When “sciatic” type of symptoms won’t go away, what else can be considered as causes? Travell and Simons emphatically state that “Sciatica is a symptom, not a diagnosis; it’s cause should be identified.” (Vol II, p. 173) Here’s Part 2 of a list of things you can check.
Sacroiliac joint dysfunction or arthritis: These conditions cause pain in lower limb, lumbar muscles, lateral thigh, gluteals, sacrum, iliac crest, in the sciatic nerve distribution areas. Dysfunction can be corrected with osteopathic manipulation and treatment of attaching muscles.
Trigger Points from many muscles: Low back muscles, QL, iliopsoas, lower abdominals, gluteus minimus, tensor fascia latae, piriformis, hamstrings, lateral quadriceps all have Trigger Points that refer pain that feels like sciatica. If TrPs have been left untreated for years, treatment may take a while to be effective.
Nerve entrapment: Muscular pressure on a nerve blocks or distorts nerve signals. Piriformis entrapment of the sciatic nerve is classic.
Bursitis (trochanteric or subgluteal): This inflammatory condition can be treated medically or by relieving joint tension. Icing helps.
Fracture of a vertebral transverse process: A fracture can be imaged radiographically and will heal.
Thoracolumbar articular dysfunction: Mostly causing one-sided restricted movement, it can be corrected with osteopathic or chiropractic manipulation.
Fibrosis of the superficial lumbosacral fascia: Fibers used in the healing process can accumulate in areas where microtears exist from excessive muscle tension. These fibers can be broken up with manual work and with release of TrPs and muscle tension.
Medical problems like tumors, liver disease, kidney disease, infection, inflammatory bowel disease, MS or other nerve disease can cause sciatica symptoms.