Your back is made up of a number of bony vertebrae. Between each pair of vertebra, one nerve emerges from the spinal cord. In the lower part of the back, four of these nerves join up in the buttock to form the sciatic nerve. This nerve runs diagonally across the buttock, and down the back of the thigh, sending off branches to supply most of the leg. The sciatic nerve consists of individual nerve fibres that can receive sensation (eg. pain, heat), and send messages to muscles to make them contract or relax. As they emerge from the spinal cord, and pass through narrow spaces between the vertebrae, the nerve fibres that form the roots of the sciatic nerve are easily pinched if there is any distortion or narrowing of the disc between the vertebrae, or if the ligaments joining the vertebrae together are damaged and swollen. As a nerve is progressively pinched harder and harder, you feel pins and needles, numbness, pain and finally weakness and loss of movement in the area supplied by the nerve. Sciatica is caused by the hard pinching of some of these nerve roots in the lower part of the back, and the pain then runs along the course of the nerve, across the buttock and down the back of the thigh. The most effective way to relieve sciatica is to unpinch the nerve by physiotherapy manipulation, and medication to reduce inflammation and swelling in the back. X-rays are often taken to see how badly deformed the back is, and to give the doctors and physios some idea of the appropriate treatment and the long-term outcome. If there is significant back damage, the sciatica may come and go for years, and in severe cases, corsets may be recommended, injections given into the back and surgery performed. Sciatica may come and go by itself, but it can usually be relieved, and sometimes cured, by the appropriate treatment.

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