© 2019 by Spinal Symmetry Pty Ltd

 

Why is there pain down my legs?

June 3, 2016

 

Do you have pain going down your leg?

 

Do you have pain in your back?

 

Have you ever wondered if they are related or caused by two different things?

 

Has someone told you that you must have sciatica?

 

Here we will explain why there is often leg pain associated with back pain, how it occurs and what can be done to alleviate it effectively through the Spinal Symmetry method.

 

 

The term sciatica is used because of the involvement of the sciatic nerve, which is a very large, cord like nerve, originating from the combination of the lumbar and sacral nerve roots forming one large nerve. The sciatic nerve forms outside of the spine and extends down along nearly the entire length of the leg at the back. 

 

 

Sciatica is sometimes associated with dull or sharp shooting pain, numbness, pins and needles, muscle weakness and possibly reduced reflexes at the ankle or knee.
 
Most commonly, the leg pain is worse than the low back pain, and the leg pain usually travels from the low back through the buttocks, down the back and or side of the thigh, past the knees to the foot or heel.
 
Sciatica is not a medical diagnosis, but rather a term to describe a set of symptoms, which can be caused by an underlying neuro-musculoskeletal issue, such as:

  • A lumbar disc irritation or tear (majority of cases)

  • Degenerative lumbar joint osteoarthritis- bony growth affecting the space for the sciatic nerve

  • Tightness of the piriformis muscle- the sciatic nerve directly runs through this muscle and can irritate the nerve.

 

In summary, sciatica can be directly caused by any form of tissue that is inflaming, compressing and or irritating the sciatic nerve. It is possible that any of the above can occur all at the same time.


 
Does this mean that all pain down the leg is sciatica?
No, sciatica is only clinically correct when the nerve it self is involved.
There are many different structures in the low back and pelvis that can also cause pain down your legs.
Examples include lumbar joint (facet joints) or sacroiliac joint restriction/irritation, muscle strains or trigger point (muscle knots) in any of the muscles around the low back and pelvis. The main muscle culprits are usually the gluteal muscles and TFL (Tensor Fascia Latae). 

 

Trigger point pain referral patterns

 

These examples are called “referred” pain down your leg, while true sciatica is a “radicular” (radiates) type of pain, meaning the nerve it self is involved. 

 

 

 

 

How do we effectively treat these types of leg pain?

 
Within the Spinal Symmetry method, the root cause of why these tissues may be causing leg pain, can be explained through the approach that we use in that “structure governs function”.
 
‘Structure’ includes the skeletal system, which in the spine, houses the spinal cord and affects the nerve roots- including the sciatic nerve root.
The spine is supported in gravity by the pelvis and the hips.
It is the structural integrity of the hips and pelvis (how they are aligned) which determine how well they move ie. how well they function.
 
So whether the pain you are experiencing is radicular or referred pain, the structure of the pelvis will affect how it is functioning, which can be the primary cause of why you are feeling the way you are.
 
A simple example would be the piriformis muscle which, as previously mentioned, has the sciatic nerve run directly through it’s fibres.
The piriformis muscle attaches itself to the skeletal system at two points- one at the the pelvis and the other at the hip.
If there is a structural misalignment at the pelvis and the hip, the mechanics of how these two bones move are compromised, meaning it is unable to function or move correctly.
If the piriformis muscle is attached to these two parts, which are compromised, it also means that the piriformis muscle will be compromised.
Since the sciatic nerve runs directly through the piriformis, it in turn will be affected- which is most cases results in pain in the leg.

 

 

 

So during your history and examination by one of our practitioners they will be able to determine if your leg pain is a true sciatica irritation or another musculoskeletal dysfunction causing the referred pain down your leg.
 
By identifying whichever the cause may be, your practitioner will be able to correct the dysfunction, and with the assistance of the Dynamic Therapy, your body will be able to correct and maintain the hip angles to provide the optimum function through this area. In time, this will allow the pain to reduce.
 
If you have any questions about the exact cause of your particular leg pain please talk to one of our practitioners.

 
 
References

  1. K Konstantinou, K M. Dunn. 2008. Sciatica -  Review of Epidemiological Studies and Prevalence Estimates. SPINE Volume 33, Number 22, pp 2464–2472

  2. J.-P. Valat et al. 2010. Sciatica . Best Practice & Research Clinical Rheumatolog, 24. 241–252o

  3. KL Moore, AF Dalley, A M.R Agur. 2010. Clinically Oriented Anatomy. 6th Ed. Lippincott Williams & Wilkins.

  4. Hadjipavlou AG1, Tzermiadianos MN, Bogduk N, Zindrick MR. 2008. The pathophysiology of disc degeneration: a critical review. J Bone Joint Surg Br. 2008 Oct;90(10):1261-70. doi: 10.1302/0301-620X.90B10.20910.

  5. Ohnmeiss DD1, Vanharanta H, Ekholm J. 1997. Degree of disc disruption and lower extremity pain. Spine. 15;22(14):1600-5.

  6. Peng B, Wu W, Li Z, Guo J, Wang X. 2007. Chemical radiculitis. Pain.: 127(1-2):11-6.

  7. Grgić V. 2013. Piriformis muscle syndrome: etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy. Lijec Vjesn. 135(1-2):33-40.

  8. Grgić V. 2011. Lumbosacral facet syndrome: functional and organic disorders of Lumbosacral facet joint . Lijec Vjesn. 133(9-10):330-6

  9. Margules KR, Gall EP.1997. Sciatica-like pain arising in the sacroiliac joint. J Clin Rheumatol ; 3(1):9-15.

  10. Facco E, Ceccherelli F. 2005. Myofascial pain mimicking radicular syndromes. Acta neurochirurgica. Supplement ; 92:147-50

     

     

     

     

     

     

     

     

     

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