Sciatica 5

Physiotherapy

Sciatica 1

Manipulation

Sciatica 6

Acupuncture & Dry Needling

Sciatica 2

Specialist Back Pain Doctors

Sciatica 3

Spinal Injections

Sciatica 4

X-Ray Guided Injection Theatres

Causes of Sciatica

Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or sacral nerves S1, S2 or S3. This is generally due to a spinal disc bulge or herniation of a spinal disc (slipped disc), from roughening, enlarging, and/or misalignment of the vertebrae (spondylolisthesis), or degeneration of the discs. The intervertebral discs consist of an annulus fibrosus which forms a ring surrounding the inner nucleus pulposus. When there is a tear in the annulus fibrosis, the nucleus pulposus (pulp) may protrude through and push against spinal nerves, causing numbness or excruciating pain.

Pseudosciatica or non-discogenic sciatica, which causes symptoms similar to spinal nerve root compression, is most often referred pain from damage to facet joints in the lower back and is felt as pain in the lower back and posterior upper legs. Pseudosciatic pain can also be caused by compression of peripheral sections of the nerve, usually from soft tissue tension in the piriformis or related muscles (see piriformis syndrome below).

One of the possible causes of sciatica is trauma to the discs. The discs cushion the spine from compressive forces, but are weak to pressure applied during rotational movements. That is why a person who bends to one side at a bad angle to pick something up, may be more likely to herniate a spinal disc than a person jumping from a ladder and landing on his or her feet.

Herniation of a disc occurs when the pulpy centre of the disc bulges outwards, tearing the external ring of fibres. It extrudes into the spinal canal and compresses a nerve root against the lamina or pedicle of a vertebra, thus causing sciatica. This extruded material from the nucleus pulposus may cause inflammation and swelling of the surrounding tissue, which may cause further compression of the nerve root in the confined space in the spinal canal.

Sciatica caused by pressure from a disc herniation and swelling of surrounding tissue can spontaneously subside if the tear in the disc heals and pulposus extrusion and inflammation cease.