Low back and leg pain is common in the trucking industry. Sitting for extended periods of time can put added stress on your spine and increase the tonicity of the muscles in your back, neck and gluteal region (your butt!) Improper twisting, turning and lifting on a day to day basis, increases the risk of injury to your back.

Have you ever heard someone say they have sciatica? What is it? It is a common diagnosis that is used to describe pain that starts in the lower back area and goes down the back of the leg and into the foot.

Sciatica is caused by pressure on the sciatic nerve. One common cause for sciatica is a herniated disc. When you have herniated a disc, the disc bulges and compresses or irritates the nerve, which results in sciatica. Pain in the buttocks, burning or tingling down the leg, weakness, numbness or difficulty moving the leg/foot and/or shooting pain down the leg are common symptoms. If you have any of the above-mentioned symptoms, you may have some form of sciatica.

The treatment for sciatica due to a herniated disc is primarily focused on relieving the pressure on the nerve. Extension exercises, manual therapy, and traction are common forms of therapy, which have been shown to be effective.

Piriformis syndrome is a common neuromuscular disorder which results when the piriformis muscle impinges the sciatic nerve. Since the sciatic nerve passes under the piriformis muscle, if this muscle is hypertonic or tight it can put direct pressure on the nerve. Sitting for long periods of time, a lack of stretching and exercise can cause the muscle to go into spasm, resulting in sciatica-type pain. All sciatica symptoms are similar, with minor differences. These small differences are what are used to diagnose where the pain is coming from. For example, individuals with piriformis syndrome will complain of pain originating in the buttocks area, with a burning, pulling, sharp sensation down the back of the leg. People with a disc herniation will complain of low back pain with the same symptoms. Treatment for piriformis syndrome includes soft tissue therapy, stretching and spinal manipulation.

Sacroiliac (SI) Joint dysfunction is another condition that produces a sciatica-type pain, but it does not affect the sciatic nerve. The pain radiates down the back of the leg, but rarely into the lower leg. The sacroiliac joint is in your lower back. The two “bumps” that are just to the left and right of the spine around belt level are the SI joint. If the joints are irritated or “stuck” (not moving properly), pain can result. The pain that you are experiencing in your leg is coming from the SI joint, and is not the sciatica nerve being compressed or irritated. The treatment for SI joint dysfunction includes stretches, spinal manipulation and soft tissue therapy.

Finally, a more severe and permanent cause for numbing and tingling in the foot is a stenotic intervertebral foramen. The nerves that are leaving the spine have to go through a foramen (hole). Sometimes this hole is smaller due to excessive bone growth. The extra bone narrows the hole and decreases the space for the nerve to go through. The end result is compression on the nerve, which produces the symptoms.

For some people, conservative therapies (chiropractic/physiotherapy) can provide some relief. Unfortunately, if there is too much bone growth, surgery may be the only option. Sciatica-type pain can be annoying and painful. Luckily, the pain can be treated. There are many potential causes for sciatic pain. Providing a detailed history will help your health professional help you. Until next month:

“Your health is an investment, not an expense.”

– Dr. Jerry Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 1 888 252-7327, or e-mail singhjerry@hotmail.com.