Written by: Jamie Camp
Physiotherapist Jamie Camp explains the causes of the dreaded back pain caused by sciatica.
Back pain is common in riders due to the number of falls and injuries that occur with the nature of the sport, combined with the jostling that our spine takes from the horse’s movement, sending a ripple effect through our pelvis and spine.
Pain that originates in the back and travels down the leg is often described as “sciatica,” named for the nerve that feeds the back of the leg. This nerve is formed by branches exiting the lower back and travelling deep through the buttock, under the piriformis muscle, and farther down the leg into the foot. Symptoms of sciatica include pain in the back and/or down the leg, numbness, tingling, and possibly weakness.
The causes of sciatica are varied and unique to each individual. While a common conception is that the sciatic nerve is compressed by a disc bulge in the spine, this long, large nerve can become compressed by a variety of structures as it traverses down the leg. Discs in the spine can compress the nerve roots and tight muscles throughout the hip and leg can cause these symptoms. Other joints in the pelvis close to the spine can also refer pain in a similar pattern.
Pain is, very basically, an error message. It can indicate an error in joint mobility, in muscle strength and stability, or dysfunctional movement patterns. Previous injuries affect our body’s ability to have full range in our joints and to stabilize properly. Each rider’s injury history is important in determining the structure causing pain, and also the reason for that structure at fault.
For example, a disc bulge can be a result of impaired movement in the spine. The sciatic nerve becoming entrapped under a tight muscle indicates there is a dysfunction in the body’s attempt to stabilize. Finally, referral pain from other joints indicate either increased tension/closing of the joint or too much laxity in the joint.
The combination of individual injury history, contact with the saddle, and the horse’s varied movement patterns creates many variables contributing to similar symptoms. The most helpful overall exercise, depending on the cause and severity of the sciatica, is the hip movement exercises from the June issue (hip hike, shift, rotate). See what feels good/bad/ugly and work through those. With sciatica especially, it is important to get assessed and treated on an individual basis to discern the root cause of the pain and ensure that the rider’s biomechanics are functioning optimally for an effective and pain-free ride.