Sciatic nerve impingement, also known as sciatic nerve encroachment or a pinched sciatic nerve, is a common diagnosis often used to explain lower back and especially leg pain symptoms blamed on some nonspinal structural issue. Although this diagnosis is often made in conjunction with findings of a herniated lumbar disc or spinal osteoarthritic osteophyte complex in the lower back, this is a mistaken analysis of the problem.
Remember that the sciatic nerve never attaches directly to the spine, so issues which affect the spinal nerve roots which serve as the origins of the sciatic nerve should never be confused with sciatic nerve compression itself. These are 2 distinct diagnoses.
examines how the fully formed sciatica nerve can be compressed by
various processes, enacting the syndrome known as pseudo-sciatica.
Impingement of the sciatic nerve does not describe any spinal issue which affects the nerve roots at L4, L5, S1, S2 or S3, prior to them actually coming together to form the sciatic nerve in the lower body. If a herniated disc or other concern affects one or more of these spinal nerve roots, the condition can be called a pinched nerve, but not a pinched sciatic nerve.
Additionally, even though a great number of spinal conditions are blamed for causing sciatica due to anatomical impingement issues in the lumbar or lumbosacral spinal regions, these diagnostic theories are most commonly incorrect. Actual pinched nerves are quite rare and usually produce numbness and weakness, not the continuing pain most often associated with the diagnosis.
True impingement of the sciatic nerve can occur due to injury or certain anatomical concerns. Any crushing or penetrating trauma to the lower body might cause injury or compression of the sciatic nerve.
Severe inflammation can also impart a compression effect on the nerve. However, this is almost always a temporary phenomenon.
Piriformis syndrome is a muscular impingement issue in which the piriformis muscle is thought to squeeze the sciatic nerve and this does occur in some patients.
However, the suspected reason why this happens generally relates to injury or muscle imbalance, while the reality of the scenario places ischemia as the actual culprit in many diagnosed sufferers. Remember, a lack of oxygen will cause any muscle to go into spasm, which is exactly what happens when the piriformis clamps down on the sciatic nerve.
Unless you have been in a serious crushing or lacerating incident in which the sciatic nerve was obviously affected, there is only a slim chance that an impinged sciatic nerve diagnosis is right. Even in these rare events where the theory is accurate, the underlying reason is most often mistakenly pronounced, leaving the patient seeking treatment for a coincidental issue.
Sciatica is known as a chronic and treatment-resistant pain syndrome for good reason. This is because diagnosis of the actual source of pain fails in most cases, so subsequent therapy choices stand no chance at all of success. Other nonspinal diagnostic theories which might explain symptoms which exist without structural compression include local neuralgia, diabetes and other disease processes.