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 Facts About Your Tonsils

iStock/Neustockimages
iStock/Neustockimages

Most of us only become aware of our tonsils if they become swollen or infected. But these masses of lymphatic tissue in the mouth and throat are important immunological gatekeepers at the start of the airways and digestive tract, grabbing pathogens and warding off diseases before they reach the rest of your body. Here are some essential answers about these often-overlooked tissues—like what to do when your tonsils are swollen, and whether you should get your tonsils removed.

1. People actually have four kinds of tonsils.

The term tonsils usually refers to your palatine tonsils, the ones that can be seen at the back of your throat. But tonsillar tissue also includes the lingual tonsil (located in the base of the tongue), tubal tonsils, and the adenoid tonsil (often just called adenoids). "Collectively, these are referred to as Waldeyer's ring," says Raja Seethala, the director of head and neck pathology at the University of Pittsburgh Medical Center and a member of the College of American Pathologists Cancer Committee.

2. Tonsils are one of the body's first responders to pathogens.

The tonsils are a key barrier to inhaled or ingested pathogens that can cause infection or other harm, Seethala tells Mental Floss. "These pathogens bind to specialized immune cells in the lining—epithelium—to elicit an immune response in the lymphoid T and B cells of the tonsil," he says. Essentially, they help jumpstart your immune response.

3. Adenoid tonsils can obstruct breathing and cause facial deformities.

If the adenoid tonsils are swollen, they can block breathing and clog up your sinus drainage, which can cause sinus and ear infections. If adenoids are too big, it forces a person to breathe through their mouth. In children, frequent mouth breathing has the potential to cause facial deformities by stressing developing facial bones. "If the tonsils are too large and cause airway obstruction, snoring, or obstructive sleep apnea, then removal is important," says Donald Levine, an ear, nose, and throat specialist in Nyack, New York. Fortunately, the adenoids tend to get smaller naturally in adulthood.

4. As many of us know, sometimes tonsils are removed.

Even though your tonsils are part of your immune system, Levine tells Mental Floss, "when they become obstructive or chronically infected, then they need to be removed." The rest of your immune system steps in to handle further attacks by pathogens. Another reason to remove tonsils besides size, Levine says, is "chronic tonsillitis due to the failure of the immune system to remove residual bacteria from the tonsils, despite multiple antibiotic therapies."

5. Tonsillectomies have been performed for thousands of years ...

Tonsil removal is believed to have been a phenomenon for three millennia. The procedure is found in ancient Ayurvedic texts, says Seethala, "making it one of the older documented surgical procedures." But though the scientific understanding of the surgery has changed dramatically since then, "the benefits versus harm of tonsillectomy have been continually debated over the centuries," he says.

6. ... and they were probably quite painful.

The first known reported case of tonsillectomy surgery, according to a 2006 paper in Otorhinolaryngology, is by Cornélio Celsus, a Roman "encylopaediest" and dabbler in medicine, who authored a medical encyclopedia titled Of Medicine in the 1st century BCE. Thanks to his work, we can surmise that a tonsillectomy probably was an agonizing procedure for the patient: "Celsus applied a mixture of vinegar and milk in the surgical specimen to hemostasis [stanch bleeding] and also described his difficulty doing that due to lack of proper anesthesia."

7. Tonsil removal was performed for unlikely reasons.

The same paper reveals that among some of the more outlandish reasons for removing tonsils were conditions like "night enuresis (bed-wetting), convulsions, laryngeal stridor, hoarseness, chronic bronchitis, and asthma."

8. An early treatment for swollen tonsils included frog fat.

As early practitioners struggled to perfect techniques for removing tonsils effectively, another early physician, Aetius de Amida, recommended "ointment, oils, and corrosive formulas with frog fat to treat infections."

9. Modern tonsillectomy is much more sophisticated.

A common technique today for removing the tonsils, according to Levine, is a far cry from the painful early attempts. Under brief general anesthesia, Levine uses a process called coblation. "[It's] a kind of cold cautery, so there is almost no bleeding, less post operative pain, and quicker healing. You can return to normal activities 10 days later," Levine says.

10. Sexually-transmitted HPV can cause tonsil cancer.

The incidence of tonsillar cancers is increasing, according to Seethala. "Unlike other head and neck cancers, which are commonly associated with smoking and alcohol, tonsillar cancers are driven by high-risk human papillomavirus (HPV)," he says. "HPV-related tonsillar cancer can be considered sexually transmitted."

26 Amazing Facts About the Human Body

Mental Floss via YouTube
Mental Floss via YouTube

At some point in your life, you've probably wondered: What is belly button lint, anyway? The answer, according to Mental Floss editor-in-chief Erin McCarthy, is that it's "fibers that rub off of clothing over time." And hairy people are more prone to getting it for a very specific (and kind of gross-sounding) reason. A group of scientists who formed the Belly Button Biodiversity Project in 2011 have also discovered that there's a whole lot of bacteria going on in there.

In this week's all-new edition of The List Show, Erin is sharing 26 amazing facts about the human body, from your philtrum (the dent under your nose) to your feet. You can watch the full episode below.

For more episodes like this one, be sure to subscribe here.

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