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13 Facts About the Sciatic Nerve

If you say someone's getting on your nerves, you could just cut to the chase and say they're getting on your sciatic nerve—this nerve is plenty big enough for both minor and major irritations. It's the largest nerve in the body, running a lengthy route from each side of your lower spine, deep into your buttock, wrapping around to the back of the thigh and into the foot. Mental Floss spoke to Loren Fishman, medical director of Manhattan Physical Medicine and Rehabilitation in NYC and associate clinical professor at Columbia Medical School. Here are 13 things we learned about this important part of the nervous system.

1. AT ITS LARGEST POINT, IT'S ABOUT AS BIG AROUND AS A MAN'S THUMB.

No wonder this nerve hurts when it gets irritated—at its biggest point, it's one heck of a large nerve, says Fishman. 

2. THE SCIATIC NERVE IS ACTUALLY MADE UP OF FIVE NERVES.

The sciatic nerve is more accurately five nerves that come together on the right and left sides of the lower spine. Technically, the fourth and fifth lumbar nerves and the first three nerves in the sacral spine come together and merge into the unified sciatic.

3. WITHOUT SCIATIC NERVES, YOUR LEGS WOULD BE WEAK NOODLES.

"The sciatic nerve gives feeling and strength to the muscles and skin of the calf and foot, supplies sensation from the joints, bones, and just about everything else below the knee," says Fishman.

4. THE SPINAL CORD'S CONNECTED TO THE THIGH BONE.

The nerve connects the spinal cord with the outside of the thigh, the hamstring muscles in the back of the thigh, and the muscles in your lower leg and feet. This is why sciatic nerve impingement often results in muscle weakness, numbness and/or tingling in the leg, ankle, foot, and toes.

5. INJURIES TO THE SCIATIC NERVE OFTEN AFFECT THE CONNECTION TO THE BRAIN RATHER THAN THE NERVE ITSELF.

After severe spinal cord injury, the nerve itself is often just fine, but the connection between it and the brain has been severed, Fishman says. Until now, there's been no way to fix such injuries, but "recent work with stem cells has begun to restore the connection in dogs and other animals."

6. BACK INJURIES ARE THE MOST COMMON CAUSE OF SCIATIC PAIN.

A variety of lower back problems can lead to pain that radiates along the sciatic nerve. Most commonly, sciatica pain is caused when a herniated disc at the L5 (lower lumbar back) irritates the S1 (sacrum) nerve root in the lower spine. The exiting nerve roots are highly sensitive, and the bits of the disc that herniate contain inflammatory proteins such as interleukin and tumor necrosis factor that can also aggravate the nerve.

7. SCIATIC PAIN CAN BE A MEDICAL EMERGENCY.

In a small number of people, a condition called cauda equina syndrome (so named because the nerve bundle at the base of the spinal cord resembles a horse's tail) can masquerade as sciatica—but it also usually causes weakness that extends to bowel or bladder incontinence and sometimes weakness or loss of sensation in the legs that gets progressively worse. In this case, immediate medical attention should be sought, and recovery may not be as quick as with common sciatica.

8. ANCIENT GREEKS AND ROMANS COULDN'T DISTINGUISH BETWEEN JOINT AND NERVE PAIN …

When the ancient Greek and Roman physicians were treating the pain we now commonly know as sciatica, they believed it stemmed from "diseases of the hip joint," according to a 2007 study in Spinal Cord. It wasn't until 1764, write the authors, "that leg pain of 'nervous' origin was distinguished from pain of 'arthritic' origin."

9. …AND HIPPOCRATES TREATED IT WITH THE BOILED MILK OF A FEMALE ASS.

Among the many treatments Hippocrates and his ilk came up with for this painful condition were: "Fumigations, fasting, and subsequently, laxatives, and ingestion of boiled milk of the female ass." In his Treatise of the Predictions, Hippocrates noted that elderly patients with "cramps and colds at the loin and the legs" would experience their pain for up to a year, whereas young people could be free of pain in about 40 days.

10. SCIATICA DERIVES ITS NAME FROM THE 15TH CENTURY.

The modern name for the disease, according to Fishman, comes from 15th-century Florence. "They called sciatica ischiatica, since they thought it came from tuberculosis that worked its way down to the ischial tuberosity (the sit-bones)," Fishman says. These medieval doctors had the cause wrong, but the name stuck.

11. SOMEWHERE BETWEEN 1900 AND 1925 PHYSICIANS CONNECTED HERNIATED DISCS TO SCIATIC PAIN.

Different researchers in different countries began to make sciatic breakthroughs when doing autopsies on corpses with fractured or herniated discs, where they noticed compression on the sciatic nerve.

12. WEIGHT HAS LITTLE INFLUENCE ON SCIATIC PAIN, BUT HEIGHT DOES.

A 1991 cross sectional study of 2946 women and 2727 men published in Spine found that neither gender nor body mass made any difference in the likelihood of developing sciatica. Body height did, however, in males between the ages of 50 and 64, with taller men being more likely to have the condition. Other studies have found a similar link [PDF]. Over 5'8"? Your risk is higher. 

13. SUFFERING FROM SCIATICA? YOU'RE NOT ALONE.

Sciatica has a surprisingly common negative impact on daily life. "Low back pain and sciatica are the second biggest reason for lost days of work—just behind the common cold," says Fishman. The condition is most commonly found in people over 50 and rarely seen in anyone under 20 years old—and then it most often has a genetic cause.

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What's Really Happening When We See 'Stars' After Rubbing Our Eyes?
Photo illustration by Mental Floss. Images: iStock.
Photo illustration by Mental Floss. Images: iStock.

It's likely happened to you before: You start rubbing your eyes and almost immediately begin seeing colors, specks, and swirls from behind your closed lids. So what's happening when you see these 2001-esque "stars"? Do they only occur upon rubbing? Does everyone experience them?

Before we can get to what causes the lights, we need to understand a bit about how the eyes work. Angie Wen, a cornea surgeon at New York Eye and Ear Infirmary of Mount Sinai, tells Mental Floss that the retina—the innermost layer of the eye—consists of millions of cells, or photoreceptors. These cells, she says, "are responsible for receiving information from the outside world and converting them to electrical impulses that are transmitted to the brain by the optic nerve. Then, the brain interprets them as images representing the world around us."

However, what we see doesn't just stop there. Sometimes "we see light that actually comes from inside our eyes or from electric stimulation of the brain rather than from the outside world," Wen says. "These bursts of seemingly random intense and colorful lights are called phosphenes, and appear due to electrical discharges from the cells inside our eyes that are a normal part of cellular function."

People have been writing and theorizing about phosphenes for thousands of years. Greek philosophers thought the bursts of light were the result of fire inside our heads: "The eye obviously has fire within it, for when the eye is struck fire flashes out," wrote Alcmaeon of Croton (6th–5th century BCE), a philosopher and early neuroscientist, of the swirls and specks someone sees after getting a blow to the head. A century later, Plato—who believed that a "visual current" [PDF] streamed out of the eye—wrote that "Such fire as has the property, not of burning, but of yielding a gentle light they [the Gods] contrived should become the proper body of each day."

Plato's take was still the dominant one through the Middle Ages. Eventually, Newton (1642–1727) theorized a concept that's more in line with what's believed today about these strange sparkly visions: The phenomenon is due to light that's produced and observed when pressure and motion is placed on the eyes.

Eleonora Lad, an associate professor of ophthalmology at Duke University Medical Center who has a background in neuroscience, explains exactly why eye rubbing generates these visions: "Most vision researchers believe that phosphenes result from the normal activity of the visual system after stimulation of one of its parts from some stimulus other than light," including putting external pressure on the eyes. (Interestingly, due to retinal damage, blind people can't see phosphenes caused by pressure, but they can see them when their visual cortex is electrically stimulated. In hopes of turning this phenomenon into improved vision for the blind, scientists have developed a cortical visual prosthesis, implanted in the visual cortex, that generates patterns of phosphenes. The device has been approved by the FDA for clinical trial.)

As Alcmaeon rightly pointed out, there are causes for the bursts of light beyond just rubbing your eyes: Getting hit in the eye can produce this phenomenon—as can a sneeze, a surprisingly powerful event that tends to clamp our eyes shut, Wen says.

Receiving an MRI or EEG may also trigger it. MRIs, for example, produce a changing magnetic field which can stimulate the visual cortex, making a person see these flashing lights. When it comes to an EEG, depending on the brain stimulation frequency band (Hz) used, some patients experience the phenomenon when closing their eyes, which is believed to come from retinal stimulation during the process.

And the activity doesn't only happen on Earth; astronauts in space have also been known to experience them. As reported in 2006 in the journal Vision Research, "over 80 percent of astronauts serving in today's NASA or ESA (European Space Agency) programs have perceived phosphenes at least in some missions and often over several orbits." They're mainly attributed to interactions between the eye and cosmic ray particles in space, outside the Earth's protective magnetic field.

No matter the cause, the bursts of light are perfectly normal—but that doesn't mean you should engage in excessive eye rubbing. Wen says ophthalmologists advise against rubbing your eyes or applying vigorous pressure; according to Lad, too much rubbing may be damaging to the cornea and lens or "result in a loss of fatty tissue around the eyes, causing the eyes to look deep-set."

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Why Your Knuckles Make That Satisfying Cracking Sound, According to Science
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Scientific curiosity is not always burdened by matters of great consequence. Over the years, considerable money and time has been applied to matters involving facial recognition between sheep, whether the flow of urine is impeded by someone watching you pee, and whether humans can capably swim in a pool full of syrup. (They can, almost as well as water.)

Now, researchers from Stanford University and Ecole Polytechnique in France have turned the roving eye of science to the phenomenon of knuckle-cracking. According to Gizmodo, a computer simulation was created to confirm an earlier theory that the audible noise that comes from the human hand after putting pressure on the knuckle was the result of gas bubbles popping inside the finger joint.

Conclusion: Probably true.

The study, published in Scientific Reports, demonstrated that microscopic bubbles inside the lubricating synovial fluid of the joint collapse when a knuckle-cracking session commences. To use an imperfect analogy, the cavitation bubbles are like the body’s Bubble Wrap. Popping them produces an audible—and for many, a very pleasing—sound.

To compile data, researchers took geometric representations of the joint's movements during a cracking session and turned them into mathematical equations. (Imaging has not been shown to be very productive in this field, as the crack takes only about 300 milliseconds and is not easily visualized.) The software models demonstrated that pressure shifts in the joint fluid increase pressure on the gas bubbles. Unlike packing material, however, the gas bubbles don't really perforate—they experience a partial collapse but remain suspended in the joint.

So does this solve the mystery surrounding cracked knuckles? Not entirely. Because it was a simulation, there's a possibility of mathematical error. Proponents of alternative theories—that it's not bubbles collapsing but bubbles being created that produce the noise—feel there's more work to be done. We can only hope a complete understanding will come in our lifetime. Fingers crossed. And cracking.

[h/t Gizmodo]

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