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Transcript of Sciatica
Glutes Sciatica Where in the body? Sciatic nerve runs from your lower back
down the back of each leg
*Most Common Roots L4 & L5
Facet Joint Anatomy Spinal Stenosis The Causes for Sciatica The Sciatic Nerves are the largest and longest nerves of the body, reaching about the size of your thumb in diameter UNDERSTANDING THE CONDITION: Piriformis Sydrome pressure caused by the pirformis muscle narrowing of the spinal canal Lumbar Herniated Disc Isthmic Spondylolisthesis When a disc herinates, the outer core of the disc is directly under the spinal nerve root, thus putting direct pressure on the sciatic nerve. old age & over use pressured caused by a vertebra slipping forward
over a vertebra below *Least Common A: Exiting nerve root.
B: Inner Core of Disc (Nucleus Pulposus).
C: Torn Outer Core of the Disc (Annulus Fibrosus). 90% hernations are in the L4 -L5 or L5,S1 (Right at the start of the Sciatic nerve). *some feel tingling or numbness in feet & legs -Runners/walkers more suspectible When the piriformis muscle becomes tight or spasms it places pressure on the sciatic nerve that runs beneath it. -Condition does not compress a nerve root as it exits the spine. true sciatica define by a radiculopathy (compression of a nerve root as it exits the spine) Diagnosis: X RAYS
MRI Surgery Only in severe cases Surgeron's can: remove part of herniated disc to lower pressure
widen canal for changes in vertebra
fuse vertebra so they can not slide foward (choking) As facet joints degenerate, they get larger thus growing and "choking" the sciatic nerve. 50+ & accompanied by osteoarthritis People with Spinal Stenosis are comfortable sitting, but standing upright further decreases the space for nerve roots & can block the outflow of blood from around the nerve. Although painful, rarely have severe nerve damage. Surgery mostly elective VERY PAINFUL The pars interarticularis connects the facet joint above to the one below. It is a thin piece of bone with a poor blood supply, which makes it susceptible to stress fractures. Grade 1
25% or less of vertebral body has slipped forward
26% - 50%
51% - 75%
76% - 100% Most are in
these levels REHAB For acute Sciaticia (lasting less than 6 weeks), maintaining excercise/activies is encouraged. For chronic Sciatica doctors proscribed pain medication and encourage physio, chiropractic , & behavioral therapy. Prevention Maintain good posture
Eat healthy, extra pounds can speed up degeneration of bones/joints (no saturated fats)
Keep stress down, learn to relax
Stengthen abdomen and spine muscles.
Avoid excercises that strain the lower back & weight lifting without proper back support. 7 radiculopathy 1 feet 5 herniateddisc 15 beneath 9 piriformis 4 choking 16 facet 12 stand 11 interarticularis 3 least 13 acute 2 electromyogram 8 false 10 prevent 6 Lumbar