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.

Why Is Pee Yellow?

Chloe Effron
Chloe Effron

WHY? is our attempt to answer all the questions every little kid asks. Do you have a question? Send it to why@mentalfloss.com.

Your body is kind of like a house. You bring things into your body by eating, drinking, and breathing. But just like the things we bring home to real houses, we don’t need every part of what we take in. So there are leftovers, or garbage. And if you let garbage sit around in your house or your body for too long, it gets gross and can make you sick. Your body takes out the garbage by peeing and pooping. These two things are part of your body’s excretory system (ECKS-krih-tore-eee SISS-tem), which is just a fancy way of saying “trash removal.” If your body is healthy, when you look in the toilet you should see brown poop and yellow pee.

Clear, light yellow pee is a sign that your excretory system and the rest of your body are working right. If your pee, or urine (YER-inn), is not see-through, that might mean you are sick. Dark yellow urine usually means that you aren’t drinking enough water. On the other hand, really pale or colorless pee can mean you might be drinking too much water! 

Your blood is filtered through two small organs called kidneys (KID-knees). Remember the garbage we talked about earlier? The chemicals called toxins (TOCK-sins) are like garbage in your blood. Your kidneys act like a net, catching the toxins and other leftovers and turning them into pee.

One part of your blood is called hemoglobin (HEE-moh-gloh-bin). This is what makes your blood red. Hemoglobin goes through a lot of changes as it passes through your body. When it reaches your kidneys, it turns yellow thanks to a chemical called urobilin (yer-ah-BY-lin). Urobilin is kind of like food coloring. The more water you add, the lighter it will be. That's why, if you see dark yellow pee in the toilet, it's time to ask your mom or dad for a cup of water. 

To learn more about pee, check out this article from Kids Health. 

12 Facts About Kidney Stones

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

Kidney stones are more common than ever. According to Harvard Medical School, every year more than 3 million people see a doctor for relief from these hard mineral and salt deposits, which form in your kidney when urine becomes too concentrated. Here's what we know about the condition formally called nephrolithiasis.

1. KIDNEY STONES TYPICALLY CAUSE REALLY PAINFUL SYMPTOMS.

At first you may notice your urine is cloudy, bloody, and foul smelling. Your back may begin to ache, and nausea may come over you. Then, as the stone moves from your kidney into your urinary tract or bladder, sometimes becoming trapped, there’s often an intense, stabbing pain that many people say they wouldn’t wish on their worst enemy.

2. MOST PEOPLE DEVELOP ONE TYPE OF STONE …

What kind of kidney stone you get depends on your diet, fluid intake, genetics, hereditary disorders, and even whether you take certain medications, but the vast majority of people get calcium oxalate stones. They're formed from a mix of calcium in urine and the compound oxalate, which is found naturally in food like nuts, chocolate, and some vegetables, including beets and spinach; oxalate is also produced by your liver. There's some evidence that people who take the seizure medicine topiramate can develop these stones in the form of calcium phosphate.

3. … BUT THERE ARE THREE OTHER KINDS TOO.

Struvite stones are fast-growing mineral deposits that typically develop in response to a urinary tract infection, and can grow large enough to block the kidney, ureter, or bladder before you notice any symptoms; they affect women more than men. Uric acid stones turn up in people who eat a lot of red meat, shellfish, and organ meats, which contain hefty doses of an organic compound called purine that can lead to more uric acid than the kidneys can excrete. Cystine stones are caused by a rare hereditary disorder called cistinuria in which your kidneys excrete excessive amounts of the amino acid cystine.

4. THEY'RE EXTREMELY COMMON—ESPECIALLY IN MEN.

There's a solid chance you could end up with a kidney stone. The National Kidney Foundation notes that one in 10 people will develop one during the course of their life. And if you’re male, take note: Your gender alone is considered a kidney stone risk factor. Men are twice as likely as women to develop them. Another factor is age: Although stones are most common from ages 20 through 50, they tend to peak around age 30.

5. IF YOU’VE HAD A KIDNEY STONE, YOU’LL PROBABLY DEVELOP ANOTHER ONE …

Sorry to say, but simply having a kidney stone puts you at risk for a recurrence. If you’ve had one, the U.S. National Library of Medicine notes that there’s a 30 to 50 percent chance more stones will form within five years.

6. … BUT YOU CAN TAKE STEPS TO PREVENT THEM.

Cutting back on sodium (i.e. deli meats, packaged soups, and processed foods) can help, because a stone can form from excessive salt consumption. You should also avoid too much animal protein—it produces urine containing more acid, which is known to increase your risk for kidney stones—and increase your intake of fruits, vegetables, whole grains, and low-fat dairy. And be sure to drink plenty of fluids, especially water—at least 12 glasses a day. (That's good advice for everyone, not just those prone to kidney stones.)

Don't drink much apple or cranberry juice as both contain oxalates and are linked to an increased risk of developing calcium oxalate stones. High doses of Vitamin C may boost the concentration of oxalate in urine; the Cleveland Clinic recommends a daily maximum of 500 milligrams.

7. IT'S A MYTH THAT CALCIUM CREATES SOME KIDNEY STONES.

Despite the fact that the word calcium is part of the most common kind of kidney stone, you don’t need to treat calcium as the enemy. In fact, having too little calcium can actually increase the odds you’ll get these types of stones. According to the Cleveland Clinic, eating about two or three servings of calcium-rich foods daily reduces oxalate absorption, helping to keep calcium oxalate stones away. So get out the cheese.

8. IF YOU PASS A STONE, CONGRATULATIONS! NOW TAKE IT TO A DOCTOR.

Ninety percent of kidney stones are passed through urination. Getting one out this way may hurt a lot, but once the stone has finished causing you agony, it could provide clues that could help you avoid developing another one. If you’re able to retrieve the stone, bring it to your doctor, who can order an analysis. Identifying its components can reveal the kind of stone it is and potentially point to a treatment or prevention plan.

9. IF YOU CAN’T PASS A STONE, TREATMENTS ARE AVAILABLE …

In an attempt to exit the body, a stone travels from the kidney to the bladder through a narrow tube called the ureter. If the stone is larger than a quarter-inch, it's simply too big to pass through the ureter, and will get trapped there. (If it can make it through to your bladder, it's small enough to pass out out of your body through the urethra.) This causes intense pain, blocked urine flow, and possible bleeding from urinary tract walls. That's when it's time for treatment.

There are several methods for getting rid of a kidney stone, all of which aim to break the stone into smaller pieces so they can leave the body. In an extracorporeal shock wave lithotripsy (from the Greek for "crushed stone"), high-frequency sound waves are applied externally to break stones up, allowing them to pass when you pee. Laser lithotripsy takes a similar approach: Stones in the ureter are broken up with a laser and also leave the body naturally. More invasive is percutaneous ultrasonic lithotripsy, which involves passing narrow instruments (including a fiberoptic camera) through your back to your kidney; ultrasound breaks the stones up, and then fragments are removed by an instrument. Finally, a ureteroscopy is a treatment option in which a small scope is inserted in the ureter towards the bladder to determine the stone's location. Then it's broken up for natural passage or removed altogether. Luckily, you're unconscious under general anesthesia during the last procedure.

10. … AND THEY'RE FAR SUPERIOR TO THOSE USED IN THE PAST.

Kidney stones are nothing new—mentions of the painful formations go back more than 5000 years, to Mesopotamian medical texts—and medical interventions have occurred for just as long. Stones made it into the Hippocratic Oath, in which physicians swore they would "not use the knife, not even on sufferers from stone," leaving the procedure to "such men as are engaged in this work" [PDF]. Surgeons in ancient Greece and India were attempting stone removal as far back as the 7th century BCE.

The 16th to 18th centuries were a heyday for stone surgeons, who were largely self-taught. The most notorious of them was Frere Jacques Beaulieu. He pioneered the lateral perineal lithotomy—which involved making an incision in the perineum, inserting a terrifying cutting instrument into the bladder, cutting up the stone, and then extracting the pieces with the instrument or his fingers—in the late 17th century. Unfortunately for his patients, he had no technical training, and his method was often deadly; in 1698, after 25 of his 60 patients died, he was banned from doing the procedure—but he didn't stop. He's thought to have performed more than 5000 lithotomies. (And no, the song doesn't seem to be about him.)

11. IF ALL ELSE FAILS, TRY RIDING A ROLLER COASTER.

If you’re a thrill seeker who happens to have kidney stones (and some vacation time), you may be in luck. After a "notable number" of patients reported that riding the Big Thunder Mountain roller coaster at Walt Disney World in Orlando helped them to pass their kidney stones, Michigan State University urologist David Wartinger decided to investigate. He created a kidney replica—complete with kidney stones—put it in a backpack, and let it ride the roller coaster 60 times. It worked—but passing the stones depended on where the backpack was placed in the coaster. Rides in the last car were the most effective, with the stones passing 64 percent of the time, while the front few cars yielded only a 16 percent success rate.

Big Thunder Mountain was the only ride in the theme park that was effective. Neither Space Mountain nor Aerosmith's Rock 'n' Roller Coaster did the trick, likely because they were too fast, with a G-force that pinned the stones in place. Of course, while this is an interesting finding, if you suspect you have kidney stones, speak to your doctor before you high-tail it to Walt Disney World.

12. A KIDNEY STONE THE SIZE OF A MOUSE WAS REMOVED FROM A MAN IN 2004.

The stone measured 5.11 inches at its widest point—a world record. Five years later, a whopping 2.5-pound stone was surgically removed from a man in Hungary in 2009. Perhaps seeing a bunch of kidney stones in one place other than originating from your own body will put you at ease. If that’s the case, check out the International Museum of Surgical Science in Chicago, where a collection of stones is on display in glass jars.

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