Sciatica is the name given to pain that is caused by irritation or compression of the sciatic nerve. The sciatic nerve is the longest nerve in the body and goes from the pelvis through the buttocks and down the legs to the feet.
Sciatica is not, in fact, a condition but rather a symptom of another problem involving the sciatic nerve. Therefore it is important to understand the underlying medical cause of the sciatica symptoms as effective treatment should be focused on addressing the root cause of the pain.
What are the symptoms of sciatica?
- Constant pain in only one side of the buttock or leg
- Pain which is worse when sitting
- Leg pain that is often described as burning, tingling or searing rather than a dull ache
- Weakness, numbness or difficulty moving the leg or foot
- A sharp pain that may make it difficult to stand up or to walk
- Pins and needles in the feet and toes
Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Symptoms can be different in location and severity depending on the condition which causes the sciatica. While symptoms can be painful and debilitating, it is rare that permanent sciatic nerve damage will result.
What causes sciatica and what are the risk factors?
Sciatica is caused by irritation of the sciatic nerve. A herniated disc known as a slipped disc, is the most common cause. This occurs when a disc is temporarily pushed out of place and puts pressure on the sciatic nerve, causing pain. Other common causes and risk factors include:
- Lumbar spinal stenosis which is a narrowing of the spinal canal in the lower back
- Degenerative disc disease where the discs break down affecting the cushioning of the vertebrae
- Spondylolisthesis where one vertebrae slips forward over another one pinching the sciatic nerve
- Tumours within the spine which may compress the sciatic nerve
- Infection or injury within the spine
- Age is a risk factor as discs deteriorate with age
- A sedentary lifestyle is also a risk factor as people who sit for long periods of time or are physically inactive, are more likely to develop the symptoms
- Your profession can be a risk factor if your job involves lifting heavy weights on a regular basis
Diagram of the vertebrae showing a herniated disc
How is sciatica diagnosed?
Your doctor will look at your medical history and examine your back, hips and legs to test for strength, flexibility, sensation and reflexes. Other tests may include x-rays, MRI scans, CT scans or nerve conduction studies.
What are the treatment options?
Treatment focuses on relieving pressure and inflammation and may include:
- Anti-inflammatory drugs such as nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, or oral steroids.
- Epidural steroid injections whereby the steroids are delivered to the origin of the inflamed sciatic nerve roots.
- Hot or cold compression packs can be alternated to help reduce the pain.
- Exercises such as walking or gentle stretching.
- Chiropractic treatment can help manoeuvre the spine to alleviate pressure on the nerve.
- Physiotherapy can help prevent further episodes of sciatica.
- Yoga can help strengthen your back muscles and improve posture and flexibility.
- Surgery may be considered if the nerve pain is severe and has not been relieved by other treatment options.
What are the best exercises for sciatica pain?
- Standing Hamstring Stretch. Do this by placing your right foot on a raised surface such as a step on a staircase, a low stool or a chair. Flex your foot so that your toes and leg are straight. Then bend your body forward a little way toward your foot and ease your hip downwards. Hold this position for at least 30 seconds then repeat with the left leg.
- Spinal stretch sitting down. Do this by sitting on the ground with your legs straight out and your feet flexed upwards. Bend your right knee and place your foot on the floor outside your left knee. Then placing your left elbow on the outside of your right knee, gently turn your body to the right. Hold for 30 seconds then repeat 3 times. Now do the same with your opposite side.
- Pigeon Pose in a reclining position. To do this exercise, lie on your back and bring your right leg up to a right angle. Clasp both hands behind the thigh. Lift your left leg and place your right ankle on top of your left knee. Hold this position for a few seconds and then relax and repeat with the other leg.
- Pigeon Pose in a seated position. Do this exercise while seated on the floor. Stretch your legs out in front of you. Bend your right leg and place your right ankle on top of your left knee. Lean forward so that your upper body reaches toward your thigh. Hold the position for between 15 and 30 seconds then repeat on the other side.
It is vitally important that you ease yourself gradually into any of these exercises and if you experience any pain you should stop.
You can minimise your risk of developing a slipped disc or back injury that could lead to sciatica, by taking care at work, adopting a better posture and lifting techniques, exercising regularly and by stretching before and after exercise.
Although sciatica can be very painful, it is rare for it to cause permanent nerve damage and the inflammation will usually get better within a few weeks.
If you would like more detailed information, follow this link to the website of Spine Health
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