Up to 40% of people experience sciatica at some point in their life. The condition can affect anyone at any age except young ones. The pain caused by the sciatic nerve can be debilitating, affecting your quality of life. You may be unable to sleep or do the activities you love. You can regain control of your life within 6 to 12 weeks with proper treatment. If you have been experiencing this pain, read on to understand what causes it and how you can get pain relief.
WHAT IS SCIATIC PAIN?
Sciatica is pain, numbness, irritation, and tingling sensation caused by an injury or compression of the sciatic nerve. The pain can originate from the buttock area and can be mild to severe and disabling. Sciatica pain can also be irritating and infrequent and worsens with age. Sciatica is not a disease or medical condition but a symptom of a medical problem involving the sciatic nerve.
The sciatic nerve is the longest and widest nerve in the human body. The nerves originate from the lower back through each gluteal (buttocks) and then radiate down the legs, ending below the knee.
Typically, the pain only affects one side of the lower body, extending from the thigh and back, through the thigh, and down your leg. Sometimes the pain can spread to the toes or foot. The sciatic nerve controls several muscles in the lower legs, supplying sensation to most of the lower leg and the foot’s skin.
WHAT ARE THE SYMPTOMS OF SCIATICA?
Common symptoms include:
- A mild to sharp, excruciating pain or burning sensation that makes it hard to stand up
- Burning or tingling down the leg, foot, and toes
- Loss of bowel or bladder control
- Feeling like a jolting pain or electric shock
- Hip and lower back pain
- Muscle weakness in your foot or leg
- Constant pain on one side of the rear
- Numbness or difficulty moving the leg or foot
- Pain in the leg that gets worse when sitting
WHAT CAUSES SCIATIC PAIN?
Sciatic pain is caused by an underlying issue. Various spinal disorders cause sciatica nerve compression, including:
- Bulging or herniated disc: Discs are the cushion pads between each vertebra. Pressure can cause the gel-like center of the disk to bulge through the weak outer wall. It can also wear out due to degenerative diseases such as arthritis.
- Spondylolisthesis: This occurs when one of the discs slips forward over the vertebrae below it, resulting in a pinched nerve which increases the chance of sciatica.
- Lumbar spinal stenosis: Its caused by the narrowing of the space around the spinal cord. This increases pressure, causing pain, inflammation, and numbness in the affected leg.
- Piriformis syndrome: It’s a condition in which the piriformis muscle located in the buttock region involuntarily tightens or spasms causing sciatic pain.
- Osteoarthritis: Bone spurs can form, leading to compression in the lower back nerves.
Other causes include:
- Trauma that can result in spinal cord injuries
- Orthopedic surgery of the hip
- Muscle spasm
WHEN TO SEE A DOCTOR
You should seek urgent medical assistance if you have:
- Fever and chills
- Severe back pain
- Redness or swelling in your back or spine
- You have a loss of bladder or bowel control
- If you have been in a violent injury such as a motor accident
- Sudden severe pain in your lower back or leg and muscle weakness or weakness in your leg.
WHAT ARE THE RISK FACTORS FOR SCIATICA?
Obesity: Excess weight puts too much pressure on the spine and compresses the sciatic nerve causing inflammation and pain.
Diabetes: The disease increases your chance of nerve damage, significantly increasing the risk of sciatica.
Smoking: It deteriorates the discs in your spine over time which may result in nerve damage, increasing the chance of sciatica.
Poor back posture: The path of the sciatic nerve is affected by how we sit, walk or stand.
Physically demanding work or work-related injuries. Repetitive motions like lifting heavy objects, walking or standing for too long, and driving for long periods, put pressure on the spine, irritating the sciatic nerve.
Aging: As we age, the body loses flexibility putting our nerves at risk of injuries or pinching due to changes in spine alignment.
History of low back pain: Low back pain causes inflammation in the lumbar region and spine. This can spread to the sciatic nerve.
Sleeping problems: Poor sleeping habits can be caused by chronic illness or general health. It can lead to back pain which also causes sciatic pain.
Poor health: Wellness improves health. A poor diet and lack of exercise increase the chances of developing sciatic pain.
Psychological distress: Stress can cause the brain to deprive the sciatic nerve of oxygen, leading to leg pain, tingling sensation, and weakness.
Injury: An injury on the hip or buttocks can cause sciatic pain.
HOW IS SCIATICA DIAGNOSED?
During your diagnosis, your doctor will take your medical history and get to know your symptoms. They will also do a physical examination, like asking you to walk on your toes or your heels, stand from a squatting position, lift your legs, or perform stretches and various motions.
For severe cases and further diagnosis, your doctor may order other tests such as;
- X-ray reveals overgrown bones, bone fractures, tumors, or infections.
- MRI to take details of your bones and soft tissues like herniated disks
- CT scan to check on the condition of your spinal cord and the spinal nerves.
- Electromyography (EMG) to confirm if there is nerve compression.
- Myelogram to determine the cause of disk or vertebrae pain
WHAT IS THE TREATMENT FOR SCIATIC PAIN?
Sciatica treatment involves a combination of self-care measures, medication, or surgery (last resort). Treatment options include:
- Over-the-counter medicines such as non-steroidal anti-inflammatory drugs(NSAIDs) like ibuprofen.
- General core strengthening and aerobic exercises.
- Gentle stretches and yoga postures to alleviate pain and increase flexibility.
- Use products to relax the back like recliners, back supports, wedges, lumbar support, and footrest,
- Physical therapy is recommended to prevent future injuries and improve flexibility and posture.
- Application of ice or hot packs to relieve pain and inflammation
- Corticosteroid injections are administered into the lower back, to help reduce pain. The injections are given under local anesthesia.
- Lifestyle changes such as losing weight, exercising, quitting smoking, avoiding sitting for long hours, and lifting objects carefully to avoid damaging your back. It may seem hard to make these adjustments at first, but it is essential to give you pain relief and improve your quality of life.
Acupuncture: This involves inserting hair-thin needles into the skin at specific parts of your body. Acupuncture can help manage sciatica symptoms by relaxing tight muscles, and releasing neurotransmitters that help reduce pain, improve blood circulation and regulate nervous symptoms.
Chiropractic care: Whenever possible, it is always a good idea to opt for a more conservative, non-invasive treatment. Chiropractic care can offer you that the purpose of chiropractic treatment is to help the body heal itself without surgery or medication. Chiropractic care will aim to realign the spine and take the pressure off the sciatic nerve for immediate pain relief. Your body will then begin to heal itself once the pressure is removed.
Treatment may also combine several methods such as cold therapies, ultrasound, TENs, physical therapy, and spinal adjustments.
- Cold therapy– uses cold materials and substances to reduce inflammation and control pain
- Ultrasound– produces gentle heat created by soundwaves that penetrate deep into soft tissues such as muscles. Ultrasounds increase circulation and help to reduce muscle spasms, cramping, swelling, and stiffness.
- TENs– refers to electric nerve stimulation. Its controlled electrical current allows for pain relief and reduction in spasms.
- Physical therapy– strengthening exercises help to relieve pressure, improve the flexibility of tight muscles, and strengthen the muscles of your back, abdomen, and legs.
- Spinal adjustments– Chiropractic manipulation can free restricted movement in the spine and restores misaligned bodies to their proper position allowing for a full range of movement and comfort. Spinal adjustments reduce nerve irritability which is responsible for inflammation, pain, and other symptoms related to sciatica.
Surgery is recommended if your sciatic pain lasts for more than three months and does not respond to other treatments. The type of surgery depends on the cause of your sciatica pain. To remove fragments of a herniated disc compressing the nerve, you may need to undergo a microdiscectomy. Your doctor may also recommend a lumbar laminectomy to widen the spinal cord and reduce pressure on the nerves in the lower back.