What Is Sciatica?
Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending bi-laterally from your lower back down the backs of each leg.
The tell tale sign of sciatica is nerve / shooting pain that starts in your lower back and shoots down one leg, sometimes all the way into your foot. It can happen with an injury or just with the wear and tear of aging. Certain conditions can make it worse and usually without treatment it can last for many months.
Symptoms:
Common symptoms of sciatica include:
Lower back pain.
Pain in the back of the leg that is worse when sitting.
Hip pain.
Burning or tingling down the leg.
Weakness, numbness, or difficult moving the leg or foot.
A constant pain in one glute.
A shooting pain that makes it hard to stand up
Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of your thigh and down through your leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes. The pain may worsen when you cough or sneeze.
For some people, the pain from sciatica can be severe and disabling. For others, the sciatica pain might be infrequent and irritating but has the potential to get worse.
Seek medical attention right away if you have:
Fever and back pain.
Swelling or redness in your back or spine.
Numbness or weakness in the upper thighs, legs, pelvis, or glutes with severe difficulty in walking.
Altered bowel or bladder function.
Sciatica Causes and Risk Factors:
Sciatica always has a root cause and this is usually because there is an issue with the lower part of the spine, some of these conditions that cause Sciatica could be:
Irritation of the root(s) nerves of your lower lumbar and lumbosacral spine.
A herniated disc.
Lumbar spinal stenosis (narrowing of the spinal canal in your lower back).
Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae).
Spondylolisthesis (a condition in which one vertebra slips forward over another one).
Pregnancy.
Muscle spasm in the back or glutes.
There are certain conditions and situations that could make it more likely that you could suffer from Sciatica, risk factors, or things that may make you more likely to develop Sciatica, include:
Aging (which can cause changes in the spine, like bone spurs or herniated discs).
Diabetes.
Being overweight.
Not exercising regularly and not having strong muscles in your core (your glutes, abs, and back).
Wearing high heels.
Sleeping on a mattress that is too hard or too soft, or the age of the mattress means it has lost it’s support.
Some types of jobs: if they involve sitting or driving for long periods of time, twisting your back, or carrying heavy things.
Sciatica Diagnosis:
The first thing any Practitioner will do is ask questions about your back pain: Do you have numbness or weakness in your legs? Do certain positions help your discomfort? Has the pain kept you from doing any activities? There will also be some questions about your lifestyle: Do you do a lot of physical work, like heavy lifting? Do you sit for long periods of time? How often do you exercise?
If your pain is severe, your Practitioner may well order some imaging tests to check for bone spurs and herniated disks. You could get tests like:
X-ray, which makes pictures of the inside of your body, to check for bone spurs (growths of normal bone) and other bone deformities / issues.
CT scan, which combines a series of X-rays to get a better look at your spinal cord and spinal nerves.
MRI, which uses radio waves and magnets to create pictures of your insides to get a detailed look at your back and spine.
Electromyography (EMG), which measures how fast nerve signals travel through your muscles. This is to see if a herniated disc is compressing nerves that control muscles. A herniated disc is a torn or leaky disc between vertebrae in your spine. You may also hear it called a "slipped," "ruptured," or "bulging" disc.
Sciatica Treatment:
Some people with mild Sciatica may well feel better after some self-care activities or at-home remedies such as:
Using heat packs
Stretching
Taking over-the-counter pain medication
If your pain isn’t getting any better you may well be prescribed some stronger prescription only pain killers or anti inflammatory’s. It must be noted that these in themselves are not necessarily a “cure” but could well ease your pain and symptoms.
Physical Therapy:
A good physical therapist, Sports Therapist, Physio, Massage Therapist, may well be able to help relieve the pain and restriction and could even clear the condition but this may well take some time and will involve regular sessions and at-home exercises. It should be noted that physical therapy will not work if the condition is caused by a structural fault i.e. herniated disc, but it could well ease the symptoms while waiting for surgery.
Acupuncture can also be very effective in helping to reduce the symptoms, ease pain and restore normal function.
Steroid Injections:
In some cases it may be recommended that you have a steroid injection, cortisone for instance, this will involve giving you an injection around the lower spine to help reduce the inflammation around the nerve, which can help reduce your pain. The effects are not predictable and can range from no effect at all to relief for only a few months, but in all cases but the effect will wear off over time.
Surgery:
If you have extreme pain that doesn’t get better and the root cause has been identified as a structural issue, along with a weakness, or a loss of bladder or bowel control, it will probably be decided that surgery is the only option left open.
If that option is decided upon the surgeon will remove the bone spur or herniated disc and correct any other structural issues. But this option is always a very last resort and the conversation about surgery will start only after you’ve tried a variety of nonsurgical treatments.