinic in Oakville, to find more.
