The sciatic nerve is the largest in the body and is created by five nerve roots that come together and exit the lower spine. It goes through the buttocks on either side and down the thighs all the way to the heels and soles of the feet. The sciatic nerve connects the spinal cord to the muscles of the thigh, leg, and foot. Any type of pain and/or neurological symptom/s that comes from the sciatic nerve is known as sciatica. The symptoms can be felt along the nerve’s path. This could be the:
When the nerve is compressed,Â neurological symptoms can accompany the pain. TheseÂ include:
If the thigh muscles are affected, weakness can be felt when bending or flexing the knee.
Weakness can be felt while attempting to bend the knee or pointing the foot/toes upward/downward. This can lead to foot drop, which makes lifting the front part of the foot when walking difficult. Difficulty can also present when getting up from a sitting position or walking on the tiptoes.
Loss of sensation can happen when the nerve impulses/transmissions cannot pass all the way through. Common areas affected by numbness are the:
This is an abnormal sensation felt on the skin. It is brought on by improper nerve transmission. This sensation can include:
The sciatic nerve can become:
Physical forces could affect the nerve following common conditions:
A disc in the lower back can bulge or herniate. This causes irritation that can lead to compression of a nerve root.
Stenosis means the opening where the sciatic nerve exit into the buttocks begins to get narrow in size. This creates a clog with the other nerve roots that compresses or irritates the sciatic nerve. Degenerative changes in the spine like the thickening of the facet joint capsules and/or ligaments can also compress the sciatic nerve.
Instability of a vertebral segment happens when one vertebra slips over the one below it, known as spondylolisthesis. There are also vertebral defects like spondylolysis which is a complete dislocation of one or more vertebrae. This can directly compress the sciatic nerve roots.
The body’s own chemicals can irritate the nerve causing inflammation. These chemical irritants include:
Glycosphingolipids which are fats, and neurofilaments which are protein polymers. They are secreted by the immune system and have been found to have high levels in individuals with sciatica. It is believed they are released in reaction to the nerve roots and exposed disc material. This can lead to inflammation of the sciatic nerve.
The physical characteristics of an individual can also affect the sciatic nerve. Research has shown an increased risk of sciatica in:
Individuals with certain jobs can have an increased risk of developing sciatica. Examples include:
This comes from:
Adequate levels of vitamin B12 are important for nerve health. Vitamin B12 supports the myelin sheath that covers and protects the nerves. It is important in nerve function and in transmitting impulses. Sciatica can present from vitamin B12 deficiency. However, this is more common in individuals 60+.
Clinical nutrition is a powerful tool to help alleviate sciatica. Many individuals can relieve their pain through diet adjustments. Here are a few diet tips to alleviate sciatic nerve pain through clinical nutrition:
Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482431/.
Heuch I, Heuch I, Hagen K, Zwart JA. Association between body height and chronic low back pain: a follow-up in the Nord-TrÃ¸ndelag Health Study [published correction appears in BMJ Open. 2015;5(10):e006983]. BMJ Open. 2015;5(6):e006983. Published 2015 Jun 15. doi:10.1136/bmjopen-2014-006983.
Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.
Quero L, Klawitter M, Schmaus A, et al. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signaling pathways. Arthritis Res Ther. 2013;15(4): R94. Published 2013 Aug 22. doi:10.1186/ar4274.
Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a Risk Factor for Sciatica: A Meta-Analysis. American Journal of Epidemiology. 2014;179(8):929-937. doi:10.1093/aje/kwu007.
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