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.

10 Smart Facts About Your Gut

Colorized scanning electron micrograph of E. coli, a common gut bacteria
Colorized scanning electron micrograph of E. coli, a common gut bacteria
National Institute of Allergy and Infectious Diseases, Flickr // CC BY 2.0

Gut feelings get all the press, but your gut may be more of a thinker than you know. Some scientists now consider it a second brain. While it won’t necessarily help you study for an exam or get a promotion, your gut can influence the chemistry of your mood, emotions, immune system, and long-term health. Research even suggests the gut can “learn” new tricks through conditioning. These powerful connections are part an emerging field of science called neurogastroenterology designed to study the gut-brain link. Here are 10 facts you may not know about your gut.

1. THE GUT DOESN'T NEED THE BRAIN'S INPUT. 

You might think of your gut as a rebel against authority. It doesn’t wait for your brain’s impulses to do the important work of digestion, because it doesn’t need to—it acts as its own “brain.” No other organ, not even the all-powerful heart, can pull that off.

2. THERE ARE MORE THAN 100 MILLION BRAIN CELLS IN YOUR GUT.

Your gut’s power to think for itself is no surprise; there are millions of neurons in its lengthy coils (9 meters of intestines, from esophagus to anus). That’s more neurons than are found in the spinal cord or peripheral nervous system.

3. YOUR GUT HAS ITS OWN NERVOUS SYSTEM.

The enteric nervous system—the controlling mechanism of digestion and elimination—is the overlord of your gut, and functions all on its own. Some scientists see it as part of the central nervous system, while others consider it its own entity. It likely evolved to give the gut the go-ahead when the “got to go” impulse strikes, without requiring the brain’s sign-off, particularly when you consider the helplessness of an infant with its brand-new brain.

4. THERE'S AN INFORMATION HIGHWAY FROM YOUR GUT TO YOUR BRAIN.

There’s one big visceral nerve embedded in your gut—the vagus nerve. Research has revealed that up to 90 percent of its fibers carry information from the gut to the brain, rather than the other way around. In other words, the brain interprets gut signals as emotions. So you really should trust your gut.

5. MOST OF YOUR SEROTONIN IS IN YOUR GUT.

Some 95 percent of your body’s serotonin, that marvelous mood molecule that antidepressant drugs like Prozac keep in your body, can be found in the gut. So, it’s no wonder that diet, medications, and antibiotics can wreak havoc on one’s mood.

6. A HEALTHY GUT MAY PROTECT YOUR BONES.

In a study of the serotonin-gut relationship, scientists discovered an unexpected link between the gut and the bones. Inhibiting the gut’s release of serotonin counteracted the bone-density reduction of osteoporosis in mice. This research is going into studies on new osteoporosis-fighting drugs.

7. RESEARCH SHOWS LINKS BETWEEN AUTISM AND HAVING FEWER STRAINS OF GUT BACTERIA. 

In as many as nine out of 10 cases, autistic people have common gut imbalances such as leaky gut syndrome, irritable bowel syndrome, and fewer strains of “good” bacteria. Research on mice is looking at possible treatments of some of the behavioral disorders of autism by balancing microbes in the guts, though many warn that such treatments can’t produce a “cure” for autism.

8. FOOD REALLY DOES AFFECT YOUR MOOD. 

Different foods, when introduced to the gut via feeding tubes, have been shown to change a person's moods without the person’s awareness of what they were "eating." Fat, for instance, increased feelings of happiness and pleasure (no surprise there) because appeared to trigger the release of dopamine—the brain’s natural opiate. Carbohydrate consumption stimulated the release of serotonin, the “feel good” neurotransmitter.

9. YOUR GUT IS YOUR BEST FRIEND IN COLD AND FLU SEASON.

Not only does your gut hold brain cells, it also houses the bulk of your immune cells—70 percent—in the form of gut associated lymphoid tissue, or GALT, which plays a huge part in killing and expelling pathogens. GALT and your gut microbiome—the trillions of bacteria that live, like an immense microbial universe, in your gut—work hard to help you get over what ails you. That’s all the more reason to be careful with the use of antibiotics, which wipe out the good bacteria along with the bad.

10. YOUR GUT CAN BECOME ADDICTED TO OPIATES.

Inside your gut are opiate receptors, which are also found in the brain. The gut is just as susceptible to addiction as the brain and may contribute to the intense difficulty some addicts have trying to kick the habit.

What Causes Hiccups?

iStock/damircudic
iStock/damircudic

The cause of hiccups depends on whom you ask. The ancient Greek physician Galen thought hiccups were violent emotions erupting from the body, while others thought they were a sign of liver inflammation. Today, evidence points to spasms in the diaphragm, the large muscle between the chest and abdomen that aids airflow during breathing. This involuntary contraction can be brought on by a number of things that might irritate the nerves that control the movement of the muscle. A full stomach, heavy boozing, rapid shifts in temperature either inside or outside of the stomach, and certain emotions like shock or excitement are all common culprits.

No matter the cause, the result is the same: The diaphragm spasms and causes us to take a quick breath. The sudden rush of air causes the epiglottis (the flap that protects the space between the vocal cords) to shut and interrupt the breath, which makes the familiar "hic" sound.

WHAT CURES THEM?

The best cure for hiccups also depends on the person you ask. Almost all cures are based on one of two principles: One type works its magic by overwhelming the vagus nerve with another sensation. The vagus nerve is a cranial nerve that innervates the stomach and conveys sensory information about the body's organs to the brain. When distracted by overwhelming information of another sort, it basically tells the brain that something more important has come up and the hiccuping should probably be stopped (vagus nerve stimulation is also used to control seizures in epileptics and treat drug-resistant cases of clinical depression). The other method for curing hiccups is to interfere with the breathing, increasing the amount of carbon dioxide in the blood, and causing the body to focus on getting rid of the of the CO2 and not making hiccups.

Swallowing a spoonful of sugar is probably the most commonly prescribed hiccup cure and falls into the first category. A teaspoon of sugar is usually enough to stimulate the vagus nerve and make the body forget all about the hiccups. Even ardent supporters of the sugar cure disagree if the sugar should be taken dry or washed down with water, though.

If this home remedy doesn't work, and your hiccups are both severe and persistent, you may need to bring out the big guns. For chronic cases like this, doctors sometimes use a cocktail of Reglan (a gastrointestinal stimulant) and Thorazine (an anti-psychotic with sedative properties) to quiet things down. In some cases that resist these drugs, Kemstro, an anti-spasmodic, is also used. Other doctors have used vagus nerve stimulators implanted in the upper chest of patients. The pacemaker-like devices send rhythmic bursts of electricity through the vagus nerve to the brain to keep the hiccup cycle in check.

Many people prefer home remedies to battle their hiccups, which may include holding your breath, gargling ice water, or breathing into a paper bag. While the same people will swear by the treatment they've been using all these years, there's no firm scientific consensus that any of them actually work. But if it helps you, isn't that all that matters?

Have you got a Big Question you'd like us to answer? If so, let us know by emailing us at bigquestions@mentalfloss.com.

An earlier version of this article appeared in 2012.

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