SCIATICA & DISC HERNIATION

FALSE SCIATICA?

 

Several pain conditions have many of the same symptoms as disc herniation or discogenic pain, but can often be treated more simply. Popularly, we use the term "false sciatica" for these conditions. There are several conditions with both back pain and radiating pain, so it is very common for patients with these complaints to be misdiagnosed with lumbar disc herniation. To the untrained eye, it can be difficult to distinguish between the different conditions that cause sciatica-like pain without it being true sciatica.

Facet Joint Syndrome
 

The facet joints are small joints, two between each of the vertebrae, which guide and limit the movement of the spine. The facet joints prevent, among other things, the vertebrae from sliding forward relative to the one below. Sometimes, there may be minor sprains in ligaments or tension in the muscles around these joints. This can, in turn, create irritation and pain in the back. The pain from facet joint syndrome will normally be localised to the back, but often we see that the pain radiates into the buttocks and often also to the back of the thigh. It is rare to have pain below the knee when the pain comes from facet joints.

Piriformis Syndrome
 

Piriformis syndrome is a condition where the sciatic nerve gets pinched or irritated on its way through the gluteal muscles and causing symptom of sciatica. Because it is a muscular diagnosis, it is often categorised under false sciatica. The condition is usually recognised by pain in the buttocks/gluteal muscles and shooting, burning, or aching pain down the back of the leg. Additionally, you may experience numbness or tingling along the sciatic nerve. It is not always easy to distinguish between sciatica and piriformis syndrome since the conditions are very similar and both involve the sciatic nerve.

 

Gluteal Tendinopathy
 

Gluteal tendinopathy is an irritation of the gluteal tendon where it attaches to the hip bone. Pain is usually located in the buttocks and may radiate to the outside (but also occasionally the back) of the thigh and knee. The pain usually does not extend beyond the knee and can often be excluded if you have symptoms below the knee. It is also not common to experience numbness or tingling with gluteal tendinopathy.

Sacroiliac Joint Dysfunction

 

A condition often seen by chiropractors is reduced mobility of the sacroiliac joint, which often is experienced as a locking or stiffness sensation in the sacroiliac joint (pelvic joint) with associated local pain, or cause similar pain to sciatica, with pain in the buttocks, down the back of the thigh and calf, but rarely numbness or tingling. It is also rare for sacroiliac joint locking to cause weakness in the foot, but it can often cause a feeling of weakness in the thigh and hip. Chiropractic treatment of sacroiliac dysfunction is often effective, in combination with strength exercises and stretching.

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