What does it mean to have a pain in the butt? Unfortunately, it is one of the most common complaints treated at our clinic. Medically speaking, we’re talking about sciatica. However sciatica is not a diagnosis in it self but merely a symptom of another problem.

Sciatica simply refers to an irritation of the sciatic nerve. The sciatic nerve begins from nerves of the lumbar spine (low back) and travels through the pelvis, down the back of the leg, and all the way to the foot.  It is, impressively, the longest and thickest nerve in the body. Nerve pain of its nature is typically sharp or tingly. Some might even describe it as an electric shock. It can also present as numbness or weakness. The sciatic nerve may be felt partially or entirely from the low back, to the buttocks and all the way down the back of the leg into the foot. Typically, sciatic pain only occurs on one side.

Any type of irritation to the nerve can cause it to flare. There may be a compression at the spine, such as a disc herniation, lumbar spinal stenosis (narrowing of the spinal canal), degenerative disc disease, or osteophytes (bony growth).  It could also be caused from a vertebrae being out of place or stuck. Another less severe cause could be what is called “piriformis syndrome” (AKA tight a** syndrome). The sciatic nerve passes through, or very close to, a muscle in the buttocks called the pirformis muscle. Sometimes this muscle can be so tight it may impinge the sciatic nerve.

Anyone that has experienced sciatic pain can attest to how annoying and potentially debilitating it can be. To prevent it much of the same advice pertains to back health, as that is often the cause for it.

• Regular exercise is important, specifically core strengthening. Keeping the back muscles strong helps maintain better alignment of the spine. A personal trainer can be a great asset here to make sure exercises are done properly.
• Avoid twisting and bending at the same time, this can lead to disc herniation if there is a weakness.
• Try to avoid sitting all day, but if you must, ensure you have a firm chair with lumbar support. Also, don’t sit on your wallet or phone. This is a common cause for the pelvis to be put out of alignment.

If you do suspect that you have sciatic pain stretching, massage therapy, physical therapy and acupuncture can be great for pain relief. Usually if there is sciatic pain, there are other restrictions and compensations happening in the body that have lead to it. Osteopathy can do wonders in realigning the body and relieving the cause of the pain. If it is persistent (longer than 6 weeks), severe, or accompanies other symptoms, it is a good idea to follow up with your doctor, preferably with imaging (X-ray, or even better MRI). Pain medication and anti-inflammatory medication may be prescribed if your family doctor thinks it’s warranted. Surgery nowadays is largely reserved for the most severe cases and should be a last resort. Depending on the cause sometimes spinal injections may be considered (nerve block or cortisone) by neurologists.

So if you ever have a pain in the butt, just remember we treat the WHOLE body and we’re only a phone call away!