Sciatica – When back pain radiates down the leg

Sciatica - When back pain radiates down the leg

“I’ve got sciatica again” – when Aunt Käthe used to complain as usual in winter, people giggled and imitated her crooked posture behind her back. Decades later, this childhood memory resurfaces when a sudden pain hits the leg while carrying the crates. First, “sciatica” is short for the sciatic nerve, the longest and thickest human nerve. It arises on both sides of the lumbosacral plexus, a network of nerves formed from many spinal cord nerves at the sacrum level. The sciatica travels down the buttocks and hamstrings—the flexors it supplies—to the back of the knee, where it divides into the shin and calf nerves, supplying the muscles and skin of the lower leg and foot. It is not uncommon for disorders to occur in the course of the sciatic nerve, which can lead to typical pain and failures. This is known as sciatica syndrome, also popularly abbreviated as “sciatica”.

How does sciatica develop?

The most common cause is disorders in the lower lumbar spine. The bony processes on the vertebral bodies flexibly connect the adjacent vertebrae. In between, there are gaps through which the spinal nerves emerge; these places are also called nerve roots.

If there are signs of wear and tear on the intervertebral discs (as in the case of a herniated disc ) and the vertebral bodies, these intervertebral holes can narrow so much that the nerve roots are squeezed there. Due to the anatomical conditions, the area at the transition from the lumbar spine to the sacrum is particularly often affected, i.e. where the nerve root of the sciatic nerve is located. A narrowing, abrupt movement, twisting, or lifting of a heavy load can provoke an attack of complaints.

Other triggers for nerve irritation are cool drafts, especially after getting soaked (e.g. when sitting on a cold stone with wet swimming trunks) or the pressure on the nerve fibres from a tumour in the small pelvis or the unborn child during pregnancy. Rarer causes are nerve inflammation, for example, due to infections such as shingles, damage in the context of chronic diseases such as diabetes mellitus and rheumatism or bone injuries in the hip.

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