The sciatic nerve is the longest and largest nerve in the body. It can measure 3/4″ in diameter. It runs the length of the spine, emerging at the buttocks to continue down both legs. The condition sciatica gets its name from the nerve at times when it becomes inflamed. This can result in lower back pain and pain in the back of the legs.
Where is it?
The sciatic nerve emerges from the spine at the L4-5 and S1-3 vertebra. The first muscle it comes into contact with, therefore, is the piriformis muscle, one of the gluteal muscles in the buttocks. Although the nerve generally runs under the periformis, in some instances it can pass through the muscle belly. The sciatic nerve then crosses the adductor muscles before travelling down either leg, dividing into the tibial nerve and the common peroneal nerve (or common fibular nerve). Because of the route taken by the sciatic nerve, neural pain can occur in the lower back, buttocks and the back of the legs.
What does it do?
The sciatic nerve provides motor function to the posterior thigh, hamstrings and part of the adductor magnus muscles. The nerve’s branches also innervate the muscles to provide sensory stimulation to the lower leg and foot.
Sciatica and back pain
Sciatica is a type of inflammation of the nerve (neuritis) that results in severe pain along the length of the nerve. This type of pain can feel like ‘pins and needles’ or a numbness. The pain can radiate from the lower back down either leg to the foot. Sudden actions from coughing or sneezing can make the pain worse. Sciatica may be caused by a slipped disc, pelvic injury, temporary trapping of the nerve, uterus pressure during pregnancy or osteoarthritis in the backbone.
The most common place where sciatic pain occur are at the sacroiliac region of the lumbar spine – the lower back. Pain in this area can often be accompanied with lumbago.
A sciatic nerve test can be used to identify when the sciatic nerve is inflamed. Whilst lying on the back a straight leg is raised and passively extended to see if pain is triggered down the leg. A failed test result indicates that the sciatic nerve is inflamed. The sciatic nerve test can be used to indicate if massage is appropriate until the inflammation has reduced.
Recovery from Sciatica-type back pain
If you have sciatica, you should rest from painful activities. This does not mean rest from all activity, however. Rehab exercises should begin as soon as possible. Back stretches will help alongside a rehab programme to increase activity. Avoid sitting for long periods as this can often make the condition worse. Recovery should take 8-12 weeks. Seek medical advice where needed.
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Revised 11/6/19