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- What is Sciatica?
- What Causes Sciatica?
- Diagnosing Sciatica
- Help for Sciatica
- More Information on Sciatica
What is Sciatica?
Sciatica refers to the pain and discomfort caused by pressure on the sciatic nerve or nerve roots. This nerve is the longest nerve in the body which runs from the lower back and pelvis, through the hip and buttock area, down to the back of each leg, and controls many of the muscles in these areas.
When one of the nerve roots in the lower spine is irritated or compressed, the result is pain felt in the lower back, buttock region and/or parts of the leg and foot. This pain can range from an infrequent discomfort to a continuous, excruciating and debilitating pain accompanied by sensations of numbness or weakness in the lower limbs.
It is important to note that Sciatica is not a disorder, but rather a set of symptoms that may differ slightly depending on the cause, which nerve root is being compressed, and why.
Sciatica is more common among people between the ages of 30 and 50 years, and is often the result of general wear and tear, rather than specific injury. While Sciatica can be excruciatingly painful, permanent nerve damage is very rare and the pain symptoms often go away by themselves within about 6 weeks without any invasive treatments. There are however a few treatment options to help relieve the pain and discomfort, and encourage faster healing.
What are the symptoms of Sciatica?
Sciatica often causes a pain that radiates from your lower back, all the way through the buttock region to the back of your thigh and calf. It typically only affects one side of the body and may affect all the various areas along this nerve path, however, it frequently follows a descending pattern of pain starting from the lower back and traveling downwards. The pain may also vary between individuals and may be experienced in the following ways:
- Numbing, burning or tingling sensations in the legs or toes
- Extremely painful shooting pains that tend to worsen when walking, sitting, coughing, sneezing or after any physical activity.
- Muscle weakness or poor co-ordination in the leg or foot
- A constant pain on the one side of your buttock
- Lower back pain present with severe leg pain
What Causes Sciatica?
Sciatica usually occurs when a nerve root in the lower spine is pinched or compressed. The most common cause for this is a herniated disk (slipped disk) in the lower back. This happens when the one of the disks that cushions the vertebrae slips out of place or ruptures and presses or puts pressure on a nerve. While this is the most common cause of Sciatica, other less common conditions can also result in pressure on the spinal nerves such as:
- Spinal stenosis – a condition that causes a narrowing of the canal that holds the spinal cord and many nerve roots. This may cause pressure on the sciatic nerve.
- Spondylolisthesis – a condition where one vertebra slips forward over another vertebra causing pressure on the sciatic nerve. This condition is often a result of degenerative disk disease.
- Piriformis syndrome – this occurs when the sciatic nerve becomes trapped by the piriformis muscle in the upper thigh. When the muscle becomes tense or goes into spasm it puts pressure on the sciatic nerve.
- Spinal tumors – Tumors in the spinal cord can cause pressure on the sciatica nerve or the nerve roots as they grow.
- Trauma or injury – A bad fall or a car accident can cause damage to the sciatica nerve or the nerve roots or cause swelling that puts pressure on the nerve.
- Osteoarthritis, osteoporosis or the general wear and tear of aging may cause sciatica.
When should I worry about Sciatica?
Mild Sciatica will usually go away by itself if given a little patience and rest. Your doctor may be able to advise you on appropriate self-care techniques and treatments that may help ease your pain and discomfort. However, if you find that your symptoms change or worsen, or extend beyond six weeks, you should seek medical attention.
It is also important to seek an emergency medical assessment if you experience any of the following:
- Sciatica-like pain following an injury or accident
- Any sudden pain or numbness in back or leg that is severe or unbearable
- The or pain or weakness is getting increasingly worse after a week rather than better
- Sciatica before the age of 20 or after the age of 55
- The pain is accompanied by a fever, chills, or vomiting
- Loss of bladder or bowel control or numbness in the genital region
Your general practitioner will probably ask you a number of questions relating to your symptoms and how long they have been with you. A physical examination of your back and legs may include various stretching exercises, muscle strength and reflex tests which will help your doctor pinpoint the source of pain and the severity.
If your Sciatica has persisted for longer than 6 to 7 weeks, your doctor may suggest further tests such as a spine x-ray, Magnetic resonance imaging (MRI) or blood work for a full blood count (especially if you have another condition such as HIV or cancer).
Help for Sciatica
In most cases, Sciatica will disappear on its own with a little time and patience. Try keeping to your normal routine as much as possible, while avoiding pain triggers such as bending over to pick things up, or moving heavy things. In the meantime, explore a few of the following treatment options:
There are many home-care tips that will help ease your pain and discomfort. Try a few of the following:
- A cold ice pack (even a packet of frozen peas will do) wrapped in a towel and held on the painful area for approximately 15-20 minutes should help reduce inflammation and provide mild pain relief. Repeat this throughout the day.
- A hot pack or even regular hot baths will also help relax tight muscles that may be putting pressure on the sciatic nerve.
- Ask your doctor, or search the internet for back stretching exercises to help relieve sciatica. Remember to avoid rigorous or jerking movements during this time. A regular exercise routine will help release endorphins which will help reduce pain as well as help you manage the pain. It may also help with preventing recurrence of sciatica.
If your Sciatica is the result of a herniated disk (slipped disk), a physical therapist will probably play a vital role in your recovery. After a thorough assessment, they will develop and facilitate a treatment plan that may include exercises to relax and strengthen muscles, as well as improving flexibility and posture.
Over the counter pain relief medication or anti-inflammatory drugs such as aspirin or ibuprofen may be useful in helping to reduce the pain and provide mild relief. Ensure that you do not exceed the recommended dose as these medications still have serious side effects such as nausea, vomiting, stomach ulcers, and liver problems.
Your doctor may also prescribe stronger pain medication or muscle relaxants, as well as ant-depressants that will help you cope with chronic pain. In more severe cases an epidural steroid injection may be advised to help reduce inflammation and pressure on the nerve. These injections are not always very effective and can also cause serious side-effects. Because of the dangers, there is a limit on how many of these injections an individual can receive – not usually more than three per year.
In very severe cases where Sciatica is causing symptoms such as weakness, incontinence of the bowel or bladder, or if the pain is worsening despite treatment, surgery may be performed to remove the herniated part of a disc.
More Information on Sciatica
Tips for coping with and preventing recurrence of Sciatica
- Wear soft flat shoes that provide support and cushioning when you walk. Heels often cause jarring strain on the spine which may cause and prolongs sciatica.
- Keep mobile and mildly active. Avoid sitting still for long periods of time as this is when muscles stiffen and the symptoms of Sciatica worsen.
- Avoid your pain triggers such as bending over or lifting heavy objects. If you need to, then make sure you bend from your knees, keep your back straight and hold heavy objects close to the body.
- Exercise regularly while emphasizing stretches that will help strengthen back muscles. If you find that you continuously feel worse after exercising, you may find that one or two exercises in your routine are incorrect and causing more damage than good. If this is the case, consult a physiotherapist or you doctor for the appropriate exercise techniques to best suit your back condition.
- If pregnant, use pillows and cushions to support your tummy ‘bump’ while you sleep or lay down.
- Sit comfortably and maintain a good posture. Adjusting your chair at work so that your knees are slightly higher than your hips, your arms are supported by the arm rests and you are sitting up close to the desk, will help to prevent back pain and stiffness.
- Find productive ways to deal with stress and other negative emotions. These can cause muscle tension and make pain more difficult to bear. Try therapy with a licensed counselor or psychologist if you feel that stress is getting out of hand. Techniques such as meditation, deep breathing and visualization can also very effective.
More advice on how to manage chronic pain
- Be active – physical activities such as walking or swimming will improve your condition, help you to feel healthier and boost your confidence
- Create a daily routine for yourself that will condition your body to become used to the repetition and enable you to feel that you have control over your life.
- Pace yourself, take things slowly and try not to overexert yourself by doing too much. Take regular breaks and split daily activities and tasks into smaller, manageable steps.
- Set priorities and realistic goals with regards to your pain. Be aware of your limitations, try not to push yourself too hard and aim for a goal within your reach
- Keep a pain diary or journal to record the various levels of pain experienced, to describe the pain and when it occurred. This enables you to gain a better understanding of your pain and you will have a detailed account to report to your doctor.
- Join a support group where you can engage and share with other people who have similar problems. Here you will find support and strategies to cope more effectively.
- Stay informed about various ways to relieve pain by researching the subject via the internet, read books on chronic pain or attend seminars and discussions.
- Practice relaxation techniques such as music therapy, massage, visualization therapy and yoga to calm and relax you
- Take your mind off the pain by occupying yourself with activities such as painting, scrapbooking, watching a movie, or puzzle-making