Many people feel a stabbing pain in their buttock or back of their leg and automatically think “I have sciatica!” But it is not always like that and Not everything that looks like sciatica really is.
You've probably heard the term "true sciatica" or "false sciatica" but aren't quite sure what it means. In this blog, we'll explain it and answer any questions you may have about this injury.
Sciatica by definition It is an affectation of the nerve root of the sciatic nerve in the lumbar spine, usually due to a hernia or protrusion, foraminal stenosis, or other spinal pathology. That is, true sciatica is a radiculopathy involving damage or irritation of the nerve root (usually L5 or S1).
On the other hand, the sciatic nerve can become trapped along its path, triggering very similar symptoms, but instead of being affected where it exits the spine, it is affected peripherally through the gluteal or leg muscles, thus being considered a "false sciatica."
How do I know if I have sciatica or not? Symptoms.
True sciatica usually presents with pain that:
- It starts in the lumbar or gluteal area.
- It radiates to the back of the thigh, the leg, and sometimes to the foot.
- It may be accompanied by tingling, numbness or loss of strength in the affected limb.
- Pain that worsens when coughing, sneezing, bending over, or stooping.
- It usually appears acutely after an effort or wrong movement.
Symptoms of “false sciatica”:
- Deep pain, located in the gluteus.
- It may radiate to the thigh, but rarely to the foot.
- It gets worse when sitting for long periods of time, crossing your legs, or climbing stairs.
- There is usually no loss of strength or reflexes.
- It is usually progressive, not as severe as radicular sciatica.
Is it normal for pain to go down the leg to the foot?
Yes, as we explained previously, it is one of the most characteristic symptoms of sciatica.
When the sciatic nerve is irritated or compressed (usually by a herniated disk, a bulging disk, or muscle dysfunction), it can cause radiating pain that begins in the lower back or buttocks and extends down the entire leg, even to the foot or toes.
This type of pain isn't muscular, but rather neuropathic, meaning it follows the path of the nerve. It may be accompanied by other symptoms such as:
- Tingling or numbness in the leg or foot.
- Weakness when walking, standing on tiptoes, or lifting the leg.
- Burning or cramping sensation.
“I only have pain in my glutes, sometimes it goes down my leg, but I don't have lower back pain.”
Pain located in the gluteus can have several origins:
- Sciatic nerve involvement: It is a symptom of this pathology when the nerve is irritated or compressed.
- Joint or muscle problem: Pyramidal syndrome, overload of the gluteus medius or minimus, myofascial trigger points of the quadratus lumborum or a dysfunction of the sacroiliac joint are some of the pathologies that could trigger this symptomatology.
- Referred pain from the lower back: Without the pain being located in the back, there are injuries such as hernias or inflammation of the retrodiscal tissue that could cause pain in the gluteal area.
What can I do to reduce sciatica pain?
First of all, we recommend that you go to a specialized physiotherapist in the spine and peripheral nervous system. At Evolution Physiotherapy, we work with patients who report these types of symptoms every day, and we know how to address them.
As a second step, we recommend movement, as much as possible and gradually, as this will help the sciatic nerve glide and normalize this tissue, improving its function and reducing pain. Stretching and neural mobilization are great tools to enhance healing.
Finally, avoid taking medication, as it can mask the symptoms and won't address the root of the problem. There are much more powerful and therapeutic tools for sciatica, such as physical therapy, which addresses the real cause of the problem. Techniques such as neurodynamics, neuromodulation, exercise, pain education, movement and equipment such as diathermy They are advanced treatments for addressing sciatic pain.
How to prevent sciatica from recurring?
If you want to prevent sciatica from recurring, you must keep your body strong and flexible. The best treatment for sciatica is active prevention:
- Strengthen your lower back and glutes.
- Improve your mobility.
- Avoid standing postures, get moving!
- Improve the quality of your movements.
- Control stress and breathing.
- Go to preventive physiotherapy.
Physiotherapy treatment for sciatica in Alcalá de Henares.
A complete clinical assessment is essential, with tests such as the Lasègue test, neurodynamic evaluation, and, if necessary, support with musculoskeletal ultrasound or imaging tests.
The correct diagnosis of any pathology will determine the success or failure of the therapy, since the approach and treatment chosen will vary completely. In our case, if it is a real sciatica, we will treat the nerve root, work on lumbopelvic mobility, decompression, and use neurodynamic techniques such as the exercise in the following video. Techniques such as functional percutaneous neuromodulation or the therapeutic exercise They are also very effective in pain control.
If, on the other hand, it is a muscular or joint pain, then we will address the gluteal area, lumbar trigger points, and improve motor control in the affected area.
At Evolution Physiotherapy, the first thing we do is accurately assess the structure causing the pain so we can offer you the most appropriate treatment from the first session. We are experts in the treatment of sciatica and other musculoskeletal and sports injuries.
