If you are suffering from sciatica, you are probably experiencing significant pain in your lower back, buttocks and/or legs. Sheppard Spine And Sports Clinic may be able to help to determine what is causing your pain and the most effective ways to treat it. Below is additional information about what can cause sciatica and effective treatment options. If you are suffering from this serious lower back and leg problem, be sure to make an appointment with Sheppard Spine And Sports Clinic. We want to help.
The sciatic nerve is the biggest nerve in your body. It is comprised of many nerve roots that branch out from your spine in the lower back and then join together to form the sciatic nerve. The symptoms of sciatica happen when the nerve is compressed or irritated near the point of origin in the lower back.
The term ‘sciatica’ generally refers to tingling, numbness and/or pain that starts in the lower back, goes down the buttocks and down the sciatic nerve in one or both legs. Sciatica is not actually a diagnosed medical condition; it is rather a symptom of an underlying medical problem. There are many lower back problems that can cause the symptoms of sciatica: lumbar herniated disc, degenerative disc disease, spinal stenosis and spondylolisthesis.
Sciatica nerve pain usually consists of one or more of these symptoms:
- Pain in one side of the buttock or leg; it is not usually present in both legs at the same time.
- Pain that gets worse when you sit
- Leg pain that feels like tingling, burning or searing pain.
- Numbness, weakness of trouble moving the leg or foot
- Sharp pain that makes it harder to walk or stand up
- Pain that goes down the leg and into the foot and toes
Sciatica does not usually occur before the age of 20; it is more common to start in middle age, with age 40 or 50 being the most common. It is estimated that sciatica may affect up to 43% of the US population at some point. Fortunately, many people who have sciatica do improve with time and appropriate medical treatment. But for others, sciatic pain can be quite severe and debilitating.
Most Common Causes of Sciatica
- Lumbar herniated disc: A herniated disc happens when the inner material of a spinal disc leaks out or herniates. This leads to an irritation or pinching of the nerve root. This condition also may be referred to as a slipped disc, bulging disc, or pinched nerve.
- Degenerative disc disease: It is common for discs to degenerate to some degree as we age, but for some people, a seriously degenerating disc in the lower back can cause sciatica. Bone spurs may develop and press against nerves, leading to sciatic pain.
- Isthmic spondylolisthesis: This problem occurs when there is a tiny stress fracture that lets one of the vertebrae to slip from its normal place. The reduction of disc space combined with the fracture can cause a nerve to be pinched and cause sciatica.
- Lumbar spinal stenosis: This problem may cause sciatic pain because the spinal canal becomes narrower. This condition often is due to the aging process and is quite common in people over 60. It also may occur in combination with spinal arthritis.
- Sacroiliac joint dysfunction: This is the irritation of the sacroiliac joint at the bottom of the spine, and it can cause irritation to the L5 nerve. This may lead to pain that is similar to sciatica.
- Piriformis syndrome: Your sciatic nerve may be irritated and inflamed as it goes over the piriformis muscle in one of the buttocks. This muscle may pinch or irritate the nerve root and cause pain similar to sciatica.
Common Sciatica Symptoms
It is normal for sciatica to only affect one side of the lower body. The pain will radiate from your lower back down the back of the thigh and into the mid or lower leg. Below are some of the more common symptoms. If you experience any of these, be sure to let your Sheppard Spine And Sports Clinic professional know immediately.
- Constant and steady pain on one side of your leg and/or buttock but rarely on both sides.
- Pain that starts in the lower back or buttock and goes down the back of the leg.
- Pain that is better when you lie down or walking, but gets worse when you sit or stand
- Pain is often described as searing or sharp, and is not usually a dull ache
- You may feel pins and needles or numbness going down the leg
- Shooting pain in a leg that makes it hard to walk or stand up
- Lower back pain that is not as bad as the leg pain. Some sciatica sufferers may actually have little to no lower back pain.
Note: If you have the following symptoms, you should seek immediate medical care:
- Symptoms get worse and do not improve with time. This may indicate serious nerve damage, and can eventually lead to leg weakness.
- Symptoms are in both legs. Or, you are experiencing bowel or bladder incontinence.
- If you have sciatica as the result of an accident, you should not delay in seeking medical care, as well.
Many people who have severe or regular bouts of sciatic pain may need treatment so that the condition does not worsen. There are many nonsurgical remedies available that can relieve sciatic pain for most patients. For others, it is possible that a more structured approach to treatment, and even surgery, may be needed for the best pain relief.
Some of the most common treatment options for sciatica are:
- Heat and ice: For people who suffer acute sciatic pain, heat and ice packs can reduce some of the pain. Ice or heat that is applied for 20 minutes and repeated every 120 minutes can be effective for some patients. Many people find the most relief with ice, but heat helps others too. You also can alternate them and see which works best for you.
- Pain drugs: OTC drugs or prescription drugs can reduce your pain. Ibuprofen or naproxen or steroids can lower the level of inflammation and reduce pain. Muscle relaxants and prescription narcotics can be prescribed for the short term, but are not recommended as a long term solution.
- Epidural steroid injections: If you are experiencing serious sciatic pain, getting a steroid injection can reduce the pain and inflammation. The injection goes right to the area with the most pain near the sciatic nerve and can quickly reduce inflammation. The effects are temporary, but this can be effective to deal with acute sciatic pain.
There also are alternative sciatica treatments that have been shown to be effective in reducing pain for some patients:
- Spinal adjustments: Manual manipulation of the spine can lead to better alignment of the spine, which can address some of the conditions that may cause sciatic nerve pain. At the Sheppard Spine and Sports Clinic, our practitioners use the U.C.C.A. technique, which is a gentle adjustment of the Atlas vertebra.
- Acupuncture: Hair-thin needles are placed in the lower back near the pain source. This can help to reduce back pain and sciatica. The treatment is now approved by FDA.
- Cognitive behavior therapy: Helps you to take control of some negative behaviors that can lead to sciatic nerve pain in the short term
- Massage therapy: Some types of massage may reduce back pain and sciatica symptoms. It works by increasing blood circulation and releases endorphins into your bloodstream.
For most people sciatica usually gets better over time, and often without major medical intervention. The healing process in those cases may take only days or a few weeks. For them sciatic pain will resolve over 6-12 weeks. After the acute pain relief treatments, physical therapy and exercise should be utilized to reduce pain and to prevent recurrence.
Your Sheppard Spine and Sports Clinic professional can work with you to devise an effective long term treatment regimen that usually includes muscle strengthening, stretching, yoga and aerobic training.
- What You Need to Know About Sciatica. (n.d.). Retrieved from https://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica