Sciatica: Symptoms, Causes and Treatment

What Is Sciatica?

Sciatica is back pain caused by a problem with the sciatic nerve. The sciatic nerve is a large nerve that runs from the lower back down the back of each leg. When the nerve is injured or when pressure is mounted on it, pain in the lower back generates, that spreads to the hip, buttocks, and leg.

Symptoms of Sciatica

The most common symptom of sciatica is lower back pain that spreads through the hip and buttock and down one leg. The pain usually affects only one leg and may intensify when you cough, sit, or sneeze. The leg may also feel weak, numb, or tingly at times. The symptoms of sciatica appears suddenly and can last for days or weeks.

READ ALSO: Low Back Pain: Causes, Treatment options and Prevention

Sciatica or Other Back Pain?

Not all back pain involve the sciatic nerve. In many cases, back pain is the result of overstretching or straining the muscles in the lower back. What most often sets sciatica apart is the way the pain radiates down the leg and into the foot. It may feel like a bad leg cramp that lasts for days.

Who Gets Sciatica?

Most people who get sciatica are between the ages of 30 and 50. Women may be more likely to develop the problem during pregnancy because of pressure on the sciatic nerve from the growing uterus. Other causes include a herniated disk and degenerative arthritis of the spine.

Causes of Sciatica

  1. Herniated Disk

This is the most common cause of sciatica. Disks act like pads between the vertebrae of your spine. As you age, these disks get weaker and become more exposed to injury. Sometimes the gel-like center of a disk thrusts through its outer lining and mounts pressure on the roots of the sciatic nerve.

  1. Spinal Stenosis

Natural wear and tear of the vertebrae can cause narrowing of the spinal canal. This thinning, called spinal stenosis, may mount pressure on the roots of the sciatic nerve. Spinal stenosis is more common in adults age 60 and above.

  1. Spinal Tumors

Sciatica may result from tumors growing inside or along the spinal cord or sciatic nerve, in rare cases. As a tumor grows, it may put pressure on the nerves that branch off from the spinal cord.

  1. Piriformis Syndrome

Piriformis is a muscle located deep inside the buttocks. It connects the lower spine to the upper thighbone and runs directly over the sciatic nerve. If this muscle goes into tremor, it can put pressure on the sciatic nerve, causing sciatica symptoms. Piriformis syndrome is more common in women.

A Fat Wallet Can Trigger Piriformis

You might not think of too much cash as a source of pain, but a fat wallet can trigger piriformis syndrome. The condition can affect men who wear their wallet in the back pocket of their pants. This causes pressure to mount on the piriformis muscle and can aggravate the sciatic nerve over time.

  1. Sacroiliitis

Sacroiliitis is an inflammation of one or both of the sacroiliac joints, which is the spot where the lower spine connects to the pelvis. Sacroiliitis can cause pain in the buttocks, lower back, and may even extend down one or both legs. The pain can deteriorate with protracted standing or climbing stairs. Sacroiliitis can be caused by pregnancy, arthritis, infection, or injury.

  1. Injury or Infection

Other causes of sciatica include muscle inflammation, infection, or injury, such as a fracture. In general, any condition that irritates the sciatic nerve can trigger symptoms.

Diagnosing Sciatica

Physical Exam

Your doctor will ask you how the pain started and where exactly it is located, to determine whether you have sciatica. You may be asked to squat, walk on your heels or toes, or raise your leg without bending the knee. These muscle tests can help your doctor decide if your pain is emanating from the sciatic nerve.

Imaging

Your doctor may order imaging tests, such as an MRI, to get more information about the location and cause of the irritated nerve. An MRI can show the alignment of vertebral disks, ligaments, and muscles. Also, a CT scan can be performed using contrast dye which can also provide a useful picture of the spinal cord and nerves. Determining the cause of sciatica can help guide the course of treatment. X-rays can help recognize bony irregularities but can’t spot nerve problems.

Complications Related to Sciatica

Complication is very rare, however, if you develop a loss of bladder or bowel control, contact your doctor immediately. This can be a sign of a medical emergency that requires surgery to avoid permanent damage. Most cases of sciatica go away within a few days or weeks and cause no long-lasting harm.

Ways you can relief Sciatica

Ice and Heat

There are steps you can take at home to ease the pain of sciatica. A heating pad or ice pack may be especially helpful. Apply the heat or ice for about 20 minutes every two hours. Experiment to see which one provides more relief. You can just try alternating between the two.

Medication

Over-the-counter pain relievers that can provide short-term relief from sciatica include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen are options. Your doctor may give you a steroid injection to further reduce the inflammation.

Stretching

Try to maintain an active lifestyle while sciatica is healing. Motion can actually help reduce inflammation and pain. A physical therapist can show you how to gently stretch the hamstring and lower back. Practicing tai chi, yoga, or short walks, can help stabilize the affected area and strengthen your core.

Injections

A doctor may recommend injecting steroids into the spine area to reduce inflammation in severe cases. It delivers the medication directly to the area around the sciatic nerve.

Sciatica Relief: Surgery

If your sciatica is due to a herniated disk, and it’s still causing severe pain after four to six weeks, surgery may be an option. The surgeon will remove a portion of the herniated disk to relieve the pressure on the sciatic nerve. About 90% of patients get relief from this type of surgery. Other surgical procedures can relieve sciatica caused by spinal stenosis.

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