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Pain in the butt?

Sciatica is not a condition in and of itself, but is a symptom of an underlying issue with the sciatic nerve, predominantly caused by issues in the lumbar spine. Irritation of the sciatic nerve can cause pain or numbness from the buttock along the posterior leg and into the foot.

As the longest nerve in the body, the sciatic nerve travels from the lumbar spine down the leg. Underlying problems, usually from the lumbar vertebrae, can irritate the nerve and cause tingling, numbness, or pain that radiates from the buttocks and may travel as far as the ankle.

Most common causes:

  Herniated discs


  Spinal stenosis

Other possible causes:

Pressure from a pregnant uterus, prolonged sitting, especially on the edge of a hard chair, vertebral tumor

Which vertebrae is the problem?

With referred pain, you can use a dermatome map to see which part of the body is affected in connection to a spinal cord segment.  

L3-4: A problem in this spinal segment pushes on the nerve at the fourth lumbar vertebrae. This affects the front of thigh, inner knee and calf, inside ankle.

L4-5: This spinal segment pushes on the fifth lumbar vertebrae. Affects are felt in the outer edge of the back of the thigh or front outer lower leg, top of foot, big toe.

L5-S1: Issues in this segment cause pain in the little toe or outside of foot.

Piriformis Syndrome causes the same pain, but from a different root cause.

The piriformis is a small, deep muscle that runs from the base of the spine to the head of the femur and crosses the sciatic nerve.  If the piriformis muscle and tendon get too tight, they can irritate the sciatic nerve. Sometimes the sciatic nerve runs through the muscle and compresses the nerve during contraction. When this muscle causes pain it referred to as piriformis syndrome. 

Unlike sciatica, pain from piriformis syndrome can radiate to the front of the thigh. The sciatic nerve can also be affected, and then there may be pain, numbness, or muscle weakness in the calf or foot. The FAIR test that produces flexion,  adduction, and internal rotation of the piriformis muscle can help differentiate piriformis syndrome from other causes of sciatica.

How can acupuncture help?

~Reduce pain and inflammation

~Relax the deep spinal muscles impinging on the nerve

~Increase blood perfusion to the injured area speeding up recovery 

~Treatment can include cupping therapy to address deep tissues. Cupping lifts and loosens knotted muscles and fascia increasing  blood flow to the area and creating an anti-inflammatory response.

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