Sciatica is a symptom of compressed nerve lines along the sciatic nerve which runs from the waist to the hips along the posterior and lateral sides of the legs and the toes and is characterized by pain and possible paralysis.

Sciatica is not a single disease, but a common symptom that can be caused by many different issues, and sciatica caused by different causes is not the same. For patients of different ages, the cause may be different. For example, sports trauma in young people can cause a herniated disc to compress the nerve, the pelvic anterior muscle of a pregnant woman can compress the sciatic nerve, or gynecological disease can compress the sacrum or spine.   A Pedicle rupture can cause the vertebral body to move forward and may also cause related symptoms.    Before treatment, the cause must be clearly diagnosed, and if necessary, refer to Western medicine for x-ray or magnetic resonance examination.

Brief introduction of physiological anatomy of sciatic nerve

The sciatic nerve is the largest and longest nerve line in the human body.  It originates from the nerve roots of the waist 4,5 to the sacrum 1,2,3. The function is to bi-directionally transfer neural network messages: including hot and cold, touch and pain, as well as the muscle contraction commands from the brain to the lower limbs.

Sciatica symptoms

The pain on the back of the thigh is obvious and the pain can extend to the foot.  Other symptoms can be abnormal skin sensations in the lower extremities such as, abnormal hot and cold sensations, lower limb muscle weakness, muscle atrophy and possible paralysis.   Knee or foot fracture reflexes weaken or disappear in a condition referred to as ‘drop foot’.

Causes of sciatica

Compression along the sciatic nerve can produce sciatica. The following are common causes of compression. The symptoms of sciatica can be shared, but the root causes are different:

- Intervertebral disc herniation (intervertebral disc herniation or herniation)-intervertebral disc herniation, compressing the sciatic nerve poster laterally.
- Spinal Stenosis: the vertebral foramen space is narrowed and pressed close to the spinal cord.
- Lumbar facet joint degeneration / twist disorder (Lumbar Facet Joint): narrows the intervertebral foramen and oppresses the sciatic nerve root.
- Hypertrophy of the yellow ligament (hypertrophy of the yellow ligament).
- Spondylolisthesis (spondylolisthesis).
- Piriformis syndrome (Piriformis syndrome).
- Iliac sacral joint entropy (Sa joint dysfunction.)
- Gynecological disorders, such as severe uterine recline.

- Disc bulging, protruding, prolapsed and swimming.

Bulging, protruding, prolapse, and free are different degrees of intervertebral disc fractures.  The bulging type is a fibrous ring variant, but the structure is elongated and damaged; the protruding type is a fibrous ring variant, the structure of the fibrous ring inner ring has been damaged, and the nucleus pulpous has Invaded into the annulus fibrosis; the inner and outer annulus structures of the prolapsed annulus fibrous have been damaged, and the spherical nucleus protruded out of the annulus fibrosis, but not in a free state; in a non-free state.    In general, if there is no nerve line compression, patients can perform McKenzie exercises under the guidance of medical staff. Patients should also avoid lifting heavy objects.

Spondylolisthesis

The spinal canal is a continuous pipeline structure through the spinal cord. If the pedicle fractures, the intervertebral disc degenerates or the intervertebral instability, it can cause the vertebral body to move forward to different degrees, compress the spinal cord, and cause paralysis of the lower extremity nerve compression.

Piriformis syndrome

The piriformis muscle is responsible for controlling the lateral and internal rotation of the leg joints during walking. The physiological structure of too many people is that the sciatic nerve will pass through the piriformis muscle, so when the muscle is overworked and trampled, it will first produce lateral local pain, the pain will increase after walking, or may have the opportunity to compress the sciatic nerve, causing nerve line inflammation, resulting in sciatica .

Iliac sacral joint disturbance

Sacroiliac Joint (Sacroiliac Joint) is formed by the connection of the iliac bone and the sacrum in the pelvis. The concave joints of the articular surface are combined. The ligaments and the connected muscles provide stability for the iliac-sacral joint. Left and right long and short feet, imbalanced muscle strength, falls and injuries can all cause iliac-sacral joint disorders, and later affect the normal physiological actions of the lumbar spine, or produce iliac-sacral joint pain, sciatica or lower limb pain.

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