If you have ever had sciatica, you know it is extremely painful. As one who has had most of the overuse injuries, which I write about (with all the running which I’ve done in my life), this is one of the most painful. At the present time, I’m now suffering with this condition. Recently, I visited my orthopedic Surgeon, Dr. David Brown, who explained it so perfectly. He said, it’s like a car tire that wears out with age, and so do some of us! There are approximately 8 to 10 million Americans who suffer from sciatica, an irritation to the sciatic nerve. The symptoms include a "shooting" pain or, at times, a numb or tingling feeling starting at the hip and radiating down the thigh to the lower leg and to the foot. It can prevent a good night's sleep as it is difficult to find a comfortable position and can end a sport’s program.

The prominent cause of sciatica is a structural weakness - a malalignment of bones or ligaments in the spine, resulting in exquisite and intractable pain. It may also be caused by a postural weakness - an over development of the back muscles and a weakness in the stomach muscles. Another causative factor of sciatica is lowering of the arch by pushing off the foot in intensive workouts or pronation (rolling in of the foot) causing the leg to rotate inwardly creating a forward tilt of the pelvis, which in turn causes a cramp in the lower back. This strain on the back results in a pull of the muscles around the hip, which then creates a pressure on the sciatic nerve as it runs under the hip joint. A leg length differential might also cause a pelvic tilt resulting in sciatica.

Prevention and treatment of sciatica involves exercising and stretching of the muscles in the lower back and strengthening of the stomach muscles. It is also important to use training shoes with good shock absorption and to avoid hill training or racing. It might also be necessary to consider orthotic foot inserts to control the excessive pronation which is causing the lower back and sciatic nerve pain.

Dr. Robert F. Weiss is a podiatrist. He was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. DR. Weiss is a veteran of 35 Marathons. more information go to www.facebook.com/drrobertweiss