6 possible root causes of sciatica pain? Which one do you have? - Be My Healer

6 possible root causes of “sciatica” pain? Which one do you have?

causes of sciatica pain

What "sciatica" is might not be mysterious these days. It is not hard to understand the concept of a compressed, or pinched nerve, causing pain, weakness, and weird sensations going down your leg. However, the causes of sciatica pain are not that simple.

sciatica pain sciatic nerve

First of all, "sciatica" is not all the same. Your "sciatica" pain could be drastically different than how your cousin experiences her "sciatica."It depends on the location of the nerve irritation. It also matters the types of irritation the sciatic nerve is undergoing. Even more, the chronicity of the root problem may also play a role in the treatment of this pain.

Then, sometimes we see true "sciatica" pain and fake "sciatica" pain. Typical true "sciatica" pain is felt from the back of the hip to the outer thigh, then to the outer calf, finally possibly to the big toe. Fake "sciatica" pain may sound or feel like the real thing. However, they are commonly caused by referred pain from mechanical problems in the lower back/ hip region. 


I know. That's why "sciatica" pain is difficult to rid of. However, if you can isolate the possible pain generating problems, you can proceed with much more effective treatments. 

True "Sciatica" pain causes

Acute Herniated disc injury

Herniated disc or bulging disc are the common cause of the sudden onset of "sciatica." As the lumbar disc content protrudes out of its usual place, it may press into the narrow canal where the nerves exit your spine, thus nerve compression. If the injured lumbar disc has tears and the fluid inner content leaks to the surrounding area, it may cause chemical irritation to the surrounding nerve root as well. 

herniated disc and pinched nerve

Pain Pattern:​

  • "Sciatica" pain occurred at the same time as the lower back pain from the herniated disc injury, no sciatica prior to the disc injury
  • Sciatica pain becomes more severe towards the end of the day
  • Sciatica symptoms are usually single sided
  • Sciatica symptoms should improve significantly as the lower back pain heals

Effective treatments:

Lumbar spinal stenosis

lumbar spinal stenosis sciatica

Stenosis refers to the closing or narrowing of the space where the nerves pass through. The most common cause of stenosis in the lower back is aging and arthritis, and degeneration. Another common cause is a repetitive injury from overuse. People in the labor industry may suffer from numerous work-related lower back injuries, resulting in chronic "sciatica" pain.

Another common and similar condition are called the degenerative disc disease. As the lumbar disc content tries out, the bony parts of the spinal collapse over each other, closing down spaces that used to be available for nerve tissues.

Pain Pattern:​

  • Gradual increase in "sciatica" symptom over the years
  • More common is middle age to elderly individuals
  • May cause bilateral "sciatica", leg pain on both side
  • Worsening of symptom with prolong time on feet, relief when seated
  • Tender buttocks or piriformis muscles secondary to chronic nerve irritation
  • May or may be have obvious chronic lower back pain

Effective treatments:

  • Professional deep tissue muscle release targeting the hip flexors, lower back and gluteus muscles and fascia, reducing compression in lower back
  • Core muscle strengthening (such as abdominal and gluteus muscle strengthening) to improve lower body posture over time
  • Frequent stretching and self release of piriformis muscles, hamstring muscles
  • Severe conditions require invasive procesures and surgeries



Spondylolisthesis, or "spondy", is a less common condition where one segment of your lumbar spine (usually L5) become loose and slip out of the spinal column. If this slippage is far and severe enough, it may cause nerve impingement. 

Spondylolisthesis is categorized as developmental (found at birth, develops during childhood) or acquired from spinal degeneration, trauma or physical stress (eg, gymnastics, lifting weights). If you are relatively young, experiencing unexplained vague lower back pain with sciatica over a period of time, you should speak to your doctor. Spondylolisthesis can be identified with an x-ray.

Pain Pattern:​

  • This can happen to people at all ages
  • May cause bilateral "sciatica" symptoms (both sides)
  • Usually accompanied by vague pain across the lower back

Effective treatments:

  • In mild cases, flexion based abdominal core exercises are beneficial
  • Avoid extension based core exercises such as superman
  • Professional deep tissue release of the hip flexor muscles in a non-extended position
  • Severe cases requires surgical procedures

Piriformis Syndrome 

piriformis_muscle syndrome compression of sciatic nerve

The piriformis syndrome is the only non-spine related true "sciatica" pain cause. The piriformis muscles are two triangular muscles deep inside your buttocks. they help to stabilize and rotate our hip joints. 

What's special about these piriformis muscles are that they seat directly on top of the large sciatic nerve. In some people, the sciatic nerve travels through these muscles. When the piriformis muscles became overworked and tensed up, they apply direct pressure on the sciatic nerve, resulting in the "sciatica" symptoms.

Piriformis syndrome is common among runners and sports players. It can also happen to new runners, or office workers with weakened core muscles. Please note that dehydration and extreme diet combined with intense workout routines is also a common cause of "sciatica" pain and other health issues.

Pain Pattern:​

  • "Sciatic" symptoms with no lower back pain
  • Tender to touch buttocks
  • Symptom intensity with cardio works such as running, stair climbing or biking
  • May also experience IT band or knee pain

Effective treatments:

  • Professional deep tissue release to piriformis muscles, hamstring muscles, IT bands and gluteus medius muscles
  • Frequent stretching of piriformis muscles and hamstring muscles
  • Strengthening exercises such as clam shell, bridging, side walk with resistance, and proper squats.
  • Proper balance between strengthening, resting, hydration and calorie intake
  • Seated sciatic nerve glide exercises and targeted icing to the piriformis muscles
  • Severe cases require anti-inflammatory medication injection

Other rear causes of true "sciatica" pain include spinal tumor and direct trauma to nerve tissues.

False "Sciatica" pain causes

Sacroiliac Joint Dysfunction

The sacroiliac joint dysfunction, or SI dysfunction, is a condition where the "tail bone" joints become unstable and irritated. An irritated SI joint can cause a lot of pain, especially when we shift body weight, such as lying to sitting, sitting to standing, jumping and basic moving around.

sacroiliac joint causes sciatica pain

Sometimes the pain is tender and sore over the area between lower back and buttocks. Other times, the SI pain can shoot down the leg, mimic a nerve pain. In rear cases, the SI irritation results in spreading inflammation, affecting nearby L5 nerve roots causing real nerve pain.

Pain Pattern:​

  • Sharp pain in SI joint region while performing transitional movements such as sit to stand, getting out of bed, stepping down, etc...
  • Pain may shoot down back of leg, but does not get pass the knee
  • No movements, no shooting pain
  • SI belt reduce the symptoms

Effective treatments:

Gluteus medius and IT band pain

gluteus medius and IT band causes sciatica pain

Common soft tissue pains that mimic the "sciatica" are caused by trigger points in the gluteus medius muscles and the IT band. These muscles are frequently overused during intense sports and activities. Trigger points in these muscles will spread the pain over the hip and thigh area.

Pain Pattern:​

  • Aching pain over the hip, buttocks and outer thigh area
  • Pain does not refer pass the knee
  • No lower back pain, no tingling, numbness, weakness
  • Pain improves once staying away from intense sports or activities
  • Trigger points can be felt with massage

Effective treatments:

  • Deep tissue massage to release trigger points in gluts and IT band
  • Use Tennis ball or foam roller for trigger point release
  • Use moist heating pad over the painful area for muscle relaxation and blood circulation
  • Frequent stretching
  • Proper balance between hydration, activities and resting

Thank you for reading, and I hope you find this post helpful.

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