Sciatica and the role of Dermatomes.

According to the NHS website Sciatica occurs when the sciatic nerve which runs from your lower back to your feet is irritated or compressed. Resulting in stabbing, shooting or burning pain in the buttock, with tingling pins and needles, numbness or weakness in the back of the leg, foot and toes. It usually gets better in 4 to 6 weeks but can last longer. 

Treating this condition with Clinical Reflexology CR or any form of “hands-on” therapy is not always straight forward. To relieve symptoms and produce an effective outcome it is vital to determine whether the underlying cause is muscular (involving the periformis) or skeletal (facet joints) or a combination of both. This can be achieved by conducting a thorough assessment of the patient, drawing on a sound background knowledge of anatomy and physiology.

The spinal column is divided into 31 segments, each with a pair (right and left) of anterior and posterior nerve roots.  Anterior nerve roots are responsible for motor signals to the body, and posterior nerve roots receive sensory signals like pain. The anterior and posterior nerve roots combine on each side to form the spinal nerves as they exit the vertebral canal (spine).

The sciatic nerve exits the right side of the spine below the 5th lumbar vertebrae and disc. To enable access to this nerve via the foot using CR is best explained by understanding the action of the medically accepted existence of Dermatomes. ( patterns of sensory nerves)

There are 5 lumbar dermatomes (L1-L5) that supply sensation from these spinal nerves in the lower limb (leg, foot, hip, etc.)  the disks below them, and the corresponding area of the lower back. L1 – The hip and groin area L2 – The inside of the thigh L3 – Knee L4 – The inside part of the ankle bone (medial malleolus) L5 – Bottom of the foot and toes 1-3

There are 5 sacral dermatomes (S1-5)located below L5.  S1 – Toes 4 and 5, and the outside part of the ankle bone (lateral malleolus) S2 – The outer side (lateral portion) of the heel bone (calcaneous) S3 – The middle portion of the buttocks, perianal area, penis, and scrotum. S4 – The skin over the perianal area (in addition to S5); perianal areas, and genitals. S5 – The skin over the perianal region (along with S4) and the skin immediately at and next to the anus. 1 coccygeal nerve that originates in the spinal cord and emerges at the level of the tail bone (coccyx).

Because the distribution pattern of the spinal nerve dermatomes is so defined, the dermatomes can be used to detect the area or location that causes the sensation of abnormalities along its location in the human body. For example: If a patient had sciatica (nerve pain from the irritation of the largest nerve in the body, the sciatica nerve) with signs and symptoms of low back pain and numbness and tingling on top of the right foot, the doctor could recognize this as a problem with the nerve that comes out below the right side of the fifth lumbar vertebra (L5) and disc. The most common cause of this particular medical situation would be a rightward herniation of the disc beneath the fifth lumbar vertebra (L5). Dermatomes. Nerve Mapping.

Using CR techniques in conjunction with identifying the appropriate dermatome it is possible to effect a positive result by reducing pain. Once the pain intensity has been reduced further CR work on the muscles of the lower back etc will promote further relaxation throughout the body. This releasing of muscular tension in turn allows tendons and ligaments to soften and facet joints to move more freely. The patient is then able to carry out stretching exercises and engage in appropriate exercise to maintain pain free mobility. This sequence can often take place in one CR session. If you suffer acute or chronic muscular/skeletal issues consider CR………… relief may lie in your feet!!!!!!!