oMuscle Imbalance oInadequate nutrition and diet oInadequate hydration or dehydration 4.Herniated (i.e., ruptured) or bulging disc: This condition may be particularly problematic if theherniated disc or bulging disc is protruding posteriorly (to the back) and into the spinal canal, orimpinging on the nerve root at the intervertebral foramen, thus placing pressure on the spineand/or nerve root; and, sciatica is the result in many instances. 5.Piriformis syndrome: We will cover the piriformis syndrome and how it relates to sciatica in depthin a subsequent video and article. Recent research has demonstrated that this little-knownsyndrome, at least in the lay community, may be a factor in as many as eight out of ten sciaticacases. The piriformis muscle works particularly hard in runners and others who are physicallyactive, often resulting in RMI or repetitive motion injury. 6.Spinal stenosis: This is a narrowing of the spinal canal and/or intervertebral foramen. In fact, anynarrowing of a structure can be defined broadly as a stenosis. The stenosis, the narrowing affectsand/or obstructs the pathway for nerves, thus exacerbating pain...in this case creating the sciaticnerve pain associated with sciatica. 7.Spondylolysis: In layman's terms, it is a stress fracture at the back of the vertebra, the vertebralbody (the front part) breaks away from the back part of the vertebra (everything else). Inosteological terms, the break occurs at the pars interarticularis of the vertebra, usually at the fifthlumbar vertebra, the last vertebra before the lumbar spine articulates with the sacrum or tailbone.This is usually associated with spondylolisthesis, the next contributor to sciatic nerve pain. 8.Spondylolisthesis: Usually associated with spondylolysis in younger back pain and sciaticapatients but may present without spondylolysis in older adults. Spondylolisthesis is the result of ananterior (forward) shift in the vertebra body, in fact the entire vertebra when spondylolysis isabsent, or the vertebral column in relationship to the remainder of the vertebral column below.There are a number of reasons why this condition may occur but in younger patients it is usuallyfound with spondylolysis. We will discuss this condition in depth in a subsequent article and videobut suffice it to say that any change in the overall structure of the spine, particularly at the lumbarcurvature, will create sciatic nerve pain. 9.Trauma: Trauma and stress go hand in hand when it comes to back pain and sciatica. Traumamay be localized, meaning the spine will take the brunt of the stress at a specific location, or itmay be generalized and affect several levels simultaneously. The better equipped we are in termsof muscle strength, muscle balance (or imbalance), and the other factors affecting spine health,the better equipped we will be to handle appropriate levels of stress. The IVDs are remarkablyresilient and very strong but if the discs undergo change as a result of any of the 5 factors listedabove, or the traumatic event is profound enough, damage to the spine may occur; and, sciaticamay be the outcome. In this case, a medical practitioner should always be the first step in any badback treatment strategy.