Sciatica is the term used to describe pain caused due to any problem with the sciatic nerve, which is a large nerve that runs from the back to your legs. Read about its symptoms, causes, risk factors, diagnosis, and treatment.
Pain that results from the irritation of the sciatic nerve, which is the nerve that branches from the lower back and runs through the hips and buttocks, down to each leg. Usually, sciatica only affects one side of the body, and is commonly associated with a bone spur on the spine, herniated disk, or spinal stenosis (the narrowing of the spine), as it compresses the nerve. This compression results in symptoms in the affected leg, such as inflammation, pain, and numbness.
Sciatica, as such, is not a disease, but it is a symptom that results from any problem in the associated nerve. Sciatica should not be confused with lower back pain, because it causes pain in the legs and hips. The reason for such widespread symptoms is because the sciatic nerve is the widest and longest nerve found in our body. The nerve carries sensation to the skin in the lower leg and controls the action of many muscles in this region.
The pain associated with this condition is severe, but in most cases, the pain subsides in a few weeks with conservative treatment options. But in patients who have leg weakness or bowel changes, surgery might be needed.
The pain associated with sciatica is very distinct. The signs of sciatica are:
Pain that radiates from the lower back, buttock area, and to the legs.
Pain gets worse with movement.
Pins and needles sensation in the toes and feet.
Legs or feet numbness or weakness.
Loss of sensation and movement in the leg (in severe cases).
Urinary and bowel incontinence (the inability to control urine and bowel movement).
Mild cases of sciatica resolve on its own in a few days. Consult a doctor to know things you can do at home to relieve pain. But in the following situations, consult a doctor right away:
Sudden and severe lower back and leg pain.
If the pain resulted from a road traffic accident or other severe injury.
Weakness or numbness in the muscles of the legs.
If you are unable to control your bladder or bowels, as these are symptoms of cauda equina syndrome.
Any injury to the spine that compresses or affects the sciatica nerve or sciatica nerve tumor can result in this pain. The common causes include:
Herniated Disk - The spinal bones or vertebrae are separated by cartilage, which is filled with a thick jelly-like material and has a hard covering. When this hard covering rips and the soft inner part protrudes out, it is called a herniated disk. This herniation can compress the sciatica nerve.
Spinal Stenosis - Spinal stenosis is the abnormal narrowing of the spinal canal. As the spinal canal gets narrow, it puts pressure on the nerve roots that start from the spinal cord.
Piriformis Syndrome - This is a rare condition that results in involuntary contraction of the piriformis muscle, which is the muscle that connects the spine to the bones in the thigh. This contraction compresses the sciatic nerve, which worsens on sitting for a long time or if you fall.
Spondylolisthesis - Here, one of the lower spinal bones slips into a lower bone, which pinches the sciatic nerve.
The factors that increase the risk of you developing sciatica are:
Some actions like lifting heavy weights, sitting for a long period, etc.
Diabetes can result in diabetic neuropathy.
If you have lower back pain that radiates to your legs and hips, the doctor will do the following tests:
Check muscle strength and reflexes - You might have to walk on your heels, lift your legs while lying down, and getting up from a squatting position.
Imaging tests - To check for herniated disks, bone spurs, or other problems that can cause this pain. The tests that might be done are an X-ray of the spine, MRI, and CT scan.
Electromyography (EMG) - It is used to diagnose conditions like herniated disk or spinal stenosis. The test measures the responses of the muscles and the electrical impulses generated by the nerves.
Sciatica is treated with home remedies, and by keeping yourself active. Bed rest and inactivity often aggravates this condition.
1) Hot pack - Hot packs or heating pads can be used after a couple of days. Apply on the affected area for 2 to 3 times a day.
2) Cold compressions - Apply ice packs or a packet of frozen goods for 20 minutes to the affected area. You can repeat this several times, but only during the initial days of pain.
3) Hot and cold compresses - You can alternate between hot and cold packs.
4) Stretching - Consult a physiotherapist, who can guide you with the proper way to stretch your lower back. You can also try doing yoga.
5) Exercise - Stay active and exercise. When you exercise, your body releases endorphins, which act as natural painkillers. Swimming, cycling, and other low-impact exercises are ideal.
6) Painkillers - Over-the-counter painkillers, such as Aspirin and Ibuprofen, helps reduce pain and swelling. Always consult a doctor before taking any medication.
7) Physical therapy - Exercises in physical therapy can help to improve your posture and strengthen your back muscles.
If needed, the doctor will prescribe medications like muscle relaxers, narcotic pain relief, and antidepressants.
Steroid injection - Corticosteroid is injected into the epidural space (the canal that surrounds the spinal cord).
For severe cases with extreme pain and bowel or bladder incontinence, surgery might be needed. The types of surgery that are done are:
Discectomy - a part of the disk, which is compressing the nerve is removed.
Microdiscectomy - Here, the disk is removed using a microscope through a small cut.
Acupuncture - It is a painless procedure where an acupuncturist affects the flow of energy in the body, by inserting needles at key points.
Chiropractic treatment - To achieve maximum spinal mobility, a chiropractor manipulates the spine.
Hypnosis - Hypnosis by a trained professional puts you in a relaxed and focused state of mind, and messages related to pain relief are given.
Massage - A massage can help relieve pressure and pain.
You may be able to prevent sciatica by protecting your back or spine. Try the following preventive measures:
Perform exercise that strengthens your muscles in the back.
Maintain good posture by sitting in a chair with good back and armrest.
Maintain a healthy weight.
Keep yourself active.
To know more about how to manage sciatica pain, consult a doctor now!
Last reviewed at:
03 Jan 2020 - 5 min read
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